Survival Advantage Seen in Glioblastoma Patients Taking Valganciclovir
Valganciclovir (Valcyte), a drug used to treat cytomegalovirus (CMV) eye infections in people with HIV/AIDS, may lengthen survival in patients with glioblastoma, a Swedish study has found. The researchers evaluated 50 patients with glioblastoma who received valganciclovir as an add-on to standard therapy at Karolinska University Hospital in Stockholm, Sweden. Many of the patients were given the antiviral drug as part of a compassionate use program at the hospital. The study was reported in The New England Journal of Medicine.
Promising Outcomes
Cecilia Söderberg-Nauclér, MD, PhD, Professor in the Department of Medicine at the Karolinska Institute, and colleagues found that the rate of survival of patients with glioblastoma who were treated with valganciclovir was remarkably high compared to the control group of 137 patients who were treated for glioblastoma at the same hospital around the same time, but were not given the antiviral therapy.
After 2 years, 62% of patients treated with valganciclovir were still alive, compared with 18% of contemporary controls with a similar disease stage, surgical-resection grade, and baseline treatment (P < .001). The median overall survival was 25.0 months, compared with 13.5 months in the controls (P < .001). The median survival was higher among 40 patients who received at least 6 months of valganciclovir; their 2-year survival rate was 70%, and their median overall survival was 30.1 months (P < .001).
Twenty-five patients who received continuous valganciclovir after the first 6 months experienced the highest survival rate—90% at 2 years—and had a median overall survival of 56.4 months (P < .001).
Role in Cancer Development?
The researchers wrote: “It is unlikely that any bias in patient selection could have resulted in these high rates of survival,” and stressed the need for a randomized clinical trial targeting CMV in patients with glioblastoma. In an additional analysis of more than 250 cases of glioblastoma, the researchers found only one patient was CMV-negative. Furthermore, of the 75 patients evaluated, the median rate of overall survival was 33 months in those with low-grade CMV infection and 13 months in those with high-grade CMV infection, suggesting that the virus may play a role in cancer development and contributes to tumor progression.
Despite significant advances in the basic understanding of glioblastoma pathogenesis, the prognosis for patients with this disease remains dismally low, with a median overall survival of between 12 and 14 months and a 2-year survival rate between 15% and 26%.
The study research was partially funded by Hoffmann-La Roche.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
