***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Dendritic cell (DC)-based tumor vaccination has rendered promising results in relapsed high- grade glioma patients . In the HGG-2006 trial ( EudraCT 2006 - 002881 - 20 ) , feasibility , toxicity , and clinical efficacy of the full integration of DC-based tumor vaccination into st and ard postoperative radiochemotherapy are studied in 77 patients with newly diagnosed glioblastoma . Patients and methods Autologous DC are generated after leukapheresis , which is performed before the start of radiochemotherapy . Four weekly induction vaccines are administered after the 6-week course of concomitant radiochemotherapy . During maintenance chemotherapy , 4 boost vaccines are given . Feasibility and progression-free survival ( PFS ) at 6 months ( 6mo-PFS ) are the primary end points . Overall survival ( OS ) and immune profiling , rather than monitoring , as assessed in patients ’ blood sample s , are the secondary end points . Analysis has been done on intent-to-treat basis . Results The treatment was feasible without major toxicity . The 6mo-PFS was 70.1 % from inclusion . Median OS was 18.3 months . Outcome improved significantly with lower EORTC RPA classification . Median OS was 39.7 , 18.3 , and 10.7 months for RPA classes III , IV , and V , respectively . Patients with a methylated MGMT promoter had significantly better PFS ( p = 0.0027 ) and OS ( p = 0.0082 ) as compared to patients with an unmethylated status . Exploratory “ immunological profiles ” were built to compare to clinical outcome , but no statistical significant evidence was found for these profiles to predict clinical outcome . Conclusion Full integration of autologous DC-based tumor vaccination into st and ard postoperative radiochemotherapy for newly diagnosed glioblastoma seems safe and possibly beneficial . These results were used to power the currently running phase IIb r and omized clinical trial We have recently shown that low intensity , intermediate frequency , electric fields inhibit by an anti-microtubule mechanism of action , cancerous cell growth in vitro . Using implanted electrodes , these fields were also shown to inhibit the growth of dermal tumors in mice . The present study extends these findings to additional cell lines [ human breast carcinoma ; MDA-MB-231 , and human non-small-cell lung carcinoma ( H1299 ) ] and to animal tumor models ( intradermal B16F1 melanoma and intracranial F-98 glioma ) using external insulated electrodes . These findings led to the initiation of a pilot clinical trial of the effects of TTFields in 10 patients with recurrent glioblastoma ( GBM ) .  Median time to disease progression in these patients was 26.1 weeks and median overall survival was 62.2 weeks . These time to disease progression and OS values are more than double the reported medians of historical control patients . No device-related serious adverse events were seen after > 70 months of cumulative treatment in all of the patients . The only device-related side effect seen was a mild to moderate contact dermatitis beneath the field delivering electrodes . We conclude that TTFields are a safe and effective new treatment modality which effectively slows down tumor growth in vitro , in vivo and , as demonstrated here , in human cancer patients Background The peak incidence of glioblastoma multiforme ( GBM ) occurs in those aged 65 years and older . However , studies on this patient group remain limited . The goal of this study is to evaluate the efficacy of surgery versus biopsy for older patients with these lesions . Methods 133 and 72 consecutive patients aged 65 years and older who underwent surgery and needle biopsy for intracranial primary ( de novo ) GBM between 1997 and 2007 were retrospectively review ed . Among these patients , 40 who underwent surgical resection were matched with 40 who underwent needle biopsy alone for factors consistently shown to be associated with survival [ age , Karnofsky Performance Scale ( KPS ) indexing , eloquent involvement , radiation , temozolomide ] . Survival was expressed as estimated Kaplan – Meier plots , and log-rank analysis was used to compare survival curves . Results Mean ± st and ard deviation age was 73 ± 5 years , and median survival was 4.9 months . There were no significant differences in perioperative outcomes among patients who underwent surgical resection versus needle biopsy . Patients who underwent resection had median survival of 5.7 months as compared with 4.0 months for patients who underwent needle