June 29, 2018

Poliovirus Therapy Extends Survival in Recurrent Glioblastoma

A genetically modified poliovirus therapy shows significantly improved long-term survival for patients with recurrent glioblastoma, according to a study published in The New England Journal of Medicine.

“Glioblastoma remains a lethal and devastating disease, despite advances in surgical and radiation therapies, as well as new chemotherapy and targeted agents,” said Darell D. Bigner, MD, Duke University Medical Center, Durham, North Carolina. “There is a tremendous need for fundamentally different approaches. With the survival rates in this early phase of the poliovirus therapy, we are encouraged and eager to continue with the additional studies that are already underway or planned.”

For the study, patients were selected according to strict guidelines based on the size of their recurring tumour, its location in the brain, and other factors designed for patient protection. A comparison group of patients was drawn from historical cases involving patients who would have matched the poliovirus enrolment criteria. All of the patients in the control group are known to have died, aside from 1 patient who was lost to follow-up.

A total of 61 patients received treatment with recombinant nonpathogenic polio-rhinovirus chimera (PVSRIPO). Median follow-up was 27.6 months, and among these patients, the median overall survival was 12.5 months, compared with 11.3 months for the control group.

The rate of overall survival for patients taking PVSRIPO at 24 months was 21%, compared with 14% for the control group. At 36 months, the gap widened further, with a survival rate of 21% for patients taking PVSRIPO, compared with 4% in the control group.

The researchers reported that 69% of patients had a mild or moderate adverse event attributed to PVSRIPO as their most severe side effect. Low-dose bevacizumab was used to help control the localised inflammation of the tumour and its side effects.

“Similar to many immunotherapies, it appears that some patients do not respond, but if they respond, they often become long-term survivors,” noted Annick Desjardins, MD, Duke University Medical Center. “The big question is, how can we make sure that everybody responds?”

Reference: http://doi.org/10.1056/NEJMoa1716435

SOURCE: Duke University Medical Center
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