gms | German Medical Science

Objective: Cancer immunotherapy is rapidly evolving and has been applied to glioblastoma as well. Next to CAR-T-cell therapy, monoclonal antibodies and checkpoint inhibitors, options for antitumor vaccinations are under development. The allogeneic/autologous antitumor vaccine ERC1671 is composed of whole, inactivated glioblastoma cells and of tumor lysate from three donors and from the specific patient. The vaccine is administered intradermally five times per cycle for six consecutive cycles.

Methods: Between April 2015 and February 2018, 4 male patients (mean age 56 years; range: 43–66 years) with recurrent or progressive glioblastoma (mean number of recurrences or progressions: 2; range: 1–3) and heterogeneous clinical performance status (mean KPS: 65%; range: 40–100%) were treated with ERC1671 per protocol after tumor resection or biopsy. All tumors had IDH1/2 wild-type status and negative MGMT promoter hypermethylation. The mean CD3+/CD4+ lymphocyte cell count before the first vaccination was 576 * 103/L (range 493–702 * 103/L).

Results: Thirteen cycles of ERC1671 were administered. All patients showed local hyperthermia and flush at the injection site and developed symptomatic cerebral edema requiring steroid-sparing conservative treatment, including intravenous application of bevacizumab. No other local or systemic side effects were observed after the injections. Median overall survival was 5.4 months (1.5–8.5 months).

Conclusion: The application of ERC1671 was safely feasible in inpatient or outpatient settings depending on the individual KPS. There was a learning curve regarding steroid-sparing treatment of symptomatic perifocal edema in these patients. The use of bevacizumab in two patients better stabilized the symptoms than other available non-steroidal agents and may be considered as a simultaneous medication. The overall survival in our cohort is comparable to other second, third- and fourth-line therapies, especially when considering the universally unfavorable molecular pathological tumor status present in this small observational series.