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SUCCESSFUL COMBINED IMMUNOTHERAPY OF MALIGNANT GLIOMAS OF CENTRAL NERVOUS SYSTEM IN CHILDREN AND ADOLESCENTS
  • Igor Dolgopolov,
  • Georgij Chkadua,
  • Maxim Rykov
Igor Dolgopolov
Rossiiskii onkologicheskii nauchnyi tsentr imeni NN Blokhina

Corresponding Author:[email protected]

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Georgij Chkadua
N.N. Blokhin National Medical Research Center of Oncology
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Maxim Rykov
Tver State Medical University
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Abstract

The incidence of high-grade malignant gliomas (MG) ranges from 35 to 46% of all central nervous system tumors. Despite combined therapy including surgery, radiation and chemotherapy overall five-year survival does not exceed 10%. Our study included 9 patients, median age 10 years (2-19). 3 pts had anaplastic astrocytoma (AA), 4 pts had glioblastoma multiforme (GBM) and 2 pts had diffuse brainstem glioma (BSG). The median time to the first relapse was 12 months, to the second one– 5 months. The protocol of immunotherapy included combined administration of autologous dendritic cell-based vaccine (DV) and repeated intrathecal/intraventricular injections of donor allogenic immunocompetent cells (alloIC) for at least 2 years. Four of 9 pts are alive and well 82, 23, 71 and 67 months after the immunotherapy start (2 pts with GBM in the 3rd and 2nd relapse, and 2 pts with AA in the 1st relapse and 2nd, respectively). Three of them are in CR proved by PET with 11C methionine and free of any therapy for more than 15 months. One pt with 2nd relapse of metastatic GBM is currently in SD status and on immunotherapy for 23 months. Five pts died from disease progression within 2 – 4 months from the start of immunotherapy. Over the period of treatment the pts received a median of 19 (4 to 60) alloIC injections and 16 (2 to 44) DV administrations. Immunotherapy could be an attractive option for treating patients with gliomas irresponsible to conventional therapy and is worthy of further investigation.