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Potential new gene therapy option with sitimagene ceradenovec for newly diagnosed patients with glioblastoma multiforme

Glioblastoma multiforme (GBM) is associated with a poor prognosis with a 5-year survival rate of less than 5%, making GBM one of the most aggressive neoplastic malignancies. However significant strides have been made over the past few years with respect to understanding the pathophysiology as well as treatment modalities. The use of local therapies, particularly gene therapy, has been evaluated, but have yet to make a major clinical impact on treatment of GBM. In a study published by Westphal and colleagues in The Lancet Oncology, the use of sitimagene ceradenovec, a first generation replication-deficient adenovirus containing a prodrug converting enzyme, herpes-simplex virus thymidine kinase, followed by intravenous ganciclovir administration and standard therapy was evaluated compared with standard therapy alone. Patients who received sitimagene ceradenovec had improved time to death or re-intervention, but did not show improvement in overall survival. Patients receiving sitimagene ceradenovec experienced more adverse effects related to treatment, including seizures and hyponatremia. While further studies need to be conducted to determine clinical significance, gene therapy appears to be a viable approach for patients who may be resistant to chemotherapy.