biopsy ( P = 0.02 ) . Likewise , for patients aged 70 years and older  , median survival was 4.5 months for 26 patients who underwent surgical resection as compared with 3.0 months for 26 patients who underwent needle biopsy ( P = 0.03 ) . Conclusion This study demonstrates that older patients tolerate aggressive surgery without increased surgery-related morbidity and have prolonged survival as compared with similar patients undergoing needle biopsy . These findings may help guide treatment decisions for patients , their families , and their physicians Background The prognosis of patients bearing high grade glioma remains dismal . Epidermal Growth Factor Receptor ( EGFR ) is well vali date d as a primary contributor of glioma initiation and progression . Nimotuzumab is a humanized monoclonal antibody that recognizes the EGFR extracellular domain and reaches Central Nervous System tumors , in non clinical and clinical setting . While it has similar activity when compared to other anti-EGFR antibodies , it does not induce skin toxicity or hypomagnesemia . Methods A r and omized , double blind , multicentric clinical trial was conducted in high grade glioma patients ( 41 anaplastic astrocytoma and 29 glioblastoma multiforme ) that received radiotherapy plus nimotuzumab or placebo .  Treatment and placebo groups were well-balanced for the most important prognostic variables . Patients received 6 weekly doses of 200 mg nimotuzumab or placebo together with irradiation as induction therapy . Maintenance treatment was given for 1 year with subsequent doses administered every 3 weeks . The objectives of this study were to assess the comparative overall survival , progression free survival , response rate , immunogenicity and safety . Results The median cumulative dose was 3200 mg of nimotuzumab given over a median number of 16 doses . The combination of nimotuzumab and RT was well-tolerated . The most prevalent related adverse reactions included nausea , fever , tremors , anorexia and hepatic test alteration . No anti-idiotypic response was detected , confirming the antibody low immunogenicity . The mean and median survival time for subjects treated with nimotuzumab was 31.06 and 17.76 vs. 21.07 and 12.63 months for the control group . Conclusions In this r and omized trial , nimotuzumab showed an excellent safety profile and significant survival benefit in combination with irradiation . Trial registration Cuban National Register for clinical trials ( No. 1745 ) ( http://registroclinico.sld.cu/ensayos ) Objective There has been an increased focus on the region adjacent to the lateral ventricles ( LV ) as a potential source of malignant tumors and /or more aggressive disease . We set out to determine if glioblastoma multiforme ( GBM ) bordering the LV was associated with decreased survival as compared to non-LV GBM . Methods We review ed the clinical records of 69 consecutive patients undergoing craniotomy for GBM at a single academic institution . Twenty-six patients were identified with contrast-enhancing lesions ( CEL ) bordering the LV ( LV CEL ) . These 26 patients were matched with 26 patients with CEL not bordering the LV ( non-LV CEL ) . These cohorts were matched for factors consistently shown to be associated with survival , which were age , tumor size , Karnofsky performance score , extent of resection , Gliadel implantation , and Temodar chemotherapy .  Overall survival was compared between the cohorts via Log-rank analysis . Results Despite similarities in pre-operative clinical status , tumor size , peri-operative outcome , and treatment regimens , the median survival for patients with LV CEL was significantly decreased as compared to patients with non-LV CEL ( 8 months vs. 11 months ) , P = 0.02 . Additionally , survival analysis in patients stratified by primary and secondary resection also demonstrated a strong trend towards decreased survival after resection of LV CEL . After primary and secondary resection , patients with LV CEL versus non-LV CEL had a median survival of 11 months vs. 14 months ( P = 0.10 ) and 7 months vs. 10 months ( P = 0.11 ) , respectively . Conclusion While the causal factors underlying this observation are not provided with this observational study , GBM bordering the LV may carry a prognostic significance To evaluate the safety and efficacy of nimotuzumab , a humanized monoclonal antibody specific for the epidermal growth factor receptor ( EGFR ) , in combination with temozolomide ( TMZ ) and radiation therapy ( RT ) in the treatment of newly diagnosed glioblastoma ( GBM ) in Chinese patients BACKGROUND Concurrent treatment with temozolomide and radiotherapy followed by maintenance temozolomide is the st and ard of care for patients with newly diagnosed glioblastoma .  