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Oncolytic Virotherapy for Relapsed, IDH-Mutant, Grade 3 Astrocytoma: A New Promising Approach - A Case Report
Benjamin Gesundheit1, Jayadeepa Srinivas Raju1, Chaim Y Brauns1
1Department of Research and Development, RapoYerape Ltd., Jerusalem, Israel.
Introduction:
IDH-mutant astrocytomas are high-grade gliomas with a poor prognosis. Transformation to glioblastoma multiforme is common, which further shortens overall survival and frequently renders the tumor inoperable. Oncolytic viruses (OVs) have been shown to be safe and effective agents for the treatment of some malignant brain tumors. Intra-tumoral application may further enhance their therapeutic potential.
Case Presentation:
This report presents a case of a 37-year-old female patient with advanced relapsed grade 3 astrocytoma, with multiple foci, including one along the rim of the left fronto-parietal post-op cavity, who was treated with a one-shot OV regimen via an Ommaya reservoir (IO-OV), with the catheter tip placed intra-tumorally. Adjunct electro-hyperthermia therapy was also provided. No evidence of disease (NED) was achieved after the first cycle of IO-OV and was maintained for 9 months until the non-vaccinated patient contracted COVID-19, after which aggressive and refractory relapse occurred.
Conclusion:
OV therapy proved to induce significant clinical improvements and radiological NED for this incurable astrocytoma. This promising modality should be evaluated as an adjunct to first-line therapy for inoperable brain tumors.
Insights
Oncolytic virus (OV) therapy showed promise for treating recurrent high-grade astrocytoma. A patient achieved no evidence of disease after intra-tumoral OV treatment, highlighting its potential for inoperable brain tumors.
Area of Science:
- Neuro-oncology
- Viral oncology
- Cancer immunotherapy
Background:
- IDH-mutant astrocytomas are aggressive brain tumors with poor prognosis, often progressing to glioblastoma.
- Current treatments for advanced astrocytomas have limited efficacy, necessitating novel therapeutic approaches.
- Oncolytic viruses (OVs) demonstrate potential as a safe and effective treatment modality for malignant brain tumors, particularly with intra-tumoral delivery.
Observation:
- A case report details a 37-year-old female with advanced, relapsed grade 3 astrocytoma treated with intra-tumoral OV (IO-OV) therapy via an Ommaya reservoir.
- The patient received a single OV treatment cycle combined with electro-hyperthermia therapy.
- Initial treatment resulted in no evidence of disease (NED) for 9 months.
Findings:
- Intra-tumoral OV therapy led to significant clinical and radiological improvements in a patient with an otherwise incurable astrocytoma.
- The patient experienced a durable response (9 months NED) following the OV regimen.
- Disease relapse occurred after the patient contracted COVID-19, suggesting potential interactions between viral therapies and immune status.
Implications:
- Intra-tumoral OV therapy is a promising strategy for managing advanced and inoperable brain tumors.
- OV therapy should be considered as an adjunct to first-line treatments for malignant gliomas.
- Further research is warranted to explore the full therapeutic potential and optimize OV delivery methods for brain cancers.
