New studies into an aggressive brain cancer are giving hope to people with glioblastoma, which normally kills within 18 months.
One patient has seen his cancer shrink by half in only a matter of 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 was the first patient to enroll in the University College London Hospitals NHS Foundation Trust (UCL) trial, where a small amount of radiation is injected directly into the cancer.
This is designed to kill cancer cells in the immediate vicinity while sparing healthy tissue, and doctors hope they could even eradicate the disease completely with this method.
After surgery to remove as much of the tumour as possible, a small medical device called an Ommaya reservoir is implanted under the scalp, connected to the tumour via a tube.
A radioactive drug is then injected weekly every four to six weeks to attack the tumour.
Paul said the trial was a ‘lifeline’ and he hadn’t experienced major side effects.
‘I am more than happy – even it if doesn’t benefit me, it may benefit someone else down the line,’ he said.
Medics are treating one patient a month in the first phase of the trial and plan to expand it to include more patients.
Oncologist and chief investigator Dr Paul Mulholland said it should be possible to one day cure this type of cancer because it only occurs in one location in the brain, without metastasising around the body.
The dose of radiation will be increased throughout the trial and the plan is then to combine the drug with an 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 stabilise in a clinical trial for a new ‘revolutionary’ type of scan.
Treatments for the aggressive form of brain cancer have not changed significantly for decades, researchers say, but now there may be a second breakthrough.
Under current processes, the only way to find out if people are good candidates for immunotherapy is a biopsy, which can cause infection or a brain bleed.
The risks are so great that biopsies are rarely carried out prior to surgery, so patients could be missing out.
With the new scan, it is hoped that more personalised treatment could be possible than the current standards which are surgery, radiotherapy and chemotherapy.
What does the new scan involve?
The ‘immuno-PET imaging technique’ by scientists from The Institute of Cancer Research, London (ICR), measures levels of a protein called PD-L1.
High levels of this protein are found in rapidly progressing glioblastomas.
It acts as ‘the brakes’ on the body’s immune system, so if doctors can block the protein it could ‘kick-start’ the body to fight the cancer.
How did scientists do the imaging?
To measure the levels of PD-L1, scientists developed a ‘radiotracer’ which binds it, enabling medics to measure the protein’s levels in glioblastoma patients, the authors wrote in the journal Neuro-Oncology.
The tracer was tested on eight patients in Poland who were newly diagnosed with glioblastoma.
The scans showed that the tracer successfully binds to PD-L1 positive cells within the tumour and throughout the body.
They were each given the tracer, followed by scans after 48 and 72 hours.
Five of the patients also received pembrolizumab – a treatment which blocks the function of PD-L1 – before surgery.
The researchers found that these patients had lower levels of the tracer in their tumours – suggesting that the drug is acting on the PD-L1 protein and helping the body fight the cancer.
Three of the five patients have seen their cancer stabilise and not grow any further, the ICR said.
The ongoing clinical trial aims to recruit 36 patients diagnosed with glioblastoma to see whether pembrolizumab given before surgery is effective.
Researchers will also assess whether PET imaging using the radiotracer can be used to monitor progress and adjust treatment as needed.
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 levels of this target means that we can predict the patients’ response, see their immune system responding to the treatment, and alter treatment where necessary – providing a personalised treatment plan based on the unique characteristics of their tumour, all without the need for a pre-surgery biopsy.’
Professor Kristian Helin, chief executive of The ICR, added: ‘Glioblastoma is a devastating disease, and treatments haven’t significantly changed for decades.
‘Although immunotherapies seem like they might be effective, progress has been stalled by not having a biomarker test to show who might benefit from them, or a way to monitor each patient’s response to treatment.’
Dr Simon Newman, chief scientific officer at The Brain Tumour Charity, said: ‘These tumours 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 from this study as there is an urgent need for new approaches to monitor and treat this devastating disease.
‘Immunotherapies have shown progress in other cancer types, and we hope to see similar advancements for brain tumours.
‘We are pleased to see progress in this area and look forward to following this work as it advances to larger clinical trials.’
Get in touch with our news team by emailing us at [email protected].
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