Cancer stem cell assay-guided chemotherapy improves survival of patients with recurrent glioblastoma in a randomized trial

Tulika Ranjan, Department of Neuro-Oncology, Allegheny Health Network, Pittsburgh, PA, USA; Department of Neuro-Oncology, Cancer Center Southern Florida, Tampa General Hospital, Tampa, FL, USA.
Soma Sengupta, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA.
Michael J. Glantz, Department of Neurosurgery, Penn State Neuroscience Institute, Hershey, PA, USA.
Richard M. Green, Department of Neuro-Oncology, Southern California Permanente Medical Group, Los Angeles, CA, USA.
Alexander Yu, Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, USA.
Dawit Aregawi, Department of Neurosurgery, Penn State Neuroscience Institute, Hershey, PA, USA.
Rekha Chaudhary, Department of Internal Medicine, Division of Hematology-Oncology, University of Cincinnati, Cincinnati, OH, USA.
Ricky Chen, Department of Neuro-Oncology, Providence Brain & Spine Institute, Portland, OR, USA.
Mario Zuccarello, Department of Neurosurgery, University of Cincinnati, Cincinnati, OH, USA.
Christine Lu-Emerson, Department of Neuro-Oncology, Maine Medical Center, Scarborough, ME, USA.
Hugh D. Moulding, Department of Neuroscience, St. Luke's University Hospital & Health Network, Bethlehem, PA, USA.
Neil Belman, Department of Neuroscience, St. Luke's University Hospital & Health Network, Bethlehem, PA, USA.
Jon Glass, Departments of Neurology and Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Aaron Mammoser, Department of Neurosurgery, LSU Health Sciences Center, New Orleans, LA, USA.
Mark Anderson, Department of Neurology, University of Mississippi Medical Center, Jackson, MS, USA.
Jagan Valluri, Cordgenics, LLC, Huntington WV, USA.
Nicholas Marko, Department of Neurosurgery, LewisGale Regional Health System, Salem, VA, USA.
Jason Schroeder, Department of Neurosurgery, University of Toledo, Toledo, OH, USA.
Steven Jubelirer, Department of Neuro-Oncology, Charleston Area Medical Center, Charleston, WV, USA.
Frances Chow, Departments of Neurological Surgery and Neurology, University of Southern California, Los Angeles, CA, USA.
Pier Paolo Claudio, Cordgenics, LLC, Huntington WV, USA; Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, USA.
Anthony M. Alberico, Department of Neurosurgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Seth T. Lirette, Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA.
Krista L. Denning, Department of Pathology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Candace M. Howard, Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA. Electronic address: cmhoward@umc.edu.

Document Type

Article

Publication Date

4-27-2023

Journal Title

Cell reports. Medicine

Abstract

Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors. In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2-14.7) compared with 9 months (95% CI, 4.2-13.8) in the physician-choice group (p = 0.010) as per interim efficacy analysis. The ChemoID assay-guided group has a significantly lower risk of death (hazard ratio [HR] = 0.44; 95% CI, 0.24-0.81; p = 0.008). Results of this study offer a promising way to provide more affordable treatment for patients with rGBM in lower socioeconomic groups in the US and around the world.

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