Thema: Recombinant mutant human tumor necrosis factor-alpha (TNF-SAM2) immunotherapy with ranimustine
Recombinant mutant human tumor necrosis factor-alpha (TNF-SAM2) immunotherapy with ranimustine
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15.12.2003 11:37:38
Fukushima T, Yamamoto M, Oshiro S, Tsugu H, Hirakawa K, Soma G.
Department of Neurosurgery, Fukuoka University School of Medicine, 45-1, 7-chome, Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
BACKGROUND: This study assessed the safety, tolerance and preliminary efficacy of a combination chemotherapy regimen consisting of
ranimustine (MCNU) and recombinant human mutant tumor necrosis factor-alpha (TNF-SAM2) for patients with newly diagnosed
supratentorial malignant astrocytomas. MATERIALS AND METHODS: The initial regimens were prescribed as adjuvant therapy in
conjunction with radiotherapy following standard surgical treatment. Ranimustine (MCNU) was administered intravenously at 100 mg/m2
on Day 1, i.e., at the onset of radiation therapy, and was followed by 80 x 10(4) U/m2 TNF-SAM2 intravenously from Day 3. TNF-SAM2
was prescribed weekly for up to 5 injections during the postoperative period concurrent with radiation therapy. TNF-SAM2 and MCNU were
given each 8- to 12-week cycle until tumor progression was evident, or for a total of four cycles over a 1-year period. The primary
end-points were safety and tolerability and the secondary end-point was overall survival. RESULTS: Twenty-six consecutive eligible
patients, including 5 with anaplastic astrocytoma (3 men and 2 women) and 21 with glioblastoma (13 men and 8 women), were treated. All
of the 3 evaluable patients with anaplastic astrocytoma partially responded to treatment (PR), with a time to tumor progression (TTP) of
107 weeks and an estimated median survival time of 330 weeks. Of the 15 evaluable patients with glioblastoma, 8 (53.3%) showed no
change in response to the treatment (NC), while 7 (46.7%) had progressive disease (PD), with a time to tumor progression (TTP) of 36
weeks and an estimated median survival time of 69 weeks. Although this regimen appeared to be safe, there was no improvement in
response or survival time compared with a historical control of patients who received chemotherapy with MCNU alone in conjunction with
radiotherapy for glioblastoma. Neither neurological toxicity, severe or life-threatening hematological toxicity, nor fatal toxicity (WHO Grade
4) was experienced. CONCLUSION: These results suggest that combined chemotherapy with mutant TNF-alpha (TNF-SAM2) in this
patient population seems to be safe and tolerable and may benefit those with anaplastic astrocytoma. These intriguing clinical
observations warrant further evaluation to determine whether this approach can provide therapeutic benefits and improve survival.
Department of Neurosurgery, Fukuoka University School of Medicine, 45-1, 7-chome, Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
BACKGROUND: This study assessed the safety, tolerance and preliminary efficacy of a combination chemotherapy regimen consisting of
ranimustine (MCNU) and recombinant human mutant tumor necrosis factor-alpha (TNF-SAM2) for patients with newly diagnosed
supratentorial malignant astrocytomas. MATERIALS AND METHODS: The initial regimens were prescribed as adjuvant therapy in
conjunction with radiotherapy following standard surgical treatment. Ranimustine (MCNU) was administered intravenously at 100 mg/m2
on Day 1, i.e., at the onset of radiation therapy, and was followed by 80 x 10(4) U/m2 TNF-SAM2 intravenously from Day 3. TNF-SAM2
was prescribed weekly for up to 5 injections during the postoperative period concurrent with radiation therapy. TNF-SAM2 and MCNU were
given each 8- to 12-week cycle until tumor progression was evident, or for a total of four cycles over a 1-year period. The primary
end-points were safety and tolerability and the secondary end-point was overall survival. RESULTS: Twenty-six consecutive eligible
patients, including 5 with anaplastic astrocytoma (3 men and 2 women) and 21 with glioblastoma (13 men and 8 women), were treated. All
of the 3 evaluable patients with anaplastic astrocytoma partially responded to treatment (PR), with a time to tumor progression (TTP) of
107 weeks and an estimated median survival time of 330 weeks. Of the 15 evaluable patients with glioblastoma, 8 (53.3%) showed no
change in response to the treatment (NC), while 7 (46.7%) had progressive disease (PD), with a time to tumor progression (TTP) of 36
weeks and an estimated median survival time of 69 weeks. Although this regimen appeared to be safe, there was no improvement in
response or survival time compared with a historical control of patients who received chemotherapy with MCNU alone in conjunction with
radiotherapy for glioblastoma. Neither neurological toxicity, severe or life-threatening hematological toxicity, nor fatal toxicity (WHO Grade
4) was experienced. CONCLUSION: These results suggest that combined chemotherapy with mutant TNF-alpha (TNF-SAM2) in this
patient population seems to be safe and tolerable and may benefit those with anaplastic astrocytoma. These intriguing clinical
observations warrant further evaluation to determine whether this approach can provide therapeutic benefits and improve survival.
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