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一项声动力疗法联合替莫唑胺治疗复发性胶质母细胞瘤的I期临床试验。

A phase I clinical trial of sonodynamic therapy combined with temozolomide in the treatment of recurrent glioblastoma.

作者信息

Zha Boya, Yang Junping, Dang Qianqian, Li Peihong, Shi Shuling, Wu Jingjing, Cui Haiyang, Huangfu Linkuan, Li Yuxin, Yang Daoke, Zheng Yingjuan

机构信息

Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Erqi District, Zhengzhou, 450052, Henan, China.

Institute of Radiotherapy and Critical Care Oncology, Zhengzhou University, Zhengzhou, 450000, Henan, China.

出版信息

J Neurooncol. 2023 Apr;162(2):317-326. doi: 10.1007/s11060-023-04292-9. Epub 2023 Mar 29.

Abstract

PURPOSE

The prognosis of recurrent glioblastoma (rGBM) is poor, and there is currently no effective treatment strategy. Sonodynamic therapy (SDT) is a new method for cancer treatment that uses a combination of low-frequency ultrasound and sonosensitisers to produce antitumor effects, which have shown good therapeutic effects in preclinical studies. Therefore, we initiated an open, prospective pilot study to evaluate the safety, tolerability, and efficacy of SDT for the treatment of rGBM.

METHODS

Nine patients with rGBM were enrolled who had received multiple treatments, but the nidus continued to progress without additional standard treatments. After MRI localisation, porphyrin drugs were injected, and intermittent low-frequency ultrasound therapy was performed for five days.

RESULTS

None of the nine patients in this clinical trial showed any clinical, neurological, haematological, or skin-targeted adverse effects associated with SDT. After the completion of the trial, one patient maintained stable disease, and eight patients experienced disease progression. Among the eight with progressive disease, the median progression-free survival time was 84 days. Four patients died, and the median overall survival duration after recurrence was 202.5 days.

CONCLUSION

The number of patients in this study was small; therefore, a long-term survival benefit was not demonstrated. However, this study suggests that SDT has potential as a treatment for rGBM and warrants further exploration. Trial information: Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ): ChiCTR2200065992. November 2, 2022, retrospectively registered.

摘要

目的

复发性胶质母细胞瘤(rGBM)预后较差,目前尚无有效的治疗策略。声动力疗法(SDT)是一种新的癌症治疗方法,它利用低频超声和声敏剂联合产生抗肿瘤作用,在临床前研究中已显示出良好的治疗效果。因此,我们开展了一项开放性前瞻性试点研究,以评估SDT治疗rGBM的安全性、耐受性和疗效。

方法

招募了9例rGBM患者,这些患者已接受多种治疗,但病灶仍持续进展且无其他标准治疗方案。经MRI定位后,注射卟啉类药物,并进行为期5天的间歇性低频超声治疗。

结果

该临床试验中的9例患者均未出现与SDT相关的任何临床、神经、血液学或皮肤靶向不良反应。试验完成后,1例患者病情稳定,8例患者病情进展。在8例病情进展的患者中,无进展生存期的中位数为84天。4例患者死亡,复发后的总生存期中位数为202.5天。

结论

本研究的患者数量较少;因此,未证明有长期生存获益。然而,本研究表明SDT作为rGBM的一种治疗方法具有潜力,值得进一步探索。试验信息:中国临床试验注册中心(http://www.chictr.org.cn/):ChiCTR2200065992。2022年11月2日,回顾性注册。

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