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Therapeutic efficacy of specific immunotherapy for glioma: a systematic review and meta-analysis

  • Sara Hanaei , Khashayar Afshari , Armin Hirbod-Mobarakeh , Bahram Mohajer , Delara Amir Dastmalchi and Nima Rezaei EMAIL logo
Published/Copyright: January 10, 2018
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Reviews in the Neurosciences
From the journal Reviews in the Neurosciences Volume 29 Issue 4

Abstract

Although different immunotherapeutic approaches have been developed for the treatment of glioma, there is a discrepancy between clinical trials limiting their approval as common treatment. So, the current systematic review and meta-analysis were conducted to assess survival and clinical response of specific immunotherapy in patients with glioma. Generally, seven databases were searched to find eligible studies. Controlled clinical trials investigating the efficacy of specific immunotherapy in glioma were found eligible. After data extraction and risk of bias assessment, the data were analyzed based on the level of heterogeneity. Overall, 25 articles with 2964 patients were included. Generally, mean overall survival did not statistically improve in immunotherapy [median difference=1.51; 95% confidence interval (CI)=−0.16–3.17; p=0.08]; however, it was 11.16 months higher in passive immunotherapy (95% CI=5.69–16.64; p<0.0001). One-year overall survival was significantly higher in immunotherapy groups [hazard ratio (HR)=0.69; 95% CI=0.52–0.92; p=0.01]. As the hazard rate in the immunotherapy approach was 0.83 of the control group, 2-year overall survival was significantly higher in immunotherapy (HR=0.83; 95% CI=0.69–0.99; p=0.04). Three-year overall survival was significantly higher in immunotherapy as well (HR=0.67; 95% CI=0.48–0.92; p=0.01). Overall, median progression-free survival was significantly higher in immunotherapy (standard median difference=0.323; 95% CI=0.110–0.536; p=0.003). However, 1-year progression-free survival was not remarkably different between immunotherapy and control groups (HR=0.94; 95% CI=0.74–1.18; p=0.59). Specific immunotherapy demonstrated remarkable improvement in survival of patients with glioma and could be a considerable choice of treatment in the future. Despite the current promising results, further high-quality randomized controlled trials are required to approve immunotherapeutic approaches as the standard of care and the front-line treatment for glioma.

Keywords: active immunotherapy; brain neoplasms; glial cell tumor; glioma; passive immunotherapy

Acknowledgments

The whole design of the systematic review was based on the BITERN and Cochrane protocol for conducting systematic reviews and meta-analysis. The manuscript structure and analyses were all applied according to the Cochrane protocol and Review Manager (RevMan) (Version 5.3. The Nordic Cochrane Centre, Copenhagen, Denmark). This study was not funded by any organization or institution.

  1. Conflict of interest statement: The authors have no conflicts of interest to declare. The authors alone are responsible for the content and writing of the paper.

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Supplemental Material:

The online version of this article offers supplementary material (https://doi.org/10.1515/revneuro-2017-0057).

Received: 2017-07-21
Accepted: 2017-10-02
Published Online: 2018-01-10
Published in Print: 2018-06-27

©2018 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/revneuro-2017-0057
Keywords for this article
active immunotherapy; brain neoplasms; glial cell tumor; glioma; passive immunotherapy

Articles in the same Issue

  1. Frontmatter
  2. Neuroanatomy of conversion disorder: towards a network approach
  3. Calcitonin gene-related peptide (CGRP): role in peripheral nerve regeneration
  4. Role of central oxytocin and dopamine systems in nociception and their possible interactions: suggested hypotheses
  5. Mechanisms of disordered neurodegenerative function: concepts and facts about the different roles of the protein kinase RNA-like endoplasmic reticulum kinase (PERK)
  6. Mechanisms of action of intravenous immunoglobulin in septic encephalopathy
  7. Cracking novel shared targets between epilepsy and Alzheimer’s disease: need of the hour
  8. Therapeutic efficacy of specific immunotherapy for glioma: a systematic review and meta-analysis
  9. Crossover design in transcranial direct current stimulation studies on motor learning: potential pitfalls and difficulties in interpretation of findings
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