UP - logo
E-resources
Full text
Peer reviewed Open access
  • L-RNA aptamer-based CXCL12 ...
    Giordano, Frank A; Layer, Julian P; Leonardelli, Sonia; Friker, Lea L; Turiello, Roberta; Corvino, Dillon; Zeyen, Thomas; Schaub, Christina; Müller, Wolf; Sperk, Elena; Schmeel, Leonard Christopher; Sahm, Katharina; Oster, Christoph; Kebir, Sied; Hambsch, Peter; Pietsch, Torsten; Bisdas, Sotirios; Platten, Michael; Glas, Martin; Seidel, Clemens; Herrlinger, Ulrich; Hölzel, Michael

    Nature communications, 05/2024, Volume: 15, Issue: 1
    Journal Article

    The chemokine CXCL12 promotes glioblastoma (GBM) recurrence after radiotherapy (RT) by facilitating vasculogenesis. Here we report outcomes of the dose-escalation part of GLORIA (NCT04121455), a phase I/II trial combining RT and the CXCL12-neutralizing aptamer olaptesed pegol (NOX-A12; 200/400/600 mg per week) in patients with incompletely resected, newly-diagnosed GBM lacking MGMT methylation. The primary endpoint was safety, secondary endpoints included maximum tolerable dose (MTD), recommended phase II dose (RP2D), NOX-A12 plasma levels, topography of recurrence, tumor vascularization, neurologic assessment in neuro-oncology (NANO), quality of life (QOL), median progression-free survival (PFS), 6-months PFS and overall survival (OS). Treatment was safe with no dose-limiting toxicities or treatment-related deaths. The MTD has not been reached and, thus, 600 mg per week of NOX-A12 was established as RP2D for the ongoing expansion part of the trial. With increasing NOX-A12 dose levels, a corresponding increase of NOX-A12 plasma levels was observed. Of ten patients enrolled, nine showed radiographic responses, four reached partial remission. All but one patient (90%) showed at best response reduced perfusion values in terms of relative cerebral blood volume (rCBV). The median PFS was 174 (range 58-260) days, 6-month PFS was 40.0% and the median OS 389 (144-562) days. In a post-hoc exploratory analysis of tumor tissue, higher frequency of CXCL12 endothelial and glioma cells was significantly associated with longer PFS under NOX-A12. Our data imply safety of NOX-A12 and its efficacy signal warrants further investigation.