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Brain Tumor News!

Note: The comments under each article title are the opinion of our president, Al Musella, DPM,
and do not reflect official policy of the Musella Foundation!
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09/18/20 Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer        

Radiation induced alopecia is hair loss due to damage from radiation therapy.   This article talks about how to treat it, starting with something really easy - rubbing a cream on the skin. This resulted in complete response in 16% of people but it helped 82% of the people who tried it.  If that doesn't work, there are harder things to try.  So if you have a bald spot from radiation and it bothers you, go to a dermatologist and show them this article!

09/17/20 Cs-131 brachytherapy for patients with recurrent glioblastoma combined with bevacizumab avoids radiation necrosis while maintaining local control        

 This is another option for patients with recurrent glioblastomas including those who already had re-irradiation.   The radiation seeds were popular years ago but had the side effect of a lot of radiation necrosis so it lost favor.  Now they tried it in combination with Avastin and found no radiation necrosis. This treatment is available to patients now.

09/14/20 2nd Annual Brain Tumor TOGETHER and ACTION Day        

 From our good friends at that End Brain Cancer Initiative!  Sounds like a great program.

09/11/20 Medexus gets Health Canada nod to market tumor imaging material Gleolan for neurosurgery        

 Gleolan is finally approved in Canada.   It has been standard of care in Europe for many years before it was approved in the USA 3 years ago.   According to the article cited , it doubles the chance of a complete resection, and doubles the 6 month progression free survival rate.  This is a dye used at the time of surgery to make it easier for the surgeon to identify where the tumor is.

09/09/20 New Webinar Added: Assessment of Treatment Response to Established and Novel Therapies in Glioblastoma Patients using Metabolic and Physiologic MR Imaging Techniques        

This is a different technique than in our last advanced imaging webinar! Looks very interesting.  Let us know if you have any ideas for topics or speakers for future webinars!

09/02/20 Return to work following diagnosis of low-grade glioma        

 Only half of patients with a low grade glioma return to work in the first year.   5% of Glioblastoma patients are working at the 1 year point.  This underscores the devastation that a diagnosis of a brain tumor - even low grade - can bring to a family. The ability to work at 1 year (at a level they worked before the tumor) should be an important endpoint for clinical trials.

08/31/20 Glioblastoma Utilizes Fatty Acids and Ketone Bodies for Growth Allowing Progression during Ketogenic Diet Therapy        
This study shows how complicated the biology of these tumors are. You can not just say that because something makes sense and seems obvious, it should work. In theory, the ketogenic diet should slow down tumor growth.  There are even a few small gbm studies that suggest it might help.  This study shows the opposite - that it had the potential to make the tumor grow faster, at least in the test tube.  
   This is not proof one way or the other. More research needs to be done. 

08/29/20 Prevention and Management of Dermatologic Adverse Events Associated With Tumor Treating Fields in Patients With Glioblastoma        

 This is a must read article for anyone using Optune.  It discusses the most common side effects and how to prevent or treat them!

08/25/20 GT Medical Technologies Announces Data Demonstrating Positive Local Control and Safety Outcomes with GammaTile Therapy for Large Brain Metastases        

 This may be a good option to ask your doctor about  for people who are going to have brain surgery for brain mets. Small study but impressive results with high local control rates.

 Disclaimer: GT Medical is a sponsor of the Musella Foundation!

08/24/20 Phase I trial of convection-enhanced delivery of IL13RA2 and EPHA2 receptor targeted cytotoxins in dogs with spontaneous intracranial gliomas        

 Although only in dogs now, this is impressive results for a phase 1 dose finding trials.  I have long been interested in this approach.  About 15 years ago a phase 3 trial of CINTREDEKIN BESUDOTOX (IL13-PE38QQR) failed (although some patients did very well). The researchers analyzed the trial, figured out why it did not work and fixed it.  The 2 main problems were the delivery by convection enhanced delivery was not good enough at that time - but it is now, and the receptor they chose was not restricted to only brain tumor.  They changed from the wild type IL13 receptor to the mutant Il-13ra2 which is mostly found in tumors.  They then added a second receptor, EPHA2 which is also only found in tumor.    Unfortunately, it has been hard to get this into human trials because the first generation failed.   Now with proof of concept in dogs, hopefully it will move to human trials quickly!

