AI Article Synopsis

  • Glioblastoma (GBM) is a fast-growing and aggressive brain tumor with a poor prognosis, where current treatments offer limited survival benefits, prompting the exploration of new therapies like photodynamic therapy (PDT).
  • The INDYGO clinical trial aims to evaluate the feasibility and safety of using intraoperative PDT immediately after the surgical resection of GBM, in conjunction with standard treatments like surgery, radiation, and chemotherapy.
  • The trial will monitor 10 patients for immunological responses and biomarkers, with expectations that combining PDT will not significantly alter the outcomes compared to standard treatment alone, serving as a foundational step for future research.

Article Abstract

Background: Glioblastoma (GBM) is characterized by marked proliferation, major infiltration, and poor prognosis. Despite current treatments, including surgery, radiation oncology, and chemotherapy, the overall median survival is 15 mo and the progression-free survival is 7 to 8 mo. Because of systematic relapse of the tumor, the improvement of local control remains an issue. In this context, photodynamic therapy (PDT) may offer a new treatment modality for GBM.

Objective: To assess the feasibility of intraoperative PDT early after surgical resection of GBM without unacceptable and unexpected toxicities.

Methods: The INDYGO clinical trial (INtraoperative photoDYnamic Therapy for GliOblastomas) treatment will be carried out in addition to the current standard of care (SOC) of glioblastoma: maximum resection surgery followed by concomitant radio-chemotherapy and adjuvant chemotherapy. PDT treatment will be delivered during surgery early, after the fluorescence-guided resection. Immunological responses and biomarkers will also be investigated during the follow-up. A total of 10 patients will be recruited during this study.

Expected Outcomes: Clinical follow-up after the SOC with PDT is expected to be similar (no significant difference) to the SOC alone.

Discussion: This INDYGO trial assesses the feasibility of intraoperative 5-aminolevulinic acid PDT, a novel seamless approach to treat GBM. The technology is easily embeddable within the reference treatment at a low-incremental cost. The safety of this new treatment modality is a preliminary requirement before a multicenter randomized clinical trial can be further conducted to assess local control improvement by treating infiltrating and nonresected GBM cells.

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http://dx.doi.org/10.1093/neuros/nyy324DOI Listing

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