Bevacizumab , a humanized monoclonal antibody against vascular endothelial growth factor A , is currently approved for recurrent glioblastoma . Whether the addition of bevacizumab would improve survival among patients with newly diagnosed glioblastoma is not known . METHODS In this r and omized , double-blind , placebo-controlled trial , we treated adults who had central ly confirmed glioblastoma with radiotherapy ( 60 Gy ) and daily temozolomide .  Treatment with bevacizumab or placebo began during week 4 of radiotherapy and was continued for up to 12 cycles of maintenance chemotherapy . At disease progression , the assigned treatment was revealed , and bevacizumab therapy could be initiated or continued . The trial was design ed to detect a 25 % reduction in the risk of death and a 30 % reduction in the risk of progression or death , the two co primary end points , with the addition of bevacizumab . RESULTS A total of 978 patients were registered , and 637 underwent r and omization . There was no significant difference in the duration of overall survival between the bevacizumab group and the placebo group ( median , 15.7 and 16.1 months , respectively ; hazard ratio for death in the bevacizumab group , 1.13 ) . Progression-free survival was longer in the bevacizumab group ( 10.7 months vs. 7.3 months ; hazard ratio for progression or death , 0.79 ) . There were modest increases in rates of hypertension , thromboembolic events , intestinal perforation , and neutropenia in the bevacizumab group . Over time , an increased symptom burden , a worse quality of life , and a decline in neurocognitive function were more frequent in the bevacizumab group . CONCLUSIONS First-line use of bevacizumab did not improve overall survival in patients with newly diagnosed glioblastoma .  Progression-free survival was prolonged but did not reach the prespecified improvement target . ( Funded by the National Cancer Institute ; Clinical Trials.gov number , NCT00884741 . ) Fifty-nine patients with primary presentation of high- grade gliomas of the brain , 13 with astrocytomas with anaplastic foci and 46 with glioblastoma multiforme , were treated with surgical intervention and definitive postoperative radiation therapy followed by multiple intravenous administration of iodine-125-labeled monoclonal antibody-425 , which binds specifically to human epidermal growth factor receptor . The total cumulative labeled antibody doses ranged from 40 to 296 mCi . The administration of the radiolabeled antibody was performed in most instances within 3 months following completion of the primary surgery and radiation therapy . No significant life-threatening toxicities were observed during the trial . At one year , 34 ( 58 % ) of the 59 patients in the trial were alive . The median overall survival for both groups was 13.5 months IMPORTANCE Glioblastoma is the most devastating primary malignancy of the central nervous system in adults . Most patients die within 1 to 2 years of diagnosis . Tumor-treating fields ( TTFields ) are a locoregionally delivered antimitotic treatment that interferes with cell division and organelle assembly . OBJECTIVE To evaluate the efficacy and safety of TTFields used in combination with temozolomide maintenance treatment after chemoradiation therapy for patients with glioblastoma . DESIGN , SETTING , AND PARTICIPANTS After completion of chemoradiotherapy , patients with glioblastoma were r and omized ( 2:1 ) to receive maintenance treatment with either TTFields plus temozolomide ( n = 466 ) or temozolomide alone ( n = 229 ) ( median time from diagnosis to r and omization , 3.8 months in both groups ) . The study enrolled 695 of the planned 700 patients between July 2009 and November 2014 at 83 centers in the United States , Canada , Europe , Israel , and South Korea . The trial was terminated based on the results of this planned interim analysis . INTERVENTIONS Treatment with TTFields was delivered continu 
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Coadministration with radiotherapy and temozolomide provided a statistically significant increase in survival for patients suffering from glioblastoma .
However , the natural history for GBM remains poor .
Therapies including TTF pooled values of MOS and provide means of prolonging the survival of GBM patients