Treatment > Immunotherapy

Meeting Abstract

Intracavitary placement of lymphokine-activated killer (LAK) cells after resection of recurrent glioblastoma

R. O. Dillman, C. Duma, P. M. Schiltz, C. Depriest, L. Beutel, K. Okamoto, C. De Leon

Hoag Cancer Ctr, Newport Beach, CA

The purpose of this research was to obtain safety and preliminary efficacy data for the use of LAK placed intralesionally in patients with surgically proven recurrent glioblastoma.
Between 1/98-7/02 40 such patients underwent at least partial resection of tumor and placement of autologous LAK cells into the surgical cavity as localized adoptive cell immunotherapy.
There were 23 men and 17 women aged 21-76 years with a median age of 48.
All had undergone prior surgery and external beam radiation therapy; 25 had undergone prior gamma knife therapy; 19 had received chemotherapy; 7 had prior placement of BCNU wafers.
18 lesions were in the frontal lobe and 22 non-frontal.
Median survival from the date of original diagnosis of a malignant brain tumor to the date of LAK treatment was 10.9 months.
Peripheral blood lymphocytes (PBL) were harvested without cytokine mobilization using a single 4-hour leukapheresis.
Mean number of PBL collected was 3.6 ± 1.88 x 10⁹ that yielded 2.0 ± 1.04 LAK, with viability of 91 ± 6.8%.
Cells were placed intraoperatively in 37 patients, via Ommaya reservoir in 2 patients, and stereotactically in 1.
In 23 patients LAK cells were suspended in 1.0 MU IL-2.
Treatment was well tolerated with no late complications related to therapy.
At a median follow up of 2.4 years after LAK instillation, 32 patients have died, 8 are alive at 3.1 to 31.4 months, with a median survival post-LAK therapy of 9.0 months.
In univariate subset analyses, gender, age, location of tumor, addition of IL-2 at the time of cell instillation, and number of cells implanted were unrelated to outcome.
Survival results are being compared to a matched control group of patients who underwent surgery for recurrent glioblastoma; results of this comparison will be available at the time of presentation.
This treatment is feasible, and the survival post-therapy is encouraging.

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