WITHDRAWN: Intranasal GM-CSF enhances efficacy of local ACNU delivery rendezvousing with TMZ plus irradiation in glioblastoma

Abstract

This study aims to investigate the efficacy and safety of intranasal granulocytemacrophage colony stimulating factor (GM-CSF) treatment rendezvousing with chemoradiotherapy for post-operative glioblastoma patients. A total of ninety-two patients were randomized into two groups: control group (n = 46), patients who received radiotherapy with concomitant and adjuvant local delivery of nimustine hydrochloride (ACNU) rendezvousing with systemic administration of temozolomide (TMZ); observation group (n = 46), patients who received intranasal GM-CSF prior to each cycle of adjuvant chemotherapy based on the control group. Karnofsky performance status (KPS) scores, progression-free survival (PFS), overall survival (OS) and adverse effects were compared between these two groups. Two patients in the control group were excluded due to grade 3 hematologic toxicity. Furthermore, the observation group was superior to the control group with regard to PFS (7.8 months vs. 6.9 months, P = 0.016) and OS (19.2 months vs. 17.1 months, P = 0.045 without adjustment for interim analyses). KPS scores was higher in the observation group than in the control group after six months (84.35 ± 8.86, 80.65 ± 7.72; t = 4.552, P = 0.036). Neutropenia and thrombocytopenia decreased in the observation group, with incidences of 8.7% and 8.7%, respectively, when compared with the control group (29.5% and 18.2%, respectively; P = 0.012); while other adverse events were similar in both groups. Most adverse events were grade I-II and resolved spontaneously. Intranasal GM-CSF enhances the efficacy of the local delivery of ACNU rendezvousing with oral TMZ chemotherapy associated with significantly improved survival and quality of life in glioblastoma patients after surgery. This therapy could relieve chemotherapy related neutropenia, and does not increase the adverse events of other aspects.www.impactjournals.com/oncotarget/