Long term survival in a patient with recurrent malignant glioma treated with intratumoral infusion of an IL4-targeted toxin (NBI-3001).
Intratumoral infusion of a recombinant targeted toxin (NBI-3001) consisting of the receptor binding domain of human interleukin 4 (IL-4) and Pseudomonas aeruginosa exotoxin A is an investigational treatment for malignant brain tumors. This 27-year-old male patient presented with a recurrent malignant glioma WHO grade IV after surgery and adjuvant radiation and chemotherapy. The recurrence was treated with intratumoral infusion of NBI-3001 at a dose of 9 microg/ml in 66 ml of infusate. Treatment resulted in long-term survival for 3 years after toxin infusion with a durable tumor response. There were some permanent neurological side effects resulting from toxin infusion. The patient eventually died after a late local recurrence of the known brain tumor. Such clinical evolution of a malignant glioma after a single round of immunotoxin infusion is rather unusual. The late local recurrence may suggest that repeated courses rather than a single infusion of intratumoral toxin are possibly needed for successful long-term tumor control.
Rainov
N G
NG
Department of Neurological Science, University of Liverpool, UK. rainov@liv.ac.uk
Heidecke
V
V
D000328:Adult; D001427:Bacterial Toxins / Q000008:administration & dosage* / Q000009:adverse effects; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D005098:Exotoxins / Q000008:administration & dosage* / Q000009:adverse effects; D005910:Glioma / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D015552:Injections, Intralesional; D015847:Interleukin-4 / Q000008:administration & dosage* / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male
D001427:Bacterial Toxins; D005098:Exotoxins; C479467:interleukin-4-Pseudomonas exotoxin; D015847:Interleukin-4