Personalized Immunotherapy in the Treatment of Patients with Malignant Gliomas
Purpose. Improving the survival rate of patients with gliomas. Materials and methods. Our study included 5 patients, median age 7.6 years (2-16). Three pts had anaplastic astrocytoma (AA) (1st recurrence - 1 pt, 2nd recurrence - 2 pts), 1 pt had glioblastoma multiforme (GBM) (3rd recurrence) and 1 pt had diffuse brainstem glioma (BSG). The median time to the first relapse was 12 months (4 to 16), to the second one - 5 months (1 to 8). 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. Results. Two of 3 pts with AA experienced a progression-free interval of 67 and 71 months One pt. with 3rd GBM relapse is alive without any therapy 13.3 years after immunotherapy start. The median time of follow-up was 67 months with the 2-years overall survival was 58%. Two pts died from disease progression within 6 and 7 months from the start of immunotherapy. Over the period of treatment the pts received a median of 20 (8 to 60) alloIC injections and 18 (8 to 44) DV administrations. No serious side-effect was observed. Conclusion. Immunotherapy could be an attractive option for treating patients with high-grade malignant gliomas irresponsible to conventional therapy and is worthy of further investigation.