1. ¹The NABTT CNS Consortium, Baltimore, MD 21231, USA
2. ²Onyx Pharmaceuticals, Redmond, CA, USA
3. ³Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA

Correspondence: E. Antonio Chiocca, The NABTT CNS Consortium, 1650 Orleans Street, Room G93, Baltimore, MD 21231. Fax: +1 410 614 9335. E-mail: jfisher@jhmi.edu

Received 4 May 2004; Accepted 19 July 2004.

Abstract

ONYX-015 is an oncolytic virus untested as a treatment for malignant glioma. The NABTT CNS Consortium conducted a dose-escalation trial of intracerebral injections of ONYX-015. Cohorts of six patients at each dose level received doses of vector from 10⁷ plaque-forming units (pfu) to 10¹⁰ pfu into a total of 10 sites within the resected glioma cavity. Adverse events were identified on physical exams and testing of hematologic, renal, and liver functions. Efficacy data were obtained from serial MRI scans. None of the 24 patients experienced serious adverse events related to ONYX-015. The maximum tolerated dose was not reached at 10¹⁰ pfu. The median time to progression after treatment with ONYX-015 was 46 days (range 13 to 452 + days). The median survival time was 6.2 months (range 1.3 to 28.0 + months). One patient has not progressed and 1 patient showed regression of interval-increased enhancement. With more than 19 months of follow-up, 1/6 recipients at a dose of 10⁹ and 2/6 at a dose of 10¹⁰ pfu remain alive. In 2 patients who underwent a second resection 3 months after ONYX-015 injection, a lymphocytic and plasmacytoid cell infiltrate was observed. Injection of ONYX-015 into glioma cavities is well tolerated at doses up to 10¹⁰ pfu.