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[Advances of BRM therapy of malignant brain tumors]
1Dept. of Neurosurgery, Dokkyo University School of Medicine.
Abstract:
The cooperative study on the beta-interferon (IFN) therapy for glioblastoma and malignant astrocytoma reported the response rate as 14.0%. Continuing study resulted the response rate of 24.0% to low grade astrocytoma and 20.0% to medulloblastoma. Totally, effectiveness of 19.2% to gliomas was confirmed in 120 evaluated cases. A randomized study was conducted on combination therapy with beta-interferon and chemoradiotherapy. The response rate of 41.2% (21/51) in the group treated with IFN, ACNU and Radiation was significantly higher than the rate of 19.6% (10/51) in the group treated with ACNU and radiation only. Application of IFN to a maintenance therapy is also on going. Adoptive immunotherapy has been developed as potential therapeutic method of malignant glioma. Lymphokine activated killer cells (LAK) and Tumor infiltrating lymphocytes (TIL) are put to clinical use. Clinical application of human monoclonal antibody (MAb) CLN-IgG was conducted to recurrent malignant glioma. 131I labeled MAb was administered intratumorously and the specific incorporation was confirmed by gamma-scintigraphy. Concomitant administration of interferon enhanced the efficacy of the therapy. This radio-immunotherapy holds future promise as a new therapeutic approach to gliomas.
Insights
Beta-interferon (IFN) therapy shows promise for brain tumors like glioblastoma. Combination therapy with IFN, ACNU, and radiation significantly improved response rates in malignant glioma patients.
Area of Science:
- Neuro-oncology
- Immunotherapy
- Radiation Oncology
Background:
- Glioblastoma and malignant astrocytoma are aggressive brain tumors with limited treatment options.
- Beta-interferon (IFN) has been investigated for its therapeutic potential in gliomas.
- Adoptive immunotherapy, including LAK cells and TILs, represents a developing strategy for malignant glioma.
Purpose of the Study:
- To evaluate the effectiveness of beta-interferon (IFN) therapy in various glioma types.
- To assess the efficacy of combination therapy involving IFN, ACNU, and chemoradiotherapy.
- To explore novel immunotherapeutic approaches, including monoclonal antibodies and radio-immunotherapy, for malignant gliomas.
Main Methods:
- Cooperative and randomized studies were conducted to assess IFN monotherapy and combination therapies.
- Evaluated response rates in patients with glioblastoma, malignant astrocytoma, low-grade astrocytoma, and medulloblastoma.
- Investigated adoptive immunotherapy with LAK cells and TILs, and radio-immunotherapy using 131I labeled MAb CLN-IgG for recurrent malignant glioma.
Main Results:
- IFN therapy demonstrated an overall effectiveness of 19.2% across 120 evaluated glioma cases.
- Combination therapy with IFN, ACNU, and radiation yielded a significantly higher response rate (41.2%) compared to ACNU and radiation alone (19.6%).
- Intratumoral administration of 131I labeled MAb CLN-IgG showed specific incorporation, with enhanced efficacy when combined with interferon.
Conclusions:
- Beta-interferon (IFN) shows a measurable response rate in glioma treatment.
- Combination therapy including IFN significantly improves treatment outcomes for malignant gliomas.
- Radio-immunotherapy with monoclonal antibodies, potentially enhanced by interferon, offers a promising future direction for glioma treatment.