Immun-Onkologisches Zentrum Köln (IOZK), Hohenstaufenring 30-32, 50674, Köln, Germany.
Genes Immun. 2022 Dec;23(8):255-259. doi: 10.1038/s41435-022-00162-y. Epub 2022 Feb 16.
The prognosis of IDH1 wild-type MGMT promoter-unmethylated GBM patients remains poor. Addition of Temozolomide (TMZ) to first-line local treatment shifted the median overall survival (OS) from 11.8 to 12.6 months. We retrospectively analyzed the value of individualized multimodal immunotherapy (IMI) to improve OS in these patients. All adults meeting the criteria and treated 06/2015-06/2021 were selected. Thirty-two patients (12f, 20m) had a median age of 47 y (range 18-69) and a KPI of 70 (50-100). Extent of resection was complete (11), <complete (12) or not documented (9). Seven patients were treated with surgery/radio(chemo)therapy and subsequent IMI (Group-1); 25 patients were treated with radiochemotherapy followed by maintenance TMZ plus IMI during and after TMZ (Group-2). Age, KPI and extent of resection were not different amongst both groups. The median OS of group-1 patients was 11 m (2 y OS: 0%). Surprisingly the median OS of group-2 patients was 22 m with 2 y OS of 36% (CI95%: 16-57), which was significantly (Log-rank: p = 0.0001) different from group-1. The data suggest that addition of IMI after local therapy on its own has no relevant effect on OS in these GBM patients, similar to maintenance TMZ. However, the combination of both TMZ + IMI significantly improved OS.
IDH1 野生型 MGMT 启动子未甲基化 GBM 患者的预后仍然较差。替莫唑胺（TMZ）联合一线局部治疗将中位总生存期（OS）从 11.8 个月延长至 12.6 个月。我们回顾性分析了个体化多模态免疫治疗（IMI）改善这些患者 OS 的价值。所有符合标准并于 2015 年 6 月至 2021 年 6 月接受治疗的成年人都被纳入研究。共选择了 32 名患者（12 名女性，20 名男性），中位年龄为 47 岁（范围 18-69 岁），KPI 为 70（50-100）。切除程度完全（11 例）、不完全（12 例）或未记录（9 例）。7 名患者接受手术/放化疗和随后的 IMI（组 1）治疗；25 名患者接受放化疗，随后在 TMZ 期间和之后使用维持 TMZ 加 IMI（组 2）。两组间的年龄、KPI 和切除程度无差异。组 1 患者的中位 OS 为 11 个月（2 年 OS：0%）。令人惊讶的是，组 2 患者的中位 OS 为 22 个月，2 年 OS 为 36%（CI95%：16-57），与组 1 相比具有显著差异（Log-rank：p=0.0001）。数据表明，局部治疗后单独使用 IMI 对这些 GBM 患者的 OS 没有明显影响，与维持 TMZ 相似。然而，TMZ+IMI 的联合应用显著改善了 OS。
