Journal Article

Antisecretory factor for treatment of peritumoral edema in glioblastoma patients

Lyczak, Monika, Vecchio, Tomás Gómez, Jennische, Eva, Åberg, Hanna, Gatzinsky, Kliment, Carstam, Louise, Lange, Stefan, Jakola, Asgeir S.

2025

Overview

Purpose Glioblastoma (GBM) is an aggressive brain tumor often accompanied by a vasogenic peritumoral edema, which contributes to symptoms both at diagnosis and during later stages of the disease. Previous studies have suggested effectiveness of the endogenous protein, Antisecretory Factor (AF), in reducing the intracranial pressure in cytotoxic brain edema after trauma. Interestingly, AF also seems to carry antineoplastic effects in experimental GBM models. This study investigated whether AF reduces peritumoral edema in GBM patients. As a secondary aim, we assessed potential effects on tumor progression by AF. Methods Fifteen newly diagnosed GBM patients were treated for 7 days preoperatively with AF in addition to standard of care (SOC) treatment with corticosteroids. The change in edema volume was assessed volumetrically using T2/FLAIR weighted MRI and compared to a control group of 10 GBM patients receiving SOC only. Results At baseline the mean tumor volume for the entire cohort was 35.7 cm3 with a mean edema of 62.2 cm3. There was no significant difference in edema volume change between the AF treated patients, who demonstrated a mean edema reduction of 7.1cm3 (95%CI -5.4–19.6), and the controls, 11.3cm3 (95%CI -0.8–23.5), p  = 0.61. No difference was observed in tumor volume change between the two groups, p  = 0.79. No adverse treatment effects were noted. Conclusion Treatment with AF in addition to SOC does not seem to reduce the peritumoral edema in GBM patients. The treatment was well tolerated. The lack of edema-reducing effect may be related to the different pathophysiological properties of vasogenic and cytotoxic edema.

• Publisher: Springer Vienna,Springer Nature B.V
• Subject: Adult / Aged / Brain cancer / Brain Edema / Brain Edema - diagnostic imaging / Brain Edema - drug therapy / Brain Edema - etiology / Brain Neoplasms / Brain Neoplasms - complications / Brain Neoplasms - diagnostic imaging / Brain Neoplasms - drug therapy / Brain Neoplasms - pathology / Brain tumors / Cancer and Oncology / Cancer och onkologi / complications / Corticosteroids / Cytotoxicity / diagnostic imaging / drug therapy / Edema / etiology / Female / Glioblastoma / Glioblastoma - complications / Glioblastoma - diagnostic imaging / Glioblastoma - drug therapy / Glioma / Humans / Interventional Radiology / Magnetic Resonance Imaging / Male / Medicine / Medicine & Public Health / Middle Aged / Minimally Invasive Surgery / Neurologi / Neurology / Neuroradiology / Neurosurgery / Surgical Orthopedics / Traumatic brain injury / Treatment Outcome