This Phase III trial is designed to evaluate the impact on survival time, as well as safety, in patients following treatment with DCVax(R)-L, an immunotherapy treatment for GBM. The experimental therapy uses a patient's own tumor lysate and white blood cells from which precursors of the dendritic cells are isolated. The dendritic cell is the starter engine of the immune system. The white cells are then made into dendritic cells and they are educated to "teach" the immune system how to recognize brain cancer cells. Eligible patients will receive a series of injections of DCVax-L, to activate and then boost the immune response to the tumor cells.
The primary study endpoint is OS (overall survival) compared to external controls in newly diagnosed glioblastoma, and the first secondary endpoint is OS compared to external controls in recurrent glioblastoma.
Side effects reported from early trials are mostly mild, and may include skin reactions of redness, pain \& swelling at the injection site.
Inclusion Criteria:
All patients must meet the following inclusion criteria. All tests and eligibility criteria
must be completed within four weeks of completion of radiation and chemotherapy, following
surgery.
- Patients must have sufficient tumor lysate protein that was generated from the
surgically obtained tumor material. Patients must also have sufficient DCVax-L product
available after manufacturing. These determinations will be made by Cognate
BioServices, Inc. (Cognate) and communicated to the clinical site through the Sponsor,
or its designee.
- Patients with newly diagnosed, unilateral GBM (Grade IV) are eligible for this
protocol. An independent neuropathologist will review this diagnosis during the
enrollment process.
- Subjects ≥18 and ≤70 years of age at surgery who are capable of informed consent.
Patients must be able to understand and sign the informed consent documents indicating
that they are aware of the investigational nature of this study.
- Patients must have a life expectancy of >8 weeks.
- Patients must have a KPS rating of ≥70 at the baseline visit (Visit 3).
- Primary therapy must consist of surgical resection with the intent for a gross or near
total resection of the contrast-enhancing tumor mass, followed by conventional
external beam radiation therapy and concurrent Temodar chemotherapy. Patients having a
biopsy only will be excluded. These primary treatments must be completed at least two
weeks prior to first immunization.
- Patients may have received steroid therapy as part of their primary treatment. Steroid
treatment must be stopped at least 10 days prior to leukapheresis.
- Patients must not have progressive disease at completion of radiation therapy.
Patients with suspected pseudoprogression will be enrolled and analyzed separately.
- Patients must be willing to forego cytotoxic anti-tumor therapies except temozolomide
essentially according to the schedule of the Stupp Protocol (Stupp et al. N Engl J Med
352: 987-96, 2005) while being treated with DCVax-L. DCVax-L treatment must be given
as described and temozolomide/Temodar treatment schedules must be given essentially
according to the Stupp Protocol.
- Patients must have adequate bone marrow function (e.g., hemoglobin >10 g/dl, white
blood count 3600-11,000mm3, absolute granulocyte count ≥1,500/mm3, absolute lymphocyte
count ≥1,000/mm3, and platelet count ≥100K/mm3. Eligibility level of hemoglobin can be
reached by transfusion.
- Adequate liver function (SGPT, SGOT, and alkaline phosphatase ≤1.5 times upper limits
of normals (ULN) and total bilirubin ≤1.5mg/dl), and adequate renal function (BUN or
creatinine ≤1.5 times ULN) prior to starting therapy.