Clinical trial of Serratia marcescens extract and radiation therapy in patients with malignant astrocytoma.
OBJECTIVE
A clinical trial was undertaken to determine the safety and efficacy of combining a biologic response modifier derived from the bacterium Serratia marcescens (ImuVert) and radiation therapy (RT) in patients with newly diagnosed anaplastic astrocytoma (AA) or glioblastoma multiforme (GBM).


METHODS
Fifteen patients who had undergone either a gross total resection, a partial resection, or a biopsy were treated concurrently with ImuVert and RT. Safety and tolerance were examined by assessment of symptomatic reactions recorded at each ImuVert treatment. Efficacy of treatment was examined in terms of time to progression of tumor and survival.


RESULTS
All patients experienced local reactions at the injection sites that consisted of erythema and induration. The majority of patients experienced flu-like symptoms. Hypotension was responsible for the most significant morbidity (which required fluid resuscitation and extended observation) and dose deescalation. No patients were removed from the study because of toxicity. There were no on-study deaths related to ImuVert treatment. Median time to progression was 33.4 weeks, and median survival was 78 weeks.


CONCLUSIONS
These results compare favorably with those of recent studies in patients with malignant astrocytomas who received multimodality therapy.
Black
K L
KL
Division of Neurosurgery, Jonnson Cancer Center, University of California, Los Angeles.
Ciacci
J D
JD
Ammirati
M
M
Selch
M T
MT
Becker
D P
DP
D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D001688:Biological Products; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012706:Serratia marcescens; D016019:Survival Analysis
D001688:Biological Products; D007155:Immunologic Factors; C062792:ImuVert