Abstract
Glioblastoma multiforme (GBM) remains an incurable condition, associated with a median survival time of 15 months with best standard of care and 5-year survival rate of <10%. We report on four GBM patients on combination treatment regimens that included oncolytic virus (OV) immunotherapy, who achieved clinical and radiological responses with long-term survival, thus far, of up to 14 years, and good quality of life. We discuss the radiological findings that provide new insights into this treatment, the scientific rationale of this innovative and promising therapy, and considerations for future research.
Highlights
Glioblastoma multiforme (GBM) represents ∼50% of adult primary malignant brain tumors, which occur at an annual incidence of 2–3 per 100,000 adults [1], and is the most common cause of death among patients with central nervous system tumors
The four presented GBM cases, all of which relapsed after standard treatments, benefited from treatment with various oncolytic virus (OV) strains
While the nature of this case presentation precludes a direct comparison to empiric median survival rates [5], the prolonged survival shows the potential of OV therapy for the management of GBM
Summary
Glioblastoma multiforme (GBM) represents ∼50% of adult primary malignant brain tumors, which occur at an annual incidence of 2–3 per 100,000 adults [1], and is the most common cause of death among patients with central nervous system tumors. DC-based immunotherapies have been proposed to synergize with OVs [21, 26] This case series presents the clinical and radiological outcomes of four patients with histologically-confirmed GBM treated with experimental combination virotherapy regimens as compassionate treatment. A previously healthy 54-year-old woman presented with grandmal seizures and left hemiplegia She had gross surgical resection, and the tumor was found to be MGMT promoter methylationpositive. Follow-up MRI showed radiological relapse (13 × 10 × 10 mm) in the initial tumor bed (6/12; Figure 1C), and subsequently he underwent another surgery He refused further chemo-radiation and started OV treatment instead (8/12), which he continues to receive. The patient works, enjoys a normal QoL, and remains radiologically stable with NED (7/15; Figure 1C) for 8.5 years from initial diagnosis. The patient remains clinically stable, conducts full physical work, and enjoys normal QoL >4 years after diagnosis
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