Valganciclovir as Add-on to Standard Therapy in Glioblastoma Patients

Clin Cancer Res. 2020 Aug 1;26(15):4031-4039. doi: 10.1158/1078-0432.CCR-20-0369. Epub 2020 May 18.

Abstract

Purpose: Several groups have reported a prevalence of human cytomegalovirus (CMV) in glioblastoma close to 100%. Previously, we reported that treatment with the antiviral drug valganciclovir as an add-on to standard therapy significantly prolonged survival in 50 patients with glioblastoma. Here, we present an updated retrospective analysis that includes an additional 52 patients.

Experimental design: From December 2006 to November 2019, 102 patients with newly diagnosed glioblastoma received valganciclovir as an add-on to standard therapy. No additional toxicity was observed. Contemporary controls were 231 patients with glioblastoma who received similar baseline therapy.

Results: Patients with newly diagnosed glioblastoma receiving valganciclovir had longer median overall survival (OS 24.1 vs. 13.3 months, P < 0.0001) and a 2-year survival rate (49.8% vs. 17.3%) than controls. Median time-to-tumor progression was also longer than in controls; 9.9 (0.7-67.5 months) versus 7.3 (1.2-49 months), P = 0.0003. Valganciclovir improved survival in patients with radical or partial resection and an unmethylated or methylated MGMT promoter gene.

Conclusions: Valganciclovir prolonged median OS of patients with newly diagnosed glioblastoma (with methylated or unmethylated MGMT promoter gene) and was safe to use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / genetics
  • Brain Neoplasms / mortality
  • DNA Methylation
  • DNA Modification Methylases / genetics
  • DNA Repair Enzymes / genetics
  • Disease Progression
  • Female
  • Glioblastoma / diagnosis
  • Glioblastoma / drug therapy*
  • Glioblastoma / genetics
  • Glioblastoma / mortality
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Promoter Regions, Genetic
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Tumor Suppressor Proteins / genetics
  • Valganciclovir / administration & dosage*
  • Valganciclovir / adverse effects
  • Young Adult

Substances

  • Tumor Suppressor Proteins
  • DNA Modification Methylases
  • MGMT protein, human
  • DNA Repair Enzymes
  • Valganciclovir