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Michael Sleeper: Beating the Glioblastoma Multiforme Odds

Michael SleeperMichael Sleeper is one of many patients to benefit from the clinical trial of a novel vaccine for glioblastoma multiforme (GBM), currently under way at the Mischer Neuroscience Institute (MNI) at Memorial Hermann-Texas Medical Center. Led by principal investigator Jay-Jiguang Zhu, M.D., Ph.D., the trial is determining the safety and efficacy of the ICT-107 vaccine in newly diagnosed GBM patients following resection and chemoradiation.

Sleeper began suffering severe headaches on the Fourth of July in 2011. After two days of pain, his wife drove him to the Medical Center of Southeast Texas in coastal Port Arthur, near his home in Nederland, Texas. When the neurologist on call viewed the results of Sleeper’s CT scan, he made an immediate referral to MNI, an hour-and-a-half ambulance ride away.

At the Institute Sleeper underwent an MRI and was seen by neurosurgeon Nitin Tandon, M.D., an associate professor in the Vivian L. Smith Department of Neurosurgery at UTHealth Medical School, who reviewed the results of the imaging study and recommended surgery. The Sleepers agreed, and on July 11, 2011, Dr. Tandon excised the tumor, which was located at the right temporal lobe. On biopsy, neuropathology delivered a diagnosis of GBM.

Choosing the right clinical trial

“On my first follow-up visit after the surgery, Dr. Zhu talked to me about my options for further treatment,” Sleeper

recalls. “At that time I qualified for three clinical trials. My wife and family and I decided that the ICT-107 vaccine sounded like the best fit for me. We did the medical paperwork, and I was enrolled in the trial.”

ICT-107 is an autologous vaccine consisting of dendritic cells from the patient’s own immune system, which are isolated from blood by apheresis and pulsed with synthetic peptides from six GBM-specific stem cell-associated antigens – MAGE-1, HER2, AIM2, TRIP-2, GP100 and interleukin 13 receptor alpha. The sensitized dendritic cells are then returned to the patient by subcutaneous injection as an immunotherapy to attack the tumor.

The process was supervised by neuropathologist Yu Bai, M.D., an associate professor in the department of Pathology and Laboratory Medicine at UTHealth Medical School. Sleeper began treatment with ICT-107 in August 2011 and was administered the vaccine every two weeks for the first eight weeks, then monthly for a year, then every six months.

“At the same time, we began chemotherapy treatment with temozolomide, an oral alkylating agent that has
been shown to improve progression-free survival and overall survival in glioblastoma multiforme patients,” says Dr. Zhu, director of MNI’s Clinical Cancer Program and an associate professor in the Vivian L. Smith Department of Neurosurgery at UTHealth Medical School.

Dr. Tandon performed a second surgery on Sleeper in May 2012 when a regularly scheduled MRI revealed an area of suspicion.

“Imaging is not 100 percent. On MRI we can’t tell if we’re seeing new growth or radiation necrosis, so we have to check,” Dr. Zhu says. “We were happy to see that there were no active tumor cells on biopsy by neuropathology.”

Every day is a good day

Nearly three years after his diagnosis, Sleeper takes the vaccine every six months and temozolomide five days out of every 28. “It’s remarkable that he has been able to continue on temozolomide for this long, and that the agent continues to control the tumor without major side effects,” Dr. Zhu says. “With the exception of brain-stem gliomas, GBM has the worst statistical prognosis of any central nervous system malignancy – a median survival of 14.6 months. Michael’s regular exams continue to be normal – he’s beating the odds.”

Sleeper, who remains positive about his experience with GBM, commends Dr. Zhu and his team for their caring attitude. “I wish I could say the vaccine is why I’m here today or the Temodar® or both of them, or maybe it’s the way I live life. I believe it’s a combination of everything, including Dr. Zhu’s entire caring team. Along with my family and friends, they’ve helped keep me positive. Every day’s a good day.”