Glioblastoma multiforme (GBM) is associated with a poor prognosis with a 5-year survival rate of less than 5%, making GBM one of the most aggressive neoplastic
malignancies. However significant strides have been made over the past few years with respect to understanding the pathophysiology as well as treatment modalities. The use of local
therapies, particularly gene therapy, has been evaluated, but have yet to make a major clinical impact on treatment of GBM. In a study published by Westphal and colleagues in The Lancet Oncology, the use of
sitimagene ceradenovec, a first generation replication-deficient adenovirus containing a
prodrug converting
enzyme, herpes-simplex virus
thymidine kinase, followed by intravenous
ganciclovir administration and standard
therapy was evaluated compared with standard
therapy alone. Patients who received
sitimagene ceradenovec had improved time to death or re-intervention, but did not show improvement in overall survival. Patients receiving
sitimagene ceradenovec experienced more adverse effects related to treatment, including
seizures and
hyponatremia. While further studies need to be conducted to determine clinical significance, gene therapy appears to be a viable approach for patients who may be resistant to
chemotherapy.