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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Favorable outcome after interstitial photodynamic therapy of glioblastoma may be caused by long-term activation of the adaptive immune response

Positive Effekte der photodynamischen Therapie auf das Glioblastom können durch eine Aktivierung der adaptiven Immunantwort bedingt sein

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  • presenting/speaker Niklas Thon - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland
  • Christoph Schwartz - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland
  • Max Hübner - Klinikum der Ludwig-Maximilians-Universität München – Campus Großhadern, Anästhesie - Molekulares Labor, München, Deutschland
  • Gabriele Strauss - Klinikum der Ludwig-Maximilians-Universität München – Campus Großhadern, Anästhesie – Molekulares Labor, München, Deutschland
  • Joerg-Christian Tonn - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland
  • Rupert Egensperger - Ludwig-Maximilians-Universität München, Zentrum für Neuropathologie und Prionforschung, München, Deutschland
  • Ronald Sroka - Ludwig-Maximilians-Universität München, LIFE Zentrum – Laserforschungslabor, München, Deutschland
  • Simone Kreth - Klinikum der Ludwig-Maximilians-Universität München – Campus Großhadern, Anästhesie – Molekulares Labor, München, Deutschland
  • Friedrich-Wilhelm Kreth - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV320

doi: 10.3205/19dgnc337, urn:nbn:de:0183-19dgnc3379

Published: May 8, 2019

© 2019 Thon et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Patients with glioblastoma (GBM) continue to have an unfavorable prognosis. A novel therapeutic approach is pursued with interstitial photodynamic therapy (PDT). After oral administration of a photosensitizing substance, the tumor is irradiated using stereotactically inserted laser probes. We report on long-term follow-data of our pilot study evaluating iPDT in patients with newly diagnosed, not safely resectable GBM. Moreover, the effects of PDT on malignant glioma cells and interaction with the adaptive immune system were assessed in vitro.

Methods: In our pilot study, 16 patients (9 males, median age: 58 years) with newly diagnosed, not safely resectable glioblastoma (maximum diameter of 4 cm) underwent upfront iPDT followed by standard chemoradiation. Outcome was analyzed with the Kaplan-Meier method and compared to historic controls undergoing complete resections and radiochemotherapy. The effects of iPDT on malignant glioma cells and interaction with cytotoxic CD8+ cells were assessed in vitro.

Results: In 7/16 patients a long-term tumor control with a progression-free interval >24 months could be achieved. The 2-year survival rate of the study cohort was higher than in the reference cohort (84.9% vs. 38.5%; p=0.015). In vitro, PDT of glioblastoma cells resulted in an activation of autologeous CD8+ cells with increased cytotoxic function possibly via expression of perforin and inhibition of CTLA4.

Conclusion: The favorable clinical and experimental results suggest that beyond the direct cytotoxic effects of iPDT irradiation, the adaptive immune response can be favorably and sustainably influenced.