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Dendritic cell immunotherapy versus bevacizumab plus irinotecan in recurrent malignant glioma patients: a survival gain analysis

Authors Artene S, Turcu-Stiolica A, Hartley R, Ciurea ME, Daianu O, Brindusa C, Alexandru O, Tataranu LG, Purcaru SO, Dricu A

Received 16 May 2016

Accepted for publication 30 July 2016

Published 4 November 2016 Volume 2016:9 Pages 6669—6677


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Dr William Cho

Stefan-Alexandru Artene,1 Adina Turcu-Stiolica,2 Richard Hartley,1 Marius Eugen Ciurea,3 Oana Daianu,1 Corina Brindusa,1 Oana Alexandru,4 Ligia Gabriela Tataranu,5 Stefana Oana Purcaru,1 Anica Dricu1

1Unit of Biochemistry, 2Department of Biostatistics, 3Department of Plastic and Reconstructive Surgery, 4Department of Neurology, University of Medicine and Pharmacy of Craiova, Craiova, 5Department of Neurosurgery, “Bagdasar–Arseni” Emergency Hospital, Bucharest, Romania

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.
Conclusion: 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).

Keywords: malignant glioma, irinotecan, bevacizumab, dendritic cell, systematic analysis

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