SurVaxM plus adjuvant temozolomide in newly diagnosed glioblastoma

Glioblastoma is a malignancy with poor survival times and few therapeutic options, with the most effective regimen consisting in radiation therapy with concurrent temozolomide (TMZ) followed by adjuvant TMZ. Malignant gliomas express survivin, one of the most ubiquitous cancer-associated antigens, at high levels whereas normal glial cells do not; thus, a new phase IIa study studied SurVaxM, a peptide vaccine conjugate that has been shown to activate the immune system against its target molecule survivin. The results, recently published in Journal of Clinical Oncology, are encouraging and show that the combination could represent a promising strategy for newly diagnosed glioblastoma.

The study involved 64 patients with newly diagnosed resected glioblastoma; following craniotomy and fractionated radiation therapy with concurrent TMZ, patients received four doses of SurVaxM (500 mg once every 2 weeks, subcutaneously), then adjuvant TMZ and maintenance SurVaxM concurrently until progression. SurVaxM plus TMZ was well tolerated with no serious adverse events attributable to SurVaxM. Six months after diagnosis, 95.2% (60/63) of evaluable patients remained progression-free. Measured from first SurVaxM dose, median progression-free survival was 11.4 months and median overall survival was 25.9 months. Patients generated survivin-specific immune responses, and antibody response was positively associated with survival. «Treatment with SurVaxM in combination with TMZ following chemoradiation may extend survival for patients with newly diagnosed glioblastoma. A randomized trial is underway to determine whether adding SurVaxM to TMZ chemotherapy is better than TMZ treatment alone in these patients», authors conclude.