A new EGFRvIII vaccine added to therapy for patients with glioblastomas, the most aggressive and deadly of brain cancers, has been found to extend their survival time as well as giving them a much longer progression-free survival period, according to scientists at The University of Texas MD Anderson Cancer Center and Duke University Medical Center, in an article published in the Journal of Clinical Oncology. The vaccine blocks a growth factor that fuels the brain cancer’s aggressiveness.

John Sampson, M.D., Ph.D., the Robert H. and Gloria Wilkins Professor of Neurosurgery at Duke, said:

About a third of all glioblastomas are fueled by a very aggressive cancer gene, called EGFRvIII; these tumors are the ‘worst of the worst’. Our study showed that the vaccine eliminated all of the cancer cells carrying this marker in all but one of our study participants,” said Darell D. Bigner, M.D., Ph.D., director of the Preston Robert Tisch Brain Tumor Center and the senior author of the study.

Bert Vogelstein and Albert Wong, from Johns Hopkins University and Bigner, at Duke co-discovered the EGFRvIII variant.

The researchers compared 18 patients who had been recently diagnosed with glioblastomas to 17 other patients (controls). Both groups of patients received surgery, radiotherapy and chemotherapy (temozolomide). One month after radiation therapy had been completed, the vaccine group participants started receiving their injections – they continued receiving the vaccine as long as it appeared to be effective. The control group received the same treatment, but without the injections.

The authors wrote that:

  • Those in the vaccine group experienced a median survival time of 26 months, compared to 15 months which was typically the case.
  • Participants in the vaccine group experienced 14.2 months average progression-free survival, versus 6.3 months for those without the vaccine.

Approximately 10,000 people are diagnosed with gioblastoma every year in the USA – it is the most common from of cancer of the brain. Prognosis for patients with gioblastoma is not usually good, despite some advances in radiotherapy and chemotherapy. Most patients survive for about 12 months after diagnosis.

Dr. Sampsom and colleagues have been researching new vaccine strategies for the last ten years. This current vaccine is called a peptide vaccine and was created to encourage the individual’s immune system to respond to a specific part of a protein on EGFRvIII.

Dr. Sampson adds that other vaccines are currently being investigated at various research centers.

Scientists say that CDX-110, by Celldex Therapeutics, and Rindopepimut (PF-04948568) by Pfizer stimulated an immune response in about 50% of patients; six of them developed EGFRvIII-specific antibodies, while three developed T-cell responses.

“Immunologic Escape After Prolonged Progression-Free Survival With Epidermal Growth Factor ReceptorVariant III Peptide Vaccination in Patients With NewlyDiagnosed Glioblastoma”
John H. Sampson, Amy B. Heimberger, Gary E. Archer, Kenneth D. Aldape, Allan H. Friedman, Henry S. Friedman, Mark R. Gilbert, James E. Herndon II, Roger E. McLendon, Duane A. Mitchell, David A. Reardon, Raymond Sawaya, Robert J. Schmittling, Weiming Shi, James J. Vredenburgh and Darell D. Bigner
Journal of Clinical Oncology
Published online before print October 4, 2010, doi: 10.1200/JCO.2010.28.6963 JCO.2010.28.6963

Written by Christian Nordqvist