- Liau, Linda M;
- Ashkan, Keyoumars;
- Tran, David D;
- Campian, Jian L;
- Trusheim, John E;
- Cobbs, Charles S;
- Heth, Jason A;
- Salacz, Michael;
- Taylor, Sarah;
- D’Andre, Stacy D;
- Iwamoto, Fabio M;
- Dropcho, Edward J;
- Moshel, Yaron A;
- Walter, Kevin A;
- Pillainayagam, Clement P;
- Aiken, Robert;
- Chaudhary, Rekha;
- Goldlust, Samuel A;
- Bota, Daniela A;
- Duic, Paul;
- Grewal, Jai;
- Elinzano, Heinrich;
- Toms, Steven A;
- Lillehei, Kevin O;
- Mikkelsen, Tom;
- Walbert, Tobias;
- Abram, Steven R;
- Brenner, Andrew J;
- Brem, Steven;
- Ewend, Matthew G;
- Khagi, Simon;
- Portnow, Jana;
- Kim, Lyndon J;
- Loudon, William G;
- Thompson, Reid C;
- Avigan, David E;
- Fink, Karen L;
- Geoffroy, Francois J;
- Lindhorst, Scott;
- Lutzky, Jose;
- Sloan, Andrew E;
- Schackert, Gabriele;
- Krex, Dietmar;
- Meisel, Hans-Jorg;
- Wu, Julian;
- Davis, Raphael P;
- Duma, Christopher;
- Etame, Arnold B;
- Mathieu, David;
- Kesari, Santosh;
- Piccioni, David;
- Westphal, Manfred;
- Baskin, David S;
- New, Pamela Z;
- Lacroix, Michel;
- May, Sven-Axel;
- Pluard, Timothy J;
- Tse, Victor;
- Green, Richard M;
- Villano, John L;
- Pearlman, Michael;
- Petrecca, Kevin;
- Schulder, Michael;
- Taylor, Lynne P;
- Maida, Anthony E;
- Prins, Robert M;
- Cloughesy, Timothy F;
- Mulholland, Paul;
- Bosch, Marnix L
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. Trial registration Funded by Northwest Biotherapeutics; Clinicaltrials.gov number: NCT00045968; https://clinicaltrials.gov/ct2/show/NCT00045968?term=NCT00045968&rank=1 ; initially registered 19 September 2002.