Tuesday, 9 February 2016

AVERT trial at Duke now recruiting

Nivolumab With DC Vaccines for Recurrent Brain Tumors (AVERT)

This is a trial testing

  • CMV-targeted dendritic cell vaccine +
  • PD-1 antibody (nivolumab)
  • a single dose of Td toxoid (tetanus-diptheria) prior to the fourth vaccination
The trial is for first or second recurrence of high grade glioma (grade III or IV), no prior treatment with Avastin (bevacizumab), age 18-80.


  1. Another trial requiring more or less contemporaneous surgery as part of the treatment. An unfortunate development for patients for whom surgery is not appropriate but who might benefit from the vaccine and pd-1 antibody.

  2. The new trial is a positive development. Additionally, the same Duke CMV vaccine (dc pp65) is in trial for newly diagnosed GBM as well. There is strong evidence (by my assessment) regarding the efficacy of both pp65 and Nivolumab.

  3. Would it be helpful (or harmful) to have a tenus injection between finishing radiotherapy and commencing chemotherapy for GBM Grad IV unmethylated?

    1. The purpose of the tetanus injection in this trial is to improve the lymph node homing of the dendritic cells in the context of a dendritic cell vaccine. It's not clear whether a tetanus shot alone (without a dendritic cell vaccine) would have any therapeutic anti-tumor value. I doubt it would be harmful though.