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

Figures & data

Figure 1 Flowchart of the study selection for the systematic analysis.

Table 1 Basic characteristics of analyzed studies with bevacizumab and irinotecan

Study	Number of patients	Sex (n)		Median age, years (range)	Histology (n)		Treatment
		Male	Female		WHO IV	WHO III
Bokstein et al^Citation47	20	14	6	56 (38–74)	17	3	Bevacizumab (5 mg/kg) + irinotecan (125 mg/m^2) every 14 days
Desjardins et al^Citation42	33	22	11	43 (22–62)	0	33	Bevacizumab (10 mg/kg) + irinotecan (340 mg/m^2 for EIAED; 125 mg/m^2 for non-EIAED) every 14 days, bevacizumab (15 mg/kg) Q21d + irinotecan (340 mg/m^2 for EIAED, 125 mg/m^2 for non-EIAED) on days 1, 8, 22, and 29, on a 6-week cycle
Friedman et al^Citation43	82	57	25	57 (23–79)	82	0	Bevacizumab (10 mg/kg) + irinotecan (340 mg/m^2 for EIAED; 125 mg/m^2 for non-EIAED) every 2 weeks
Kreisl et al^Citation44	48	28	20	53 (21–69)	48	0	Bevacizumab (10 mg/kg) + irinotecan (340 mg/m^2 for EIAED or 125 mg/m^2 for non-EIAED) every 2 weeks
Poulsen et al^Citation48	52	34	18	46 (26–67)	28	24	Bevacizumab (10 mg/kg) + irinotecan (340 mg/m^2 for EIAED; 125 mg/m^2 for non-EIAED) every 2 weeks
Vredenburg et al^Citation45	35	22	13	48 (18–66)	35	0	Bevacizumab (10 mg/kg) + irinotecan (340 mg/m^2 for EIAED; 125 mg/m^2 for non-EIAED) every 14 days, bevacizumab (15 mg/kg) Q21d + irinotecan (340 mg/m^2 for EIAED, 125 mg/m^2 for non-EIAED) on days 1, 8, 22, and 29, on a 6-week cycle
Vredenburg et al^Citation38	32	21	11	49 (27–66)	23	9	Bevacizumab (10 mg/kg) + irinotecan (340 mg/m^2 for EIAED or 125 mg/m^2 for non-EIAED) every 2 weeks

Abbreviations: EIAED, enzyme-inducing antiepileptic drugs; Q21d, every 21 days; WHO, World Health Organization.

Table 2 Basic characteristics of analyzed studies with dendritic cell immunotherapy

Study	Number of patients	Sex (n)		Median age, years (range)	Histology (n)		Treatment
		Male	Female		WHO III	WHO IV
Prins et al^Citation49	8	5	3	51 (26–74)	0	8	Three DC vaccinations every 14 days ± booster injections every 3 months for patients who do not develop toxic side effects or progressive disease
Chang et al^Citation50	8	4	4	36 (24–48)	2	6	DC vaccination every week, four times; then every 2 weeks, two times; then every month, four times
Sakai et al^Citation51	10	3	7	39 (24–64)	4	6	DC vaccination every 14 days for at least 5–7 sessions
Yamanaka et al^Citation46	10	4	6	46.5 (30.3–62.7)	3	7	DC vaccination every 3 weeks, for a maximum of ten sessions
Yamanaka et al^Citation31	24	16	8	46.5 (31–62)	6	18	DC vaccination every 3 weeks for a maximum of ten sessions
Yu et al^Citation29	12	8	4	43 (34.2–51.8)	3	9	DC vaccination every 2 weeks for three sessions
Iwami et al^Citation52	7	5	2	44 (30.4–57.6)	3	4	DC vaccination every 2 weeks for a maximum of six sessions

Abbreviations: DC, dendritic cell; WHO, World Health Organization.

Table 3 Treatment response of bevacizumab plus irinotecan for patients with GBM

Study	Median OS (range), weeks/months	Predicted mOS	Survival gain	Weighted gain
Bokstein et al^Citation47	7 m (95% CI 1.7–16)	7, 37	−0, 37	−1, 67
Desjardins et al^Citation42	65 w	13, 74	2, 46	14, 13
Friedman et al^Citation43	8.7 m (95% CI 7.8–10.9)	7, 88	0, 82	7, 38
Kreisl et al^Citation44	31 w (95% CI 21–54)	7, 11	0, 59	4, 09
Poulsen et al^Citation48	30 w (95% CI 24–37)	10, 75	−3, 25	−23, 41
Vredenburg et al^Citation45	42 w (95% CI 35–60)	4, 44	1, 56	9, 24
Vredenburg et al^Citation38	40 w	7, 66	−1, 96	−11, 09

Abbreviations: GBM, glioblastoma multiforme; OS, overall survival; w, weeks; m, months; CI, confidence interval; mOS, median OS.

Table 4 Treatment response of dendritic cell immunotherapy for patients with GBM

Study	Median OS, months	Predicted mOS	Survival gain	Weighted gain
Prins et al^Citation49	17, 9	20, 40	−2, 50	−7, 08
Chang et al^Citation50	34	35, 12	−1, 12	−3, 17
Sakai et al^Citation51	19	20, 31	−1, 30	−4, 13
Yamanaka et al^Citation46	15, 4	13, 73	1, 67	5, 28
Yamanaka et al^Citation31	15, 48	17, 92	−2, 44	−11, 95
Yu et al^Citation29	28, 5	18, 98	9, 52	32, 97
Iwami et al^Citation52	7, 5	11, 39	−3, 89	−10, 99

Abbreviations: GBM, glioblastoma multiforme; OS, overall survival; mOS, median OS.

Figure 2 Survival gain for the treatment protocols.

Notes: (A) Survival gain distribution in bevacizumab plus irinotecan group and (B) survival in the dendritic cell immunotherapy group. The two treatments did not show any benefit in survival time for patients with GBM.
Abbreviations: GBM, glioblastoma multiform; SD, standard deviation.

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