title: Dendritic cell immunotherapy versus bevacizumab plus irinotecan in recurrent malignant glioma patients: a survival gain analysis.
abstract: BACKGROUND
  The bevacizumab and irinotecan protocol is considered a standard treatment regimen for recurrent malignant glioma. Recent advances in immunotherapy have hinted that vaccination with dendritic cells could become an alternative salvage therapy for the treatment of recurrent malignant glioma.
  
  
  METHODS
  A search was performed on PubMed, Cochrane Library, Web of Science, ScienceDirect, and Embase in order to identify studies with patients receiving bevacizumab plus irinotecan or dendritic cell therapy for recurrent malignant gliomas. The data obtained from these studies were used to perform a systematic review and survival gain analysis.
  
  
  RESULTS
  Fourteen clinical studies with patients receiving either bevacizumab plus irinotecan or dendritic cell vaccination were identified. Seven studies followed patients that received bevacizumab plus irinotecan (302 patients) and seven studies included patients that received dendritic cell immunotherapy (80 patients). For the patients who received bevacizumab plus irinotecan, the mean reported median overall survival was 7.5 (95% confidence interval [CI] 4.84-10.16) months. For the patients who received dendritic cell immunotherapy, the mean reported median overall survival was 17.9 (95% CI 11.34-24.46) months. For irinotecan + bevacizumab group, the mean survival gain was -0.02±2.00, while that for the dendritic cell immunotherapy group was -0.01±4.54.
  
  
  CONCLUSIONS
  For patients with recurrent malignant gliomas, dendritic cell immunotherapy treatment does not have a significantly different effect when compared with bevacizumab and irinotecan in terms of survival gain (P=0.535) and does not improve weighted survival gain (P=0.620).
authors.affiliation: Unit of Biochemistry.
authors.forename: Stefan-Alexandru
authors.initials: SA
authors.lastname: Artene
authors.affiliation: Department of Biostatistics.
authors.forename: Adina
authors.initials: A
authors.lastname: Turcu-Stiolica
authors.affiliation: Unit of Biochemistry.
authors.forename: Richard
authors.initials: R
authors.lastname: Hartley
authors.affiliation: Department of Plastic and Reconstructive Surgery.
authors.forename: Marius Eugen
authors.initials: ME
authors.lastname: Ciurea
authors.affiliation: Unit of Biochemistry.
authors.forename: Oana
authors.initials: O
authors.lastname: Daianu
authors.affiliation: Unit of Biochemistry.
authors.forename: Corina
authors.initials: C
authors.lastname: Brindusa
authors.affiliation: Department of Neurology, University of Medicine and Pharmacy of Craiova, Craiova.
authors.forename: Oana
authors.initials: O
authors.lastname: Alexandru
authors.affiliation: Department of Neurosurgery, "Bagdasar-Arseni" Emergency Hospital, Bucharest, Romania.
authors.forename: Ligia Gabriela
authors.initials: LG
authors.lastname: Tataranu
authors.affiliation: Unit of Biochemistry.
authors.forename: Stefana Oana
authors.initials: SO
authors.lastname: Purcaru
authors.affiliation: Unit of Biochemistry.
authors.forename: Anica
authors.initials: A
authors.lastname: Dricu
keywords: bevacizumab; dendritic cell; irinotecan; malignant glioma; systematic analysis