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AdvHSV-tk gene therapy with intravenous ganciclovir improves survival in human malignant glioma: A randomised, controlled study
Author(s): Immonen A, Vapalahti M, Tyynela K, Hurskainen H, Sandmair A, Vanninen R, Langford G, Murray N, Yla-Herttuala S
Source: MOLECULAR THERAPY    Volume: 10    Issue: 5    Pages: 967-972    Published: NOV 2004  
Times Cited: 114     References: 24     
Abstract: Malignant glioma is a devastating brain tumour with no effective treatment. This randomised, controlled study involved 36 patients with operable primary or recurrent malignant glioma. Seventeen patients were randomised to receive AdvHSV-tk gene therapy (3 x 1010 pfu) by local injection into the wound bed after tumour resection, followed by intravenous ganciclovir (GCV), 5 mg/kg twice daily for 14 days. The control group of 19 patients received standard care consisting of radical excision followed by radiotherapy in those patients with primary tumours. The primary endpoint was survival as defined by death or surgery for recurrence. Secondary end-points were all-cause mortality and tumour progression as determined by MRI. Overall safety and quality of life were also assessed. Findings were also compared with historical controls (n = 36) from the same unit over 2 years preceding the study. AdvHSV-tk treatment produced a clinically and statistically significant increase in mean survival from 39.0 +/- 19.7 (SD) to 70.6 +/- 52.9 weeks (P = 0.0095, log rank regression vs. randomized controls). The median survival time increased from 37.7 to 62.4 weeks. Six patients had increased anti-adenovirus antibody titers, without adverse effects. The treatment was well tolerated. It is concluded that AdvHSV-tk gene therapy and GCV is a potential new treatment for operable primary or recurrent high-grade glioma.
Document Type: Article
Language: English
Reprint Address: Yla-Herttuala, S (reprint author), Univ Kuopio, AI Virtanen Inst, Dept Mol Med, POB 1627, FIN-70211 Kuopio, Finland
Addresses:
1. Univ Kuopio, AI Virtanen Inst, Dept Mol Med, FIN-70211 Kuopio, Finland
2. Univ Kuopio, Dept Neurosurg, FIN-70211 Kuopio, Finland
3. Univ Kuopio, Dept Oncol, FIN-70211 Kuopio, Finland
4. Univ Kuopio, Dept Radiol, FIN-70211 Kuopio, Finland
5. Univ Kuopio, Gene Therapy Unit, FIN-70211 Kuopio, Finland
6. Ark Therapeut Ltd, London, England
7. Univ Kuopio, Dept Med, FIN-70211 Kuopio, Finland
Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE, 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
Subject Category: Biotechnology & Applied Microbiology; Genetics & Heredity; Medicine, Research & Experimental
IDS Number: 879II
ISSN: 1525-0016
DOI: 10.1016/j.ymthe.2004.08.002
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