Granulocyte-macrophage colony-stimulating factor for newly diagnosed glioblastoma

IF 4.8 2区医学 Q1 Biochemistry, Genetics and Molecular Biology

Neoplasia Pub Date : 2025-03-15 DOI:10.1016/j.neo.2025.101156

Caineng Cao , Le Wang , Feng Jiang , Qifeng Jin , Ting Jin , Shuang Huang , Qiaoying Hu , Yuanyuan Chen , Yongfeng Piao , Yonghong Hua , Xinglai Feng , Yi Zhou , Xiaozhong Chen

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引用次数: 0

Abstract

Background

There is a clear need to improve the efficiency of therapeutic strategy for patients with newly diagnosed glioblastoma (GBM). The purpose of this study was to evaluate the feasibility of hypofractionated intensity-modulated radiation therapy (IMRT), temozolomide and granulocyte-macrophage colony-stimulating factor (GM-CSF) for patients with newly diagnosed GBM.

Methods

Patients were treated with hypofractionated IMRT (15 × 3.5Gy to the high-risk region and 15 × 3.0Gy to the low-risk region), temozolomide (75 mg per square meter of body-surface area per day, from 1 week before the beginning of radiotherapy to the last day of radiotherapy) and GM-CSF [200μg (equivalent to 125 μg/m² calculated dose) subcutaneously injected daily for 2 weeks, starting from the second week of radiotherapy]. The primary endpoint was 6-month progression free survival (PFS).

Results

Between June 2016 and Feburary 2020, 41 patients were enrolled. During concomitant chemoradiotherapy, no grade 3 or 4 hematologic toxicities were observed and grade 3 non-hematologic toxicities were documented in 5 patients (12.2 %) due to GM-CSF. All patients completed both radiotherapy and concomitant temozolomide as planned. Only five patients (12.2 %) discontinued concomitant GM-CSF because of toxicity. At a median follow-up of 33.1 months (IQR 23.0-51.2), the 6-month PFS rate was 68.3 % (95 % CI: 54.0-82.6). The median overall survival of all patients was 16.7 months (95 % CI: 10.5-22.9). Compared with pre-GM-CSF, the concentrations of TNF-α (p = 1.9615E-10) and IL-18 (p = 6.8467E-8) were increased after GM-CSF, while the proportion of CD19 (p = 0.000015), the concentrations of IgG (p = 0.000015) and CXCL12 (p = 0.000257) were decreased.

Conclusions

The combination of hypofractionated IMRT, temozolomide and GM-CSF for GBM was feasible and safe.

Trial Registration

ClinicalTrials.gov Identifier: NCT02663440.

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粒细胞-巨噬细胞集落刺激因子对新诊断的胶质母细胞瘤的影响

背景：对于新诊断的胶质母细胞瘤（GBM）患者，明显需要提高治疗策略的效率。本研究的目的是评估低分割调强放疗（IMRT）、替莫唑胺和粒细胞-巨噬细胞集落刺激因子（GM-CSF）治疗新诊断的GBM患者的可行性。方法患者接受低分割IMRT治疗（高危区15 × 3.5Gy，低危区15 × 3.0Gy）、替莫唑胺（75 mg / m2体表/ d，放疗开始前1周至放疗最后一天）、GM-CSF [200μg（相当于125 μg/m²计算剂量）每日皮下注射，放疗第2周开始]。主要终点为6个月无进展生存期（PFS）。结果2016年6月至2020年2月，共纳入41例患者。在同步放化疗期间，没有观察到3级或4级血液毒性，有5例（12.2%）患者由于GM-CSF而记录到3级非血液毒性。所有患者均按计划完成放疗和替莫唑胺治疗。只有5名患者（12.2%）因为毒性而停止使用GM-CSF。中位随访33.1个月（IQR 23.0-51.2）， 6个月PFS率为68.3% （95% CI: 54.0-82.6）。所有患者的中位总生存期为16.7个月（95% CI: 10.5-22.9）。与GM-CSF前相比，GM-CSF后TNF-α (p = 1.9615E-10)和IL-18 （p = 6.8467E-8）浓度升高，CD19 （p = 0.000015）、IgG （p = 0.000015）和CXCL12 （p = 0.000257）浓度降低。结论低分割IMRT联合替莫唑胺和GM-CSF治疗GBM是可行且安全的。临床试验注册号：NCT02663440。

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来源期刊

Neoplasia 医学-肿瘤学

CiteScore

9.20

自引率

2.10%

发文量

审稿时长

26 days

期刊介绍： Neoplasia publishes the results of novel investigations in all areas of oncology research. The title Neoplasia was chosen to convey the journal’s breadth, which encompasses the traditional disciplines of cancer research as well as emerging fields and interdisciplinary investigations. Neoplasia is interested in studies describing new molecular and genetic findings relating to the neoplastic phenotype and in laboratory and clinical studies demonstrating creative applications of advances in the basic sciences to risk assessment, prognostic indications, detection, diagnosis, and treatment. In addition to regular Research Reports, Neoplasia also publishes Reviews and Meeting Reports. Neoplasia is committed to ensuring a thorough, fair, and rapid review and publication schedule to further its mission of serving both the scientific and clinical communities by disseminating important data and ideas in cancer research.