• Neurosurgery · Jun 2019

    INtraoperative photoDYnamic Therapy for GliOblastomas: Study Protocol for a Phase I Clinical Trial.

    • Clément Dupont, Maximilien Vermandel, Henri-Arthur Leroy, Mathilde Quidet, Fabienne Lecomte, Nadira Delhem, Serge Mordon, and Nicolas Reyns.
    • University of Lille, Inserm, CHU Lille, ONCO-THAI - Image Assisted Laser Therapy for Oncology, Lille, France.
    • Neurosurgery. 2019 Jun 1; 84 (6): E414-E419.

    BackgroundGlioblastoma (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.ObjectiveTo assess the feasibility of intraoperative PDT early after surgical resection of GBM without unacceptable and unexpected toxicities.MethodsThe 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 OutcomesClinical follow-up after the SOC with PDT is expected to be similar (no significant difference) to the SOC alone.DiscussionThis 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.Copyright © 2018 by the Congress of Neurological Surgeons.

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