First results on survival from a large Phase 3 clinical trial of an autologous dendritic cell vaccine in newly diagnosed glioblastoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Linda M. Liau - , University of California at Los Angeles (Author)
  • Keyoumars Ashkan - , King's College London (KCL) (Author)
  • David D. Tran - , University of Florida (Author)
  • Jian L. Campian - , Washington University St. Louis (Author)
  • John E. Trusheim - , Allina Health (Author)
  • Charles S. Cobbs - , Swedish Medical Center (Author)
  • Jason A. Heth - , University of Michigan, Ann Arbor (Author)
  • Michael Salacz - , University of Kansas (Author)
  • Sarah Taylor - , University of Kansas (Author)
  • Stacy D. D'Andre - , Sutter Institute for Medical Research (Author)
  • Fabio M. Iwamoto - , Columbia University (Author)
  • Edward J. Dropcho - , Indiana University-Purdue University Indianapolis (Author)
  • Yaron A. Moshel - , Overlook Medical Center (Author)
  • Kevin A. Walter - , University of Rochester (Author)
  • Clement P. Pillainayagam - , Rush University (Author)
  • Robert Aiken - , Rutgers - The State University of New Jersey, New Brunswick (Author)
  • Rekha Chaudhary - , University of Cincinnati (Author)
  • Samuel A. Goldlust - , Rutgers - The State University of New Jersey, Newark (Author)
  • Daniela A. Bota - , University of California at Irvine (Author)
  • Paul Duic - , Winthrop University Hospital (Author)
  • Jai Grewal - , Winthrop University Hospital (Author)
  • Heinrich Elinzano - , Rhode Island Hospital (Author)
  • Steven A. Toms - , Rhode Island Hospital (Author)
  • Kevin O. Lillehei - , University of Colorado Denver (Author)
  • Tom Mikkelsen - , Henry Ford Health System (Author)
  • Tobias Walpert - , Henry Ford Health System (Author)
  • Steven R. Abram - , St. Thomas Research Institute (Author)
  • Andrew J. Brenner - , University of Texas Health Science Center at San Antonio (Author)
  • Steven Brem - , University of Pennsylvania (Author)
  • Matthew G. Ewend - , University of North Carolina at Chapel Hill (Author)
  • Simon Khagi - , University of North Carolina at Chapel Hill (Author)
  • Jana Portnow - , University of Antwerp (Author)
  • Lyndon J. Kim - , Thomas Jefferson University (Author)
  • William G. Loudon - , Providence St. Joseph Hospital, Orange (Author)
  • Reid C. Thompson - , Vanderbilt University (Author)
  • David E. Avigan - , Harvard University (Author)
  • Karen L. Fink - , Baylor University Medical Center at Dallas (Author)
  • Francois J. Geoffroy - , Illinois Cancer Care (Author)
  • Scott Lindhorst - , Medical University of South Carolina (Author)
  • Jose Lutzky - , Mount Sinai Medical Center Miami Beach (Author)
  • Andrew E. Sloan - , Case Western Reserve University (Author)
  • Gabriele Schackert - , TUD Dresden University of Technology (Author)
  • Dietmar Krex - , Department of Neurosurgery, TUD Dresden University of Technology (Author)
  • Hans Jorg Meisel - , Hospital Bergmannstrost (Author)
  • Julian Wu - , Tufts University (Author)
  • Raphael P. Davis - , Stony Brook University (Author)
  • Christopher Duma - , Hoag Memorial Hospital (Author)
  • Arnold B. Etame - , University of South Florida (Author)
  • David Mathieu - , Université de Sherbrooke (Author)
  • Santosh Kesari - , University of California at San Diego (Author)
  • David Piccioni - , University of California at San Diego (Author)
  • Manfred Westphal - , University of Hamburg (Author)
  • David S. Baskin - , Houston Methodist Hospital (Author)
  • Pamela Z. New - , Houston Methodist Hospital (Author)
  • Michel Lacroix - , Geisinger Medical Center (Author)
  • Sven Axel May - , Klinikum Chemnitz gGmbH (Author)
  • Timothy J. Pluard - , Saint Luke's Cancer Institute (Author)
  • Victor Tse - , Kaiser Permanente (Author)
  • Richard M. Green - , Kaiser Permanente (Author)
  • John L. Villano - , University of Kentucky (Author)
  • Michael Pearlman - , Colorado Neurological Institute (Author)
  • Kevin Petrecca - , McGill University (Author)
  • Michael Schulder - , Hofstra University (Author)
  • Lynne P. Taylor - , University of Washington (Author)
  • Anthony E. Maida - , Northwest Biotherapeutics Inc. (Author)
  • Robert M. Prins - , University of California at Los Angeles (Author)
  • Timothy F. Cloughesy - , University of California at Los Angeles (Author)
  • Paul Mulholland - , University College London (Author)
  • Marnix L. Bosch - , Northwest Biotherapeutics Inc. (Author)

Abstract

Background: Standard therapy for glioblastoma includes surgery, radiotherapy, and temozolomide. This Phase 3 trial evaluates the addition of an autologous tumor lysate-pulsed dendritic cell vaccine (DCVax ® -L) to standard therapy for newly diagnosed glioblastoma. Methods: After surgery and chemoradiotherapy, patients were randomized (2:1) to receive temozolomide plus DCVax-L (n = 232) or temozolomide and placebo (n = 99). Following recurrence, all patients were allowed to receive DCVax-L, without unblinding. The primary endpoint was progression free survival (PFS); the secondary endpoint was overall survival (OS). Results: For the intent-to-treat (ITT) population (n = 331), median OS (mOS) was 23.1 months from surgery. Because of the cross-over trial design, nearly 90% of the ITT population received DCVax-L. For patients with methylated MGMT (n = 131), mOS was 34.7 months from surgery, with a 3-year survival of 46.4%. As of this analysis, 223 patients are ≥ 30 months past their surgery date; 67 of these (30.0%) have lived ≥ 30 months and have a Kaplan-Meier (KM)-derived mOS of 46.5 months. 182 patients are ≥ 36 months past surgery; 44 of these (24.2%) have lived ≥ 36 months and have a KM-derived mOS of 88.2 months. A population of extended survivors (n = 100) with mOS of 40.5 months, not explained by known prognostic factors, will be analyzed further. Only 2.1% of ITT patients (n = 7) had a grade 3 or 4 adverse event that was deemed at least possibly related to the vaccine. Overall adverse events with DCVax were comparable to standard therapy alone. Conclusions: Addition of DCVax-L to standard therapy is feasible and safe in glioblastoma patients, and may extend survival.

Details

Original languageEnglish
Article number142
Pages (from-to)1
Number of pages1
JournalJournal of translational medicine
Volume16
Issue number1
Publication statusPublished - 29 May 2018
Peer-reviewedYes

External IDs

PubMed 29843811

Keywords

Sustainable Development Goals

Keywords

  • Dendritic cell, Glioblastoma, Immunotherapy, Vaccine