Swartz Adam M, Li Qi-Jing, Sampson John H
Duke University Medical Center, Department of Surgery, Division of Neurosurgery, DUMC Box 3050 Durham, NC 27710, USA.
Immunotherapy. 2014;6(6):679-90. doi: 10.2217/imt.14.21.
Glioblastoma multiforme (GBM) is the most common and aggressive glial cell-derived primary tumor. Current standard of care for patients with GBM includes maximal tumor resection plus adjuvant radiotherapy and temozolomide chemotherapy, increasing median overall survival to a mere 15 months from diagnosis. Because these therapies are inherently nonspecific, there is an increased likelihood of off-target and incomplete effects; therefore, targeted modalities are required for enhanced safety and efficacy. Rindopepimut is emerging as a safe and potentially effective drug for the treatment of GBM. Rindopepimut consists of a 14-mer peptide that spans the length of EGF receptor variant III, a mutant variant of EGF receptor found on approximately 30% of primary GBM, conjugated to the carrier protein keyhole limpet hemocyanin. Vaccination with rindopepimut has been shown to specifically eliminate cells expressing EGF receptor variant III. Phase II clinical trials have suggested that vaccination of newly diagnosed GBM patients with rindopepimut plus adjuvant granulocyte-macrophage colony-stimulating factor results in prolonged progression-free and overall survival with minimal toxicity. This review will outline the development of rindopepimut, as well as the current status of this vaccine.
多形性胶质母细胞瘤(GBM)是最常见且侵袭性最强的源自神经胶质细胞的原发性肿瘤。目前GBM患者的标准治疗方案包括最大限度的肿瘤切除,外加辅助放疗和替莫唑胺化疗,这使得从诊断开始计算的中位总生存期仅增加到15个月。由于这些疗法本质上是非特异性的,出现脱靶效应和不完全效应的可能性增加;因此,需要靶向治疗方式以提高安全性和疗效。Rindopepimut正在成为一种用于治疗GBM的安全且可能有效的药物。Rindopepimut由一个14肽组成,该肽跨越表皮生长因子受体变体III(EGF受体变体III)的长度,EGF受体变体III是在约30%的原发性GBM中发现的EGF受体的突变变体,它与载体蛋白钥孔戚血蓝蛋白偶联。已证明用Rindopepimut进行疫苗接种可特异性消除表达EGF受体变体III的细胞。II期临床试验表明,用Rindopepimut加辅助粒细胞巨噬细胞集落刺激因子对新诊断的GBM患者进行疫苗接种可延长无进展生存期和总生存期,且毒性最小。本综述将概述Rindopepimut的研发情况以及该疫苗的当前状况。