The findings, published online in the New England Journal of
Medicine, are the latest update on an experimental cancer vaccine
developed at Duke Cancer Institute in Durham, North Carolina, for
patients with glioblastoma, a deadly form of brain cancer.
For most patients whose glioblastoma has recurred after treatment,
the average survival is 12 months. Treatment typically involves a
mix of surgery, chemotherapy, radiation and targeted treatments.
The experimental vaccine involves a genetically modified form of
polio, which is infused into the brain tumor through a surgically
implanted catheter. The vaccine works by provoking the immune system
to specifically target tumor cells.
The phase 1 trial was designed to find a safe dose. It involved 61
patients treated with the poliovirus vaccine whose progress was
compared to historical records of similar patients treated with
standard therapy. Several patients who received a higher dose of the
vaccine had brain swelling and seizures, and most had their dosage
reduced.
The vaccine showed a dramatic response in some patients, with two
remaining alive at least 69 months. But most did not benefit and
many - 69 percent - had side effects attributable to the vaccine.
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For all 61 patients, half were still alive at 12.5 months, a measure
known as median overall survival, compared 11.3 months in the
control group.
For patients who survived two years, the impact of the cancer
vaccine became more evident.
At two years, 21 percent of vaccine-treated patients were still
alive, compared with 14 percent of the historical control group.
That rate remained stable at three years, with 21 percent of the
vaccine patients still alive, compared with 4 percent of the control
group.
“Similar to many immunotherapies, it appears that some patients
don’t respond for one reason or another, but if they respond, they
often become long-term survivors,” Dr. Annick Desjardins, one of the
study authors, said in a statement.
Desjardins and several of the researchers hold patents to the
treatment, which Duke has licensed to Istari Oncology, a startup
company. A phase 2 study is underway.
(Reporting by Julie Steenhuysen; Editing by Tom Brown)
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