This is in mice, but probably would work the same way in people. Might be a perfect use for Avastin - which also reduces brain swelling. Perhaps it could eliminate or at least reduce the amount of Dexamethasone used while undergoing immunotherapy. Also points to the need for other treatments for brain swelling like Xerecept, which did well in clinical trials but then just disappeared. At that time, the reduction in Dexamethasone dosage was not seen as important enough to continue development of the drug. Now it is.
SNO is the Society Of Neuro-Oncology's Annual Scientific meeting. Follow the link below to see my thoughts on the highlights and to discuss them!
I posted this a few weeks ago but at that time they had some paperwork delays and couldn't enroll patients. Now they can! This is for anyone with a grade 3 or grade 4 malignant tumor that needs a surgery. If you need a surgery anyway, it is worth considering adding a treatment that could help stop the tumor from coming back quickly. There is only 1 participating center right now, Moffitt Cancer Center in Tampa Florida, but one of my favorite neurosurgeons, Michael Vogelbaum, MD, PhD will be doing the surgery.
From our good friends at UCLA. Should be very informative! Now that it is virtual, everyone should watch it.
This is considered the standard of care for the treatment of brain tumors in the USA. It doesn't include GammaTile since although approved and worthwhile are not available everywhere yet - hopefully they will be added to the next version!
These guidelines say for Glioblastoma, that Clinical Trials should be considered first, then if not possible, they now include Optune and Temodar along with radiation and surgery as the recommended treatment.
(In a small study) The local control rate at 1 year for newly diagnosed metastatic tumors was 100% and for recurrent tumors it was 80%. Patients still died from the primary cancer but this seems to be an effective way to hit those brain mets.
This was one of the highlights of this week SNO conference. The concept is elegant read about it on the company's website. Impressive early results.
This was a lot of fun. Thanks to Novocure for setting it up!
This is preclinical work but fascinating new approach. CRISPR is a gene editing tool which can be programmed to cut out any gene. This first attempt is proof of the principle that it can be directed to tumors inside a live animal. The possibilities are endless, perhaps starting with other genes in the tumor like the MGMT gene which creates a repair enzyme which offers resistance to Temodar, or to genes in the entire body such as any of the oncogenes like the BRCA genes which increase chances of many types of cancer.
This is another one of the highlights from the SNO conference this week. Exciting results in recurrent Glioblastoma. Median overall survival of 12.5 months compared to historic controls of 7.2 months. Another elegant solution - see their website for details! When we get some of these treatments approved and can start combining them, we will see major breakthroughs!
I went to the presentation on this and it was impressive. RNL is a nanoliposomal formulation that delivered directly to where it is needed in the brain via convection enhanced delivery. It releases radiation in a much higher dose to the tumor bed than external beam radiation does, and a smaller dose to the surrounding tissue. It is still very early of course but the concept is elegant and early data looks good. They reported that patients who previously used Avastin did not do as well as those who never used Avastin, but in the presentation it was explained that the convection enhanced delivery of the patients who used Avastin was difficult and only reached about 1/2 of the tumor coverage that those who never had Avastin achieved. Perhaps this is a technical problem that can be solved so it helps both groups.
This should allow for the more complete removal of these tumors!
This is an impressive volume of research and most of it is from external researchers not connected to the company that makes Optune. I will view them all and report back on the highlights after the SNO meeting ends!
Through a collaboration with Cancer Commons and xCures, the Musella Foundation is proud to offer our patients free access to this system. View the press release and watch the video to see how the program works. This module is what powers our "A Patient-Centric Platform Trial for Precision Oncology" NCT03793088.
This program will evaluate you and help find the best treatment options for your specific case. We then try to help you get access to them if needed. Then we follow up to see what treatments you do and the outcome so we learn from every patient. To get started, go to Virtualtrials.org and click on FIND TREATMENTS then on FULL SERVICE.
The Musella Foundation is focused on Brain Tumors, but Cancer Commons also handles these tumor types: Pancreatic Cancer, Small Bowel Cancer, Colorectal Cancer, Melanoma, Non Small Cell Lung Cancer, Thyroid Cancer, Bladder Cancer, Head and Neck Cancer, Gastric Cancer, Esophageal Cancer, Cholangiocarcinoma, Ovarian Cancer, and Hepatocellular Carcinoma. It also handles any type of cancer that has one of these specific mutations: MAPK, KRAS, BRAF, NRAS, HRAS, MEK and ERK. For details go to Cancer Commons.Org
Disclaimer: Al Musella owns stock in xCures.
When Avastin is used for a brain tumor, it starves the brain tumor. The tumor reacts by trying to escape and invades the surrounding tissue. Theoretically, this is driven by the tumor expressing Beta 1 integrins (CD29), which signals the cells to move and grow So this trial targets those Beta 1 integrins in the hope of allowing the Avastin to kill the tumor and this new treatment to stop the escape mechanism. The Musella Foundation has awarded 2 grants to the scientists to help develop this. It makes a lot of sense. Let's hope it works!
This is a webinar to announce the results of their clinical trial. It is an exciting new type of treatment involving nanoliposome-encapsulated radionuclides. Will be keeping an eye on this.
Leptomeningeal spread is when the cancer spreads to the lining of the brain and/or spinal cord. A big problem with it is that most clinical trials will exclude you if you have leptomeningeal spread, and there are no approved treatments that really help much. However, there is an exciting clinical trial about to open that uses Car-t cell therapy to try to treat leptomenigeal spread. If you are interested in details, contact me. When the trial opens I will announce it in a news blast.
GammaTiles are FDA approved. They are implanted at the time of surgery and slowly release radiation to the tumor bed. They are not available everywhere yet but will be soon. Ask your surgeon about them. This press release describes the registry that will track patients who use GammaTiles. That is a fantastic idea and all new treatments should do this!
This article is targeted to investors and I usually do not post such articles but it talks about something very important to us. First they show the graph from the big randomized phase 3 trial of Optune for newly diagnosed Glioblastoma. This shows that the median overal survival for this new standard of care is 24.5 months. This number should be used going forward when talking about the average survival for glioblastoma. I have recently read articles that quote the survival as little as 14 months even though the Temodar trial showed it was 19 months before Optune..
Next, they talk about combinations. I feel combinations are the key to the cure, and that is the basis of our organizations - we help patients find the best combinations and track the outcomes to home in on the cure. They show some preliminary data on the combination of Optune with radiation. The traditional way to use Optune is wait a few weeks after radiation to give the skin a chance to heal before starting Optune. This graph shows that in the lab, radiation and Optune are very synergistic. Novocure is about to open a new randomized phase 3 trial testing what is the best time to start using Optune: either at the start of radiation or a few weeks after radiation ends. They did a pilot study and saw it was technically possible and the side effects of skin irritation were manageable.
They also talk about combinations with Taxol and checkpoint inhibitors. These are really exciting. There should be a lot of new research reported at the upcoming Society of Neurooncology meeting! Stay tuned!
This shows that it is possible to use Optune even in kids as young as 4 years old. This study was designed to show that it can be done. Now they have to try it at the right time to see how well it works. They chose heavily pretreated kids who were out of options and used this as a last resort, which is not the best time to use it. I feel it should be used right at the start, when it had the best chance of helping - as the large newly diagnosed gbm study showed compared to the recurrent gbm study.