Long-term treatment of malignant gliomas with intramuscularly administered polyinosinic-polycytidylic acid stabilized with polylysine and carboxymethylcellulose: An open pilot study

Andres M. Salazar*, Hilton B. Levy, Steven Ondra, Meir Kende, Barbara Scherokman, Douglas Brown, Hernando Mena, Norman Martin, Karen Schwab, Daniel Donovan, David Dougherty, Morris Pulliam, Mark Ippolito, Maria Graves, Herbert Brown, Alex Ommaya

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

115 Scopus citations

Abstract

POLYINOSINIC-POLYCYTIDYLIC ACID STABILIZED with polylysine and carboxymethylcellulose (poly-ICLC) (10-50 mcg/kg, administered intramuscularly one to three times weekly) was given for ≤56 months to 38 patients with malignant gliomas. There was minimal or no toxicity. Twenty of 30 patients (66%) receiving at least twice weekly poly-ICLC showed regression or stabilization of gadolinium-enhancing tumor, as revealed by magnetic resonance imaging (median = 65% volume decrease). All but one patient with anaplastic astrocytomas who received continuous poly-ICLC remain alive, with a median progression-free survival of 54 months from diagnosis. Median Kaplan-Meier survival is 19 months for patients with glioblastomas who receive at least twice weekly poly-ICLC treatments. Tumor response was associated with 2',5'-oligoadenylate synthetase activation (P = 0.03) but not with serum interferon. We hypothesize clinical activation by poly-ICLC of a basic host tumor suppressor system. Prolonged, quality survival with tumor stabilization or regression confirmed by magnetic resonance imaging for most patients with anaplastic astrocytomas and glioblastomas suggests that more extensive laboratory and controlled clinical studies are warranted. The concept of long-term, broad spectrum stimulation of host defenses with nontoxic, inexpensive double-stranded ribonucleic acids, such as low-dose poly-ICLC, may be applicable to the treatment of other malignancies.

Original languageEnglish
Pages (from-to)1096-1104
Number of pages9
JournalNeurosurgery
Volume38
Issue number6
DOIs
StatePublished - Jun 1996
Externally publishedYes

Keywords

  • Interferon
  • Malignant glioma
  • Oligoadenylate
  • Poly-ICLC
  • Tumor suppressors
  • dsRNA

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