Injection of genetically modified poliovirus directly in brain tumors allowed patients with gliomas to live longer, according to a study recently published in the New England Journal of Medicine. Only 21% of the patients were alive 3 years after treatment, however, with most glioma patients surviving less than 20 months on standard treatment, the team of researchers at Duke University believes that these results are sufficient enough to continue testing the vaccine on more people.
Accounting for one-third of the 80,000 brain tumors diagnosed a year, most gliomas are usually fatal. The average survival rate for patients with brain tumors is 34.7%, and those with a glioblastoma, a type of glioma, have a median survival time of 15 to 16 months with surgery, chemotherapy, and radiation treatment. With some glioma patients having survival times of over 6 years following the modified poliovirus injection, researchers are astounded at the results from trials thus far.
“It’s very unusual, almost unprecedented to get this kind of long-term survival.” -Dr. Darell Bigner, Head Researcher
61 patients were involved in the research from May 2012 to May 2017, all of which with essentially no existing treatment options left to try. Stephanie Hopper, diagnosed with a glioblastoma at the age of 20, was the first of these patients to be treated with the modified poliovirus vaccine. Stephanie is still alive and working as a nurse over 6 years since her treatment.
19% of the patients in this trial experienced notable adverse events, 45% had seizures, over a quarter experienced aphasia, over half had headaches, and half experienced partial weakness of paralysis. Two patients died during the trial. One patient suffered hemorrhage and aphasia but survived almost 5 years after treatment. Several of these side effects could be a result of the glioma itself rather than the treatment.
Dr. Bigner claims that the inflammatory nature of the poliovirus causes side effects due to swelling in the brain. The team used Avastin, a cancer pharmaceutical, to combat the swelling. The team is unsure why the treatment works in some and is unsuccessful in others and hopes to find a way to produce effectiveness in all patients treated.
Polio + Brain tumor?https://t.co/kNVQ7XvJ5E #OA @NEJM #cancer
61 patients Rx’d w/ local, nonpathogenic polio–rhinovirus chimera Rx
Rare instance when use of historical controls is reasonable pic.twitter.com/pxg5w1iNBp— Eric Topol (@EricTopol) June 26, 2018
When comparing the 61 patients treated to previous patients, researchers found that most of those who were not treated with the modified poliovirus died at an average of 11 months after onset of glioma, only 14% were alive after 2 years, and only 4% after 3 years. With 21% of the patients treated with the vaccine surviving to the three-year mark, 8 having no signs of tumor growth, and 2 having no tumor at all in 2018, the results from this study are promising.
Sources: NBC News, NEJM, Science News, Healthline
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