Usefulness of immunotherapy combined with chemotherapy for pontine glioma

Introduction: Pontine glioma is a very difficult disease to cure, and it is uncommon to be a surgical indication. Radiotherapy is generally effective, but other therapies must be considered for infants or recurrent cases. Chemotherapy does not have a sufficient effect on such tumors. Therefore, an intensive chemotherapy with additional immunotherapy using human monoclonal antibody (mAb) or interferon (IFN) was studied clinically. Methods: Four pontine glioma patients without surgical indication were treated by “Eight-in-One” chemotherapy (EOC) before or after radiotherapy. If 3 or 4 cycles of this EOC were not sufficient, additional immunotherapy using human mAB CLN-IgG (Hagiwara Institute of Health Science) was applied. CLN-IgG is derived from the lymph node of human uterine cancer and binds to malignant human glioma cells at a high rate. Recently, two pontine glioma cases without surgical indication were treated by IFN-β as immunotherapy in addition to combined chemotherapy of cisplatin (CDDP) and etoposide (VP-16). Results: These chemo-immunotherapies of EOC with mAB were undertaken in four pontine glioma patients including two children and two adults. All patients died in the end, but in one child, the general state was improved a little and a life-prolonging effect was seen, and in another child, the Gd-enhancing effect on MRI was weakened and the size of the tumor was reduced. However, in two adult cases, no changes of MRI findings nor improvement of symptoms were shown. Other chemotherapies of CDDP and VP-16 with IFN-β were undertaken in two pontine glioma patients including one child and one adult. Though the adult case died two years after onset, the child is spending six months in active life. Discussion and Conclusions: Six pontine glioma patients were treated by chemo-immunotherapy, and it is suggested that the chemotherapy followed by immunotherapy may be useful for pontine glioma patients in childhood.