First US Patient with Recurrent Glioblastoma Treated with Xoft Brain IORT

iCAD, Inc., announced that the first patient with recurrent glioblastoma (GBM) was treated with the Xoft Axxent Electronic Brachytherapy (eBx) System at Providence Saint John’s Health Center in Santa Monica, CA. This procedure was part of the international multi-center GLIOX trial, led by principal investigator and neuro-oncologist, Santosh Kesari, MD, PhD, Chair and Professor, Department of Translational Neurosciences at the Saint John’s Cancer Institute, Santa Monica, CA.

The GLIOX trial is designed to compare Xoft intraoperative radiation therapy (IORT) plus Avastin (bevacizumab) to the investigational arm of RTOG-1205 (EBRT plus bevacizumab). Researchers hope this study will validate the intriguing initial results from a prospective two center comparative study at the European Medical Center (EMC) in Moscow, Russia. Compelling data from this study were recently published in study and a subsequent erratum in the peer-reviewed journal, Surgical Neurology International.

“This is a significant milestone, not just for our institute, but also for patients with recurrent glioblastoma,” said the site’s principal investigator, Naveed Wagle, MD, Associate Professor of Neurosciences at the Saint John’s Cancer Institute in Santa Monica, CA. “The initiation of a clinical trial under normal circumstances is no small feat, but the COVID pandemic presented additional challenges that had to be overcome. It truly was an enormous achievement, and we are excited that we can now offer it to patients.”

“This is a milestone achievement, not only for iCAD but also for patients with this devastating disease,” said Stacey Stevens, President and incoming CEO of iCAD, Inc. “It is our expectation that the GLIOX study and its forthcoming data will add to the growing body of evidence that supports IORT with the Xoft System for the treatment of various types of tumors, including recurrent GBM.”

Compelling data supporting Xoft Brain IORT for the treatment of recurrent GBM were recently published in study and a subsequent erratum in the peer-reviewed journal, Surgical Neurology International. Under the guidance of lead investigator, Alexey Krivoshapkin, MD, PhD, professor and head of the neurosurgery department at the European Medical Center (EMC), the comparative study evaluated 15 patients with recurrent GBM who were treated with maximal safe resection and Xoft Brain IORT, and 15 patients with recurrent GBM treated with maximal safe resection and other modalities (control group), between June 2016 and June 2019.

As of March 2021, patients treated with Xoft Brain IORT lived for up to 54 months after treatment without recurrence, whereas patients in the control group had a recurrence within 10 months and lived for up to 22.5 months after treatment. Researchers also found there were fewer complications, such as radionecrosis, in the IORT group. Radionecrosis refers to the breakdown of normal body tissue near the original tumor site after radiation therapy. One patient from the IORT group was still alive in fall 2021, whereas none of the patients in the control group survived.

“We feel that these initial results are encouraging, as the data indicates Xoft Brain IORT may be a viable additional treatment option for patients with recurrent GBM,” added Stevens. “This compelling research offers important insights that shows this technique could potentially play a more prominent role in the treatment of brain tumors.”

Additionally, a subgroup analysis of patients with postoperative tumors volumes of less than 2.5 cm showed more favorable outcomes for patients in the IORT group. The researchers concluded that the results are encouraging and that further clinical trials are warranted.

“The results indicate Xoft Brain IORT may provide clinical benefit in overall survival and progression-free survival, in combination with maximal safe re-resection of recurrent GBM, compared to re-resection and standard adjuvant therapy,” said Dr. Krivoshapkin. “These data are particularly promising, especially for patients with smaller postoperative residual tumors, which underscores the importance of administering radiation directly after removing the tumor, rather than waiting weeks after surgery, as may be the case with other treatment options.”

The Xoft System is also currently being studied in the treatment of other types of brain tumors. In 2020, a patient with a brain metastasis from an Ewing’s Sarcoma was the first patient to be treated in Spain with Xoft Brain IORT at the Miguel Servet University Hospital in Zaragoza, Spain, where doctors successfully removed the metastasis and treated the patient using Xoft IORT. More than five patients with either brain metastases or recurrent GBM have been treated in Spain with Xoft Brain IORT since then.

“We continue to be inspired by the widespread interest in this innovative technique and the GLIOX trial from renowned key opinion leaders and international centers,” added Stevens. “Xoft Brain IORT represents just one of the exciting new and emerging applications we are currently exploring with the multiplatform Xoft System, which can rapidly be adopted into facilities, given it is highly mobile, does not require facility investment in additional shielding, and is already cleared for use by the FDA for treatment of cancer anywhere in the body.”