The War Against Glioblas­toma Needs More Than Stan­dard of Care

Improv­ing over­all sur­vival for patients with Glioblas­toma remains a chal­lenge. We installed indi­vid­u­al­ized mul­ti­modal immunother­a­py as part of a mul­ti­phase com­bined treat­ment strat­e­gy (PMID 38548421). For the cur­rent real world data analy­sis, 104 patients were select­ed out of the data­base with the cri­te­ria: treat­ment after 27/05/2015, adults between 18 and 70y, GB diag­no­sis doc­u­ment­ed IDH1wt sta­tus, known sta­tus of OS, absence of sec­ond malig­nan­cy and known MGMT pro­mot­er methy­la­tion sta­tus (meth ver­sus unmeth).

Sex dis­tri­b­u­tion was 18 female / 25 male in meth patients ver­sus 23 /38 in unmeth patients. Medi­an age at intake was 54y ver­sus 50y. The extent of resec­tion was 12 R0, 28 < R0 and 3 not avail­able ver­sus 25, 28 and 8. Medi­an KPI at intake was 70 and 70. Patients received in medi­an 37 ver­sus 31 ses­sions of mEHT, 37 ver­sus 32 injec­tions of NDV and 2 ver­sus 1 DC vac­cines. Medi­an OS and per­cent­age 2y OS were 30 months and 69.8% in meth patients ver­sus 20 months and 37.4% in unmeth patients.

There were no major adverse reac­tions (AR), but the bur­den of AR is increas­ing when using check­point inhibitors. The ben­e­fi­cial effect of this treat­ment strat­e­gy on OS and qual­i­ty of life in a larg­er group of real world patients con­firms ear­li­er data. It remains unclear how to draw evi­dence out of indi­vid­u­al­ized med­i­cine, although it is felt nec­es­sar­i­ly for patients with Glioblastoma.