Autologus dendritic cell vaccine in GBM, does geography matter? Retrospective analysis from a single institution in India.

Abstract

e14023 Background: Glioblastoma remains a devastating disease, with limited improvements in outcomes despite advancements in surgery and radiotherapy. The addition of autologous tumor lysate-pulsed dendritic cell vaccine (AdCT) to standard care has shown promise, but existing data is scarce and limited, precluding Level 1 recommendation. Further there is almost no data from Asian population especially India. Methods: We conducted a retrospective analysis of 500 glioblastoma patients at our institution, including 21 who received AdCT in the primary or recurrent setting post-chemoradiotherapy. We compared our findings to existing data to determine if patients from a different geographic region benefited similarly. Results: Between February 28, 2022, and April 1, 2024, 21 patients underwent AdCT. Our median overall survival (mOS) was 18 months from surgery (range: 8-34 months). For patients with methylated MGMT (n = 10), mOS was 17 months (range: 13-34 months) from surgery, with a 2-year survival rate of 50%. Four patients (18.1%) survived beyond 30 months, including two without MGMT methylation. No grade 3 or 4 adverse events related to the vaccine were reported. Comparison to Existing Data Our results were compared to a recent Phase 3 trial of AdCT by Liau et al., which reported a median survival of 23.1 months from surgery and a 3-year survival rate of 46.4%. While our numbers were smaller, the comparison suggests that AdCT may not significantly improve average survival amongst our patients in our geography in India. Conclusions: Historically, median survival for glioblastoma patients has ranged from 15-20 months. Our findings suggest that AdCT may not substantially impact average survival. However, the presence of long-term survivors and the lack of severe toxicity warrant further prospective study with controls to establish the treatment's efficacy. Given the limited therapeutic options, we feel compelled to investigate AdCT further.