08/24/20 The dopamine receptor antagonist trifluoperazine prevents phenotype conversion and improves survival in mouse models of glioblastoma        

 This article says that although radiation improves survival for glioblastomas, it also makes the tumor harder to treat. They found that by adding the drug trifluoperazine  (which is approved for psychiatric disorders) at the time of radiation, they were able to preserve the benefit of radiation but stop the conversion that causes the tumor cells to be harder to treat.  In mice, it resulted in longer survivals!    

There is a different clinical trial now of another dopamine receptor antagonist, Onc-201, being tested for H3K27M mutant gliomas. They are testing it during and after radiation, as well as only after. Comparing the 2 may show the effect described in the article- hopefully longer survivals!

08/24/20 Prognostic Value of ABO Blood Groups in Patients with Glioblastoma Multiforme        

 This is fascinating but needs to be confirmed in larger studies.   For patients with Glioblastoma, they found median OS was 22 months in blood group O whereas 14 months in blood group A, 11 months in blood group B and 6 months in blood group AB.    This could be significant when looking at clinical trial data. Blood type is usually not analyzed but it appears to make a larger difference in survival than any treatment ever tested.  

08/23/20 ERC Announces Interim Results from Phase 2 Trial of Immunotherapy ERC1671 (Gliovac) in Recurrent Glioblastoma Patients        

   This is the early results of a phase 2 randomized clinical trial for recurrent glioblastoma, which shows a remarkable improvement compared to historical controls (they do not discuss how the placebo group in the trial dd).    6 month survival rate was 100% in the trial compared to historical 33%. Median overall survival is 46 weeks compared to historical control of 23 weeks. Presumably some of the patients are still alive and the survivals should increase but they are already at double, and this is with a treatment that usually has minimal side effects.  

08/23/20 Ketone-Supressing Drug Combats Rare Brain Cancer in Mice        

This is a scary report.  They found that different tumors behave differently to alterations in levels of alpha-ketoglutarate.   Brainstem gliomas (in mice) benefitted from a treatment that lowers the level of alpha-ketoglutarate. However, low grade gliomas (in mice) did better when they increased the level of alpha-ketoglutarate.   It is great that they found an easy way to influence the speed of growth of tumors, but a lot more research needs to be done to fully understand how it impacts various tumors in people.   IF true, we need to be careful testing the ketogenic diet which increases the levels of alpha-ketoglutarate. It might help some tumors but also might hurt other types.  The methylation of the histones that alpha-ketoglutarate causes may be random, so the effect might not be consistent even in the same tumor types, or over time in the same patient. This definitely deserves more study.

08/23/20 Northwell neurosurgeon first on Long Island to use Modus V™ 3D exoscope to remove brain tumor        

 An exoscope is the next generation of operating microscope. It lets the surgeon better see what he is doing! 

08/17/20 Amazon Smile Fundraiser! Action Required!        

 Please pass this along to your friends and family!  If you already are using it - note that you have to turn it back on in the Amazon app if you use the App.  If you use the website in a browser, you do not have to do anything.

08/17/20 Promising Pathway Act Update.        

 if you haven't sent the message to your representatives yet - please do it now. If for any reason you are opposed to the bill, contact me to discuss it.

08/12/20 Brain Tumor Survey        

This is from our friends at Pinpoint Patient Recruiting.  They will pay you $75 for your time, and give the Musella Foundation a donation!  Let me know if you do it!

07/31/20 New video added: Metastatic Brain Tumors        

 Worth watching for anyone not only dealing with metastatic tumors but any brain tumor as he explains stereotactic radiosurgery and LITT (Laser Interstitial Therapy) which can be used on other types of brain tumors as well!

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