Review Article

Toxin-Based Targeted Therapy for Malignant Brain Tumors

Table 1

Current listing of immunotoxin trials for brain tumor therapy.

Antigen targetedImmunotoxin characteristicsClinical trialTumor treatedOutcomeReferences

TR: Tf-CRM107A conjugate of human TR and full-length DT with two point mutations in the B chain with reduced toxin binding (CRM107)Phase I/II44 patients (recurrent GBM or AA)Median survival 37 weeks; 5/34 CR; 7/34 PR[38, 39]
TR: 454A12-rRAA conjugate of a mAb (454A12) to the human TR and rRAPhase IEight leptomeningeal neoplasia patientsTumor progression[40]
IL-4R: IL-4(38-37)-PE38KDEL (NBI-3001)A circularly permuted recombinant IL-4 fused to PEPhase I/II31 patients (25 GBM and 6 AA)Median survival 8.2 months; 6 month survival 52%[4144]
IL-13R: IL-13-PE38QQR (Cintredekin Besudotox)A chimeric toxin composed of hIL-13 and a mutated version of PEPhase I/II/IIIPhase II: 51 patients (46 GBM, 3 AA, 1 anaplastic oligoastrocytoma, 1 AO; Phase III: 296 patients (276 GBM confirmed)Phase II: median survival 45.9 weeks Phase III: IL13-PE38QQR compared to GW: Median survival 36.4 weeks for the IL13-PE38QQR group and 35.3 weeks for the GW group[45, 46]
EGFR: TP-38 (IVAX)A chimeric toxin composed of EGFR ligand TGF-α and PEPhase ITwenty patients [17 GBM, 1 GSC, 1 metastatic spindle cell sarcoma, 1 AO]Median survival 28 weeks[4749]
Mutant EGFRvIII: MR1-1-PE38KDELAn affinity-matured scFv specific for EGFRvIII, MR1-1 fused to PEPhase IOngoing