New research into aggressive brain cancer offers hope for people with glioblastoma, which usually kills within 18 months.
One patient has seen her cancer cut in half in just a few weeks during a clinical trial.
Paul Read, a 62-year-old engineer from Luton, was diagnosed in December last year and said he was open to research, with ‘nothing to lose and everything to hope for’.
He is the first patient to enter the University College London Hospitals NHS Foundation Trust (UCL) trial, where a small amount of radiation is injected directly into the cancer.
It is designed to kill cancer cells in the immediate vicinity while sparing healthy tissue, and doctors hope to eradicate the disease in this way.
After surgery to remove as much of the tumor as possible, a small medical device called the Ommaya reservoir is implanted in the scalp, connected to the tumor through a tube.
Radioactive drugs are then injected weekly every four to six weeks to attack the tumor.
Paul said the trial was a ‘lifeline’ and he had no major side effects.
“I’m more than happy – even if it doesn’t benefit me, it might benefit someone else,” he said.
Medical is treating one patient per month in the first phase of the trial and plans to expand to add more patients.
Oncologist and chief researcher Dr. Paul Mulholland said that it is possible to treat this type of cancer because it is only in one location in the brain, without metastases in the body.
Radiation doses will be increased during the trial and the plan is to combine the drug with immunotherapy – which trains the body’s own immune system to kill cancer.
Separately, another major development in diagnosis and monitoring was announced today.
Three patients with glioblastoma have seen their cancer stabilize in a clinical trial for a new ‘revolutionary’ type of scan.
Treatment for aggressive brain cancer hasn’t changed significantly in decades, researchers say, but now there may be a second breakthrough.
In the current process, the only way to find out if a person is a good candidate for immunotherapy is a biopsy, which can lead to infection or bleeding in the brain.
The risk is so great that biopsies are rarely performed before surgery, so patients can be lost.
With the new scans, the hope is that more personalized treatment will be possible than the current standard of surgery, radiotherapy and chemotherapy.
What does the new scan include?
The ‘immuno-PET imaging technique’ by scientists from The Institute of Cancer Research, London (ICR), measures the level of a protein called PD-L1.
High levels of this protein are found in rapidly progressing glioblastoma.
It acts as a ‘brake’ on the body’s immune system, so if the doctor can block the protein it can ‘kick-start’ the body to fight cancer.
How do scientists do imaging?
To measure the level of PD-L1, scientists developed a ‘radiotracer’ that binds, so that doctors can measure the level of the protein in patients with glioblastoma, the authors write in the journal Neuro-Oncology.
Tracer was tested in eight patients in Poland who were newly diagnosed with glioblastoma.
The scans show that the tracer successfully binds to PD-L1 positive cells in the tumor and in the body.
Each was given a tracer, followed by a scan after 48 and 72 hours.
Five patients also received pembrolizumab – a treatment that blocks PD-L1 function – before surgery.
The researchers found that these patients had lower levels of the tracer in their tumors – suggesting that the drug acts on the PD-L1 protein and helps the body fight cancer.
Three out of five patients have seen their cancer stabilize and stop growing, the ICR said.
An ongoing clinical trial is recruiting 36 patients diagnosed with glioblastoma to see if pembrolizumab given before surgery is effective.
Researchers will also assess whether PET imaging using radiotracers can be used to monitor progress and adjust treatment if necessary.
Dr Gabriela Kramer-Marek, group leader in preclinical molecular imaging at The ICR, said: ‘Being able to take a scan of the patient’s body and see the level of this target means we can predict the patient’s response, looking at the immune system. respond to treatment, and change treatment if necessary – providing a personalized treatment plan based on the unique characteristics of the tumour, all without the need for a pre-operative biopsy.’
Professor Kristian Helin, chief executive of The ICR, added: ‘Glioblastoma is a devastating disease, and treatment has not changed significantly for decades.
‘Although immunotherapies seem to be effective, progress has been halted because we do not have biomarker tests to show who can benefit from them, or a way to monitor each patient’s response to treatment.’
Dr Simon Newman, chief scientific officer at The Brain Tumor Charity, said: ‘These tumors are notoriously difficult to treat, and research into immunotherapy has had mixed results due to the tumour’s ability to hide from the immune system.
“However, we are encouraged by the findings of this study because there is an urgent need for new approaches to monitor and treat this devastating disease.
‘Immunotherapy has shown progress in other types of cancer, and we hope to see similar progress for brain tumours.
‘We are pleased to see progress in this area and hope to follow this work as advances for larger clinical trials.’
Contact the news team by emailing webnews@metro.co.uk.
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