Abstract
BACKGROUND
The therapeutic potential of virotherapy for malignant glioma has sparked much interest recently, however, little is known about its effect on quality of life (QOL). We sought to explore patients QOL before and after treatment with a neural stem cell (NSC) driven oncolytic adenovirus (CRAd-S-pk7) plus standard of care therapy using the FACT-Brain.
METHODS
Patients with pathologically confirmed high-grade glioma at the time of resection received an intratumoral injection of CRAd-S-pk7. Concurrent radiotherapy to 60Gy with daily temozolomide (75mg/m2) followed, beginning within 7–10 days after surgery. Patients then received 6 cycles of adjuvant temozolomide (150–200 mg/m2) for the first 5 days every 28 days, and then were followed until progression. FACT-Brain was collected at baseline, day 14, day 56 (end of concurrent period), and then every 8 weeks during the adjuvant period.
RESULTS
7 patients have been enrolled to date, all with glioblastoma. Mean FACT-Brain Total and TOI scores at baseline were 162.0 (SD=19.1) and 115.3 (SD=23.8), consistent with expected baseline QOL scores in the newly diagnosed population. Mean scores declined significantly (p=.05 and p<0.01 respectively) by the end of concurrent treatment to 142.7 (SD=31.4) and 99.0 (SD=23.8), rebounded after adjuvant Cycle 1, and were similar to baseline by cycle 2.
CONCLUSION
HGG patients treated with NSC virotherapy have declines in QOL after completing concurrent chemoradiation followed by improvement. This QOL pattern is similar to patients receiving standard treatment and may help clinicians discuss the impact of virotherapy with future patients. In addition, information may assist in evaluating net clinical benefit in future virotherapy studies.