Primary Objective: To evaluate the safety and tolerability of targeted Survivin DC cell injection for postoperative treatment of newly diagnosed primary glioblastoma multiforme. Secondary Objectives: Utilize progression-free survival (PFS) and overall survival (OS) to preliminarily assess the effectiveness of targeted Survivin DC cell injection for postoperative treatment of newly diagnosed primary glioblastoma multiforme in China. Evaluate the immunological effects of targeted Survivin DC cell injection. Explore the impact of targeted Survivin DC cell injection on human DC cell activity and in vivo processes. Patients will undergo a combined treatment of radiotherapy and temozolomide (TMZ) for a duration of 6 weeks, with concurrent chemotherapy. After completing this phase, there will be a 4-week interval (28 days) before entering multiple cycles of adjuvant TMZ chemotherapy. Each cycle will last 28 days, involving daily oral administration of temozolomide at a dose of 150-200mg/m2 for 5 consecutive days, followed by a 23-day drug-free period. This entire cycle will be repeated every 28 days. Nine days after completing the standard 6-week concurrent chemoradiotherapy, targeted Survivin DC cell injections will be administered. The injections will be given on days 0, 14, and 28. The administration will involve both intradermal (ID) and intravenous (IV) routes. Four hours before the administration, the injection sites will be pre-treated with lidocaine cream. The injection procedures will be conducted sequentially, starting with ID injection. After completing the ID injection, a 30-minute observation will be conducted. If no adverse reactions are observed, IV infusion will be initiated. Both IV infusion and ID injection will be performed on the same side. Intradermal Injection: Draw 1ml of cell suspension with a 1ml syringe, and the remaining cell product will be stored at 2-8℃. Administer the drug immediately after preparation. Intravenous Infusion: Before administration, infuse 20ml of normal saline through IV.Extract 25ml of normal saline, dilute the remaining cell product (5ml), and administer it through IV infusion. Control the room temperature during infusion and complete it within 30 minutes. After administration, inject 50ml of normal saline into the cell bag to ensure all cell products are returned to the patient's body.
The trial was designed as an open-label, dose-escalation trial. This study is divided into two phases: a dose escalation phase and an expansion cohort phase. Dose escalation phase: This project is for 3 immunizations, and the tolerability and efficacy of 3 immunizations are evaluated. Expansion cohort phase: Based on the safety and efficacy data of the dose escalation phase, combined with safety and immune effect indicators, the dosage and sample size of the expansion cohort study were formulated, their safety and efficacy were evaluated, and the appropriate dose was recommended for subsequent clinical trials. The sample size of the dose escalation test was planned to be 9\~18 cases, and the number of cases in the expansion cohort study was estimated according to the data of the previous dose escalation test. A total of 3 dose groups were set up for Survivin DC cell injection, which were 1×107 DCs, 2×107 DCs, and 3×107 DCs, and the preparation specification was 6ml. Intradermal administration and intravenous administration are allocated according to a ratio of 1:5, 1ml intradermally and 5ml intravenously.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
The injections will be given on days 0, 14, and 28. The administration will involve both intradermal (ID) and intravenous (IV) routes.
Dose Limiting Toxicity
The following adverse events that occurred within 28 days after the first dose to the third dose, as judged by the investigator, to be related to the study drug
Time frame: 28 days
Progression Free Survival Progression Free Survival
The time from the date of first dose to the occurrence of disease progression or death due to any cause
Time frame: 2 years
Overall Survival
The time from the date of first dose to death due to any cause in the subject
Time frame: 2 years
Immune effect
Anti-Sauvignon antibody test;
Time frame: 84 days
Cytokine
Cytokine (IL-6, IL-8, IL-10, TNF-α, IFN-γ, TGF-β) detection;
Time frame: 56 days
Specific T cell responses
Specific T cell responses (Survivin-specific CD4+/CD8+ T cell responses)
Time frame: 84 days
DC cell activity and in vivo processes
The quantitative detection of the content of Survivin fusion gene in blood RNA was limited to the quantitative detection of the transcription level of Survivin fusion gene in patients.
Time frame: 35 days
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