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Musella Foundation Logo and Name of Email Blast
Wednesday, June 15, 2022
Issue 5876

The most important bill ever introduced into congress for brain tumor patients needs your support!
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Latest News

Discuss these articles in our forum!
  • Unintended effects of proton pump inhibitors (PPIs) in patients with glioblastoma (GBM): A double-edged sword        

     This may affect you -  so read this!   Brain tumor patients are usually given a drug to help prevent stomach problems from the steroids they use. Most commonly it is a proton pump inhibitor such as 

    • Omeprazole (Prilosec)
    • Esomeprazole (Nexium)
    • Lansoprazole (Prevacid)
    • Rabeprazole (AcipHex)
    • Pantoprazole (Protonix)
    • Dexlansoprazole (Dexilant)
    • Zegerid (omeprazole with sodium bicarbonate), 

    This letter to the editor to Neuro-Oncology practice raises a very serious issue.  These drugs may cause resistance to Temodar (Temozolomide) by increasing the levels of an enzyme called ALDH1A1.  If this enzyme is high, the average survival for a patient with a methylated MGMT GBM is 14.6 months compared to 32.9 months if the enzyme is low.  For Unmethylated MGMT, the  numbers are 12.6 vs 21.4 months.  This is a HUGE difference.

    This has not been tested in a GBM trial, but it raises a red flag when considering these drugs, especially when there are easy alternatives. Instead of the drugs listed above,  H3 blockers, such as 

    • cimetidine (Tagamet)
    • ranitidine (Zantac)
    • nizatidine (Axid)
    • famotidine (Pepsid)
    can be used instead.   If you are using one of the drugs,  print the article out and show it to your doctor and ask if you can try these alternatives while further study is underway!

  • New method delivers life-saving drugs to the brain—using sound waves        

     I think focused ultrasound is going to make a major breakthrough in the treatment of not only brain tumors but many brain diseases. There are many different ways to use it. We have video in our video library about focused ultrasound and the many ways it can be used. There is a new clinical trial that may be one of my new favorites for Glioblastoma and DIPG involving 5-ALA and focused ultrasound to kill the tumor.


     This article talks about the combination of Onc-201 and paxalisib for DIPG.  It says that Onc-201 works by itself for DIPG but usually the tumor develops resistance to it through the P13K pathway.   Paxalisib targets this P13K pathway so it makes sense to try the combination. They treated 2 patients under compassionate use and both had dramatic reductions in tumor volume, complete resolution of symptoms and extended survival.  So they started a trial https://clinicaltrials.gov/ct2/show/NCT05009992 for the combination to use in DIPG and DMG.  I will be watching this trial closely.

  • H3K27M-Altered Diffuse Midline Gliomas Among Adult Patients: A Systematic Review of Clinical Features and Survival Analysis        

     Diffuse midline gliomas with the H3K27M mutation are among the worst of the worst brain tumors, even if the diagnosis is not glioblastoma.. In this meta analysis, they found that these patients only have a median overall survival of 10 months and although radiation helps, no chemotherapies they tested helped at all. This is a huge unmet need.

  • National Walk To End Brain Tumors - NJ        

     These 5k runs / walk are a lot of fund and raise money for our brain tumor grants program!  

  • Day One Announces Positive Initial Data from Pivotal FIREFLY-1 Trial of Tovorafenib (DAY101) in Relapsed Pediatric Low-Grade Glioma        

     Impressive results: 64% overall response rate and 91% clinical benefit rate for pediatric low grade gliomas.    What makes this even more impressive is that there is very little research for this tumor type, which is the most common pediatric brain tumor type, and there are no approved treatments or even a standard of care for this type of tumor.  Best yet  - it is an oral drug and reasonable toxicity profile.

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The article commentaries are the opinions of Al Musella, DPM and do not represent the official position of the Musella Foundation. Copyright 1992-2022 Musella Foundation - All rights reserved. No part of the Brain Tumor News Blast can be reproduced without the express written permission of the Musella Foundation.