Personalised vaccines prepared from GBM tissue removed during surgery can enhance the performance of Temozolomide and Avastin and significantly increase survival times in patients with grade 4 brain cancer, according to two phases of a clinical trial.
Dr. Orin Bloch and his team at Northwestern Memorial Hospital, Chicago have prepared personalised ’vaccines’ from patients whose GBM brain cancer had recurred; the vaccine greatly improved the performances of Avastin and Temozolomide and increased survival times.
Standard treatment for GBM is surgery, then radiotherapy and cancer drugs such as Temozolomide (TMZ) or Avastin. Unfortunately, Avastin (bevacizumab) only offers a medium survival increment on average of 11 months and TMZ only works where the tumours are methylated.
Recruiting 41 patients whose brain tumours had recurred between 2007 and 2011, tissue was removed surgically from the tumour site. From this the scientists prepared a Heat Shock Peptide Protein Complex - 96 (HSPPC-96). This vaccine then helps the body’s immune system recognise and attack the specific brain tumour tissue.
Patients received 6 doses of the vaccine starting 4 weeks after the tumour surgery. Median survival for the 41 patients was 42.6 weeks. 90.2 per cent of the patients were alive 6 months after the treatment, with one third still alive after one year.
This Phase I research showed no side-effects for the vaccine.
In Phase II of the trial, 46 patients underwent surgery and then a combination of chemotherapy and radiotherapy. The vaccine was created from the tissue removed at surgery. Five weeks after the radiotherapy, the patients received weekly doses of the Heat Shock Protein vaccine.
Median progression-free survival was 17.8 months; median overall survival was 23.8 months.
Interestingly PD-L1 was an important marker. Those patients who had low levels survived two to three times longer (44.7 months median vs 18.0 months median).
This Phase II result was presented at the 2016 ASCO annual meeting.
Phase III trials are now underway.
Go to: Brain Cancer overview - the latest treatment alternatives