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Sustained radiographic and clinical response in patient with bifrontal
recurrent glioblastoma multiforme with intracerebral infusion of the
recombinant targeted toxin TP-38: Case study
John H. Sampson, David
A. Reardon, Allan H. Friedman, Henry S. Friedman, R. Edward Coleman,
Roger E. McLendon, Ira Pastan, and Darell D. Bigner
Duke University Medical
Center, Durham, NC 27710 (J.H.S., D.A.R., A.H.F., H.S.F., R.E.C.,
R.E.M., D.D.B.); National Institutes of Health, Bethesda, MD 20892
(I.P.); USA. Address correspondence to John H. Sampson, Box 3050, Duke
University Medical Center, 220 Sands Building, Research Drive, Durham,
NC 27710 USA (john.sampson@duke.edu).
Glioblastoma multiforme remains
refractory to conventional therapy, and novel therapeutic modalities
are desperately needed.
TP-38 is a recombinant chimeric protein
containing a genetically engineered form of the cytotoxic Pseudomonas
exotoxin fused to transforming growth factor (TGF)-&alpha.
TGF-&alpha binds with high affinity to
the epidermal growth factor receptor, which is uniformly overexpressed
in malignant gliomas, often because of gene amplification.
Prior to therapy with TP-38, the patient
described here was completely refractory to multiple other therapies,
with radiographic and pathologic evidence of tumor progression.
After therapy, she improved clinically,
was weaned off steroids and anticonvulsants, and experienced a
progressive decrease in enhancing tumor volume.
Despite multiple prior recurrences, she
has not progressed for >43 months after TP-38 therapy.
Small remaining areas of enhancement
demonstrate no evidence of tumor histologically and are hypometabolic
on positron emission tomography.
This report describes a dramatic and
sustained clinical and radiographic response in a patient with a
bifrontal glioblastoma multiforme treated with intratumoral infusion
of a novel targeted toxin, TP-38.
© 2005 Duke University Press
Source: http://ariel.ingentaselect.com/cgi-bin/linker?ini=dup_no&reqidx=/cw/dup/15228517/v7n1/s10/p90&user_id=undefined
DOI: http://dx.doi.org/10.1215/S1152851703000589
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