1. In this signifier 3 nonrandomized controlled trial, among 331 patients, patients with recently diagnosed glioblastoma (nGBM) receiving dendritic compartment vaccination (DCVax-L) had a median wide endurance of 19.3 months vs 16.5 months successful the outer power patients treated with modular of care.
2. Patients with recurrent glioblastoma (rGBM) had a median wide endurance of 13.2 months from relapse successful the DCVax-L radical vs 7.8 months successful the outer power cohort.
Evidence Rating Level: 2 (Good)
Study Rundown: Glioblastoma is simply a lethal superior encephalon crab with a recurrent complaint of astir 100%. The modular of attraction for recently diagnosed glioblastoma (nGBM) patients includes surgery, radiotherapy, and chemotherapy. The nonsubjective of this survey was to analyse whether adding dendritic compartment vaccination (DCVax-L) to the modular of attraction (SOC) extends the endurance of patients with glioblastoma. The main interventions successful this signifier 3 prospective externally controlled nonrandomized proceedings included DCVax-L positive SOC temozolomide and placebo. The main outcomes included a examination of wide endurance (OS) successful nGBM and rGBM, A full of 331 patients were included successful this study, with 232 randomized to the DCVax-L radical and 99 to the placebo group. The median OS among patients with nGBM receiving DCVax-L was 19.3 vs 16.5 successful the placebo group. Survival astatine 48 months from randomization was 15.7% vs 9.9%, and astatine 60 months, it was 13.0% vs 5.7%. Among 64 patients with rGBM receiving DCVax-L, the mean OS was 13.2 months from relapse vs 7.8 among the outer power cohort. Meaningful increases successful the semipermanent tails of the endurance curves for some nGBM and rGBM patients were observed. A regulation to this survey is that propensity people matching could not beryllium performed owed to a deficiency of patient-level information for the outer power group. A large spot of this study, successful summation to its comparatively ample illustration size, was that it utilized a matching-adjusted indirect examination (MAIC) investigation to flooded the deficiency of diligent information and to alteration the matching of circumstantial diligent characteristics betwixt the outer power and involution group.
Click to work the survey successful JAMA Oncology
Relevant Reading: The objective trials scenery for glioblastoma: is it capable to make caller treatments?
In-Depth [prospective cohort]: This survey investigated whether autologous tumor lysate-loaded dendritic compartment vaccination (DCVax-L) was associated with improved OS for patients with nGBM and rGBM vs SOC. This planetary multicenter proceedings was conducted astatine 94 sites crossed 4 countries betwixt 2007 and 2015. A full of 331 patients were included successful this study, with 232 randomized to the DCVax-L radical and 99 to the placebo group. The median property was 56 (19-73) years, and 202 participants (61%) were men. The median OS among patients with nGBM receiving DCVax-L was 19.3 (95% CI, 17.5-21.3 vs 16.5 (95% CI, 16.0-17.5) successful the placebo radical (HR = 0.80; 98% CI, 0.00-0.94; P = .002). Survival astatine 48 months from randomization was 15.7% vs 9.9%, and astatine 60 months, it was 13.0% vs 5.7%. Among 64 patients with rGBM receiving DCVax-L, mean OS was 13.2 (95% CI, 9.7-16.8) months from relapse vs 7.8 (95% CI, 7.2-8.2) among the outer power radical (HR, 0.58; 98% CI, 0.00-0.76; P < .001). Survival astatine 24 and 30 months aft recurrence was 20.7% vs 9.6% and 11.1% vs 5.1%, respectively. Additionally, endurance was recovered to amended successful patients with nGBM with methylated MGMT receiving DCVax-L compared with outer power patients (HR, 0.74; 98% CI, 0.55-1.00; P = .03).
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