title: Combined treatment of pediatric high-grade glioma with the oncolytic viral strain MTH-68/H and oral valproic acid.
abstract: The case of a 12-year-old boy with anaplastic astrocytoma of the left thalamus is reported. Postoperative irradiation and chemotherapy could not repress tumor progression; therefore, treatment was undertaken with an oncolytic virus, MTH-68/H, an attenuated strain of Newcastle disease virus (NDV), and valproic acid (VPA), an antiepileptic drug, which also has antineoplastic properties. This treatment resulted in a far-reaching regression of the thalamic glioma, but 4 months later a new tumor manifestation, an extension of the thalamic tumor, appeared in the wall of the IVth ventricle, which required a second neurosurgical intervention. Under continuous MTH-68/H - VPA administration the thalamic tumor remained under control, but the rhombencephalic one progressed relentlessly and led to the fatal outcome. In the final stage, a third tumor manifestation appeared in the left temporal lobe. The possible reasons for the antagonistic behavior of the three manifestations of the same type of glioma to the initially most successful therapy are discussed. The comparative histological study of the thalamic and rhombencephalic tumor manifestations revealed that MTH-68/H treatment induces, similar to in vitro observations, a massive apoptotic tumor cell decline. In the rhombencephalic tumor, in and around the declining tumor cells, NDV antigen could be demonstrated immunohistochemically, and virus particles have been found in the cytoplasm of tumor cells at electron microscopic investigation. These findings document that the oncolytic effect of MTH-68/H treatment is the direct consequence of virus presence and replication in the neoplastic cells. This is the first demonstration of NDV constituents in an MTH-68/H -treated glioma.
authors.affiliation: Dept. of Pediatric Oncology, Krankenhaus der Barmherzigen Brüder, Klinik St. Hedwig, University of Regensburg.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wagner
authors.forename: Christine M
authors.initials: CM
authors.lastname: Csatary
authors.forename: Georg
authors.initials: G
authors.lastname: Gosztonyi
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Koch
authors.forename: Christian
authors.initials: C
authors.lastname: Hartmann
authors.forename: Ove
authors.initials: O
authors.lastname: Peters
authors.forename: Pablo
authors.initials: P
authors.lastname: Hernáiz-Driever
authors.forename: Agota
authors.initials: A
authors.lastname: Théallier-Janko
authors.forename: Felix
authors.initials: F
authors.lastname: Zintl
authors.forename: Alfred
authors.initials: A
authors.lastname: Längler
authors.forename: Johannes E A
authors.initials: JE
authors.lastname: Wolff
authors.forename: Laszlo K
authors.initials: LK
authors.lastname: Csatary
mesh_terms: D000284:Administration, Oral; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D000956:Antigens, Viral / Q000032:analysis / Q000378:metabolism; D001254:Astrocytoma / Q000188:drug therapy* / Q000628:therapy*; D001921:Brain / Q000821:virology; D001932:Brain Neoplasms / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D003593:Cytoplasm / Q000821:virology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009522:Newcastle disease virus / Q000276:immunology; D012008:Recurrence; D013788:Thalamus / Q000473:pathology; D014635:Valproic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D014765:Viral Vaccines / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D000956:Antigens, Viral; C424862:Newcastle disease virus vaccine MTH-68-H; D014765:Viral Vaccines; D014635:Valproic Acid