Purpose

In the past decade, there has been little progress in the treatment of malignant glioma. Recently, oncolytic virus has made great progress in glioma treatment, and a number of clinical trials have shown their potential of prolonging the survival time of glioma patients. Our objective is to evaluate effectiveness and safety of oncolytic virus (OV) in malignant glioma treatment.

Methodology

Based upon PRISMA, we collected relevant published clinical trials by searching medical databases up to January 16, 2023, applying the language restrictions in English and Chinese. We cross-searched the terms: ‘glioma’, ‘glioblastoma’, ‘oncolytic viruses’, ‘oncolytic virotherapy’ with filter ‘clinical trial’. Two researchers independently extracted the data regarding case definitions, published years, trial phase, characteristics of patients, administration of drug, overall survival (OS), and adverse events.

Results

19 published clinical trials in OV treatment of malignant glioma were included in the further systematic review analysis. None of them induced irresistible adverse effects attributing to OV treatment, median overall survival varied from 3.25 to 20.2 months after treatments. According to trials providing patient’s detailed molecular diagnosis, we find that the effectiveness of OV treatment has no significant difference in patients with different IDH or MGMT status.

Conclusions

Current clinical trials have initially shown the potential of oncolytic virotherapy as a new treatment for malignant glioma. Besides development of virus types, the strategy of OV use is an urgent problem to be solved in future clinical application, such as repeated administrations, innovative drug delivery systems, and biomarkers.

中文翻译：

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溶瘤病毒治疗恶性胶质瘤的临床进展：系统评价

目的

过去十年，恶性胶质瘤的治疗几乎没有进展。近年来，溶瘤病毒在胶质瘤治疗方面取得了巨大进展，多项临床试验显示其具有延长胶质瘤患者生存时间的潜力。我们的目标是评估溶瘤病毒（OV）在恶性胶质瘤治疗中的有效性和安全性。

方法

基于PRISMA，我们通过检索截至2023年1月16日的医学数据库，应用英文和中文的语言限制，收集了相关已发表的临床试验。我们交叉搜索了以下术语：“神经胶质瘤”、“胶质母细胞瘤”、“溶瘤病毒”、“溶瘤病毒疗法”和过滤器“临床试验”。两名研究人员独立提取了有关病例定义、发表年份、试验阶段、患者特征、用药、总生存期 (OS) 和不良事件的数据。

结果

19项已发表的OV治疗恶性胶质瘤的临床试验被纳入进一步的系统评价分析。它们均未因 OV 治疗而引起不可抗拒的不良反应，治疗后中位总生存期为 3.25 至 20.2 个月。根据提供患者详细分子诊断的试验，我们发现OV治疗的有效性在不同IDH或MGMT状态的患者中没有显着差异。

结论

目前的临床试验初步显示了溶瘤病毒疗法作为恶性胶质瘤新疗法的潜力。除了病毒类型的开发外，OV的使用策略是未来临床应用中亟待解决的问题，例如重复给药、创新药物递送系统和生物标志物。