A New Treatment Opportunity for DIPG and Diffuse Midline Gliomas: 5-ALA Augmented Irradiation, the 5aai Regimen. This is an interesting concept. Traditional photodynamic therapy uses direct light on the tumor after the tumor is sensitized to the light with a drug. Obviously impossible for a brainstem tumor. Instead, they propose using radiation therapy as the light souce, sensitizing the tumor with the drug 5-ALA which is already approved and in common use for brain tumors as Gleolan. (It is used at the time of surgery because it makes the tumor glow when a special light is shined upon it so the surgeon can see where the tumor is). This has not been done it trials yet - so it is only a theory - I would love to see it tested.
Deleterious impact of a generic temozolomide formulation compared with brand-name product on the kinetic of platelet concentration and survival in newly diagnosed glioblastoma.
This study says that of GBM patients using concurrent radiation and Temodar, 3% developed serious thrombocyopenia. In the Temodar package insert, it was reported that about 4% for adults, and 58% for kids have problems with platelets. This abstract did not mention the ages of the patients but the article said they were all adults. 19.6% that used the generic had thrombocytopenia. Big difference.
From this it is hard to tell which is better. I doubt there is a differencem but if there is and the generic causes more thrombocytopenia, the next question is which one worked better. More side effects might mean more potency but also might mean worse quality control.
I would like to take a quick survey of the readers. If you have ever used Temodar or the generic, please fill out this quick 3 question survey:
Proposing a tandem AND-gate CAR T cell targeting glioblastoma multiforme. This is just a proposal but seems like a very good idea. To limit the toxcicity of CAR-T cells, they propose to create a new type of CAR-T cell that has to bind to 2 targets before it can kill the cell. That has been tried before, but the new idea is the logic part: there has to be EGFRvIII AND (Il-13Ra2 OR CD133). This may be a big improvement, however, as I understand it, only about 1/3 of GBMs have EGFRvIII and it is possible that in the natural course of the disease, even those that are EGFvIII positive can turn EGFRvIII negative. CD133 is a marker found on all of the GBM stem cells, which are the most important cells to target, but most non stem cells in the tumor won't have it. IL13Ra2 is overexpressed in a little over 1/2 of the GBMs but not distributed uniformly through the tumor. So the OR part should target most of the tumor cells, but the AND part might not be enough. Perhaps find a way to require (EGFRvIII or ???) AND (Il-13Ra2 OR CD133) where we have to figure out what the best target for ??? is! This is a complex math problem that can be solved and variations can be tested and perhaps even personalized to the patient.
Poliovirus Therapy Shows Potential as Cancer Vaccine in Lab Studies This is great news. I will let you know when the trials begin. Diffuse midline glioma is a new category of brain tumor, for those with the H3K27M mutation. It is one of the worst types because it is more aggressive and is in the midline structures which control important brain functions.
Disclaimer: I am on an advisory board for the Brain Tumor Center at Duke and have sponsored research on this treatment - but have never received any compensation from it!
Phase II Trial Demonstrates Benefit for Patients With Recurrent Meningiomas We have not heard any advances with meningioma treatments in a while. There was no comparison group so it is hard to tell how good it did, but both drugs are already readily available off label so this is already an option for people with aggressive and recurrent meningiomas.
