This is a very technical article that says that adding a calcium channel blocker to TTFields (Optune) may work better than TTFields alone.  There are many calcium channel blocking drugs available, approved as medications to treat high blood pressure. The authors used Benidine, which is approved in Asia but not the USA. They suggest, but did not try, Nifedipine may also work. This is available in the USA for high blood pressure and is easily available.

This is perfect for our Virtual Trial project.   (See virtualtrials.com  click on Virtual trial for details and to join). We can observe patients who are using Optune and compare those who also report using Nifedipine compared to those who do not report using Nifedipine.   We do not have any patients reporting that combination yet - so we need more participants!  All brain tumor patients should participate so when things like this come up we can just press a few keys on the keyboard and have the answer!

 This is a pretty technical article but basically it says that  you need to target both pathways (NOTCH and PI3K)  at the same time to have a major effect.  There are a few drugs approved for PI3K  inhibition and  a few experimental NOTCH inhibitors in clinical trials.  These have to be tried in combination for GBM.

 This article shows what we already knew:  If you do not have insurance and you are diagnosed with a GBM, you are going to have trouble getting treatments and you will not have any chance to beat it.  80% of the uninsured patients did not even get the standard of care treatment.  This is not acceptable. The system has to be changed.  

 This is still experimental but very interesting.  Hopefully you can get the same information as a biopsy in a much easier way. Very useful for inoperable tumors, or to see how a tumor is responding to treatment over time.

 This drug looks good in a small study (you can not always rely on small studies) - doubling survival percentage at 12 months.  The drug is approved for other types of cancers so it is available off label.  Insurance companies might complain. I do not know the cost but my guess is that it is expensive.     If anyone is going to try it, please join the virtual trial (virtualtrials.com) first so we can quickly find out how it is working.  We might also be able to help you fight your insurance company if they deny it.

This article also points out that you can have a huge benefit without moving the median progression free survival.  This issue has come up in a few other clinical trials recently.   The median survival or progression free survival is not increased so they think the drug failed.  However, the median doesn't take into account the long survival tails of these trials.  The recent article about PVSRIPO demonstrated this. A huge benefit at 2,3 and 4 years, but the median doesn't change much.

This is a very important article. It says that using Dexamethasone hurts the immune system.  Sometimes we need it - it is used to treat swelling of the brain which can cause death, but we should be careful and consider other treatments if possible,   Temozolomide has a similar effect.  This means it might be best to start immunotherapies before starting Temozolomide, and before the surgery that necessitates the use of Dexamethasone. And also keep the dosage of Dexamethasone to a minimum if possible NOTE: Dexamethasone is the one drug that you can NOT just stop cold turkey - that can kill you. There is a weaning schedule that has to be followed closely so you can not adjust the dose yourself. You need to talk to your doctors about this.

 This article talks about the role of DRD2 in GBMs.  Looks like it may play an important role.   Onc-201 is an experimental drug in clinical trials for brain tumors. It is a DRD2 antagonist. This may explain it's method of action.

 These are great get togethers for any brain tumor patient or anyone who knows a brain tumor patient!

 Thanks to generous donations, we are able to reopen our copay assistance program!  We have a lookback period of 3 months from when the completed application arrives so if you are approved, and have paid for a covered treatment in the last 3 months we can reimburse you!  

 The article they mention is at http://clincancerres.aacrjournals.org/content/early/2018/12/19/1078-0432.CCR-18-2572.long

but it is not free. It shows that the DRD2 is overexpressed in many types of cancer.  Onc-201 blocks that receptor, but they also found that high levels of DRD5 make the cells resistant to the Onc-201.  So for this drug to work, we need high DRD2 and low DRD5.  That happens in most brainstem gliomas, and high grade gliomas that are in the midline of the brain - especially those in the thalamus, and in younger patients.   There are about 14 clinical trials going on for Onc201 in various cancers, including brain.  For those who do not qualify for the clinical trials, there is a compassionate use program available – contact us (the Musella Foundation)  for details 888-295-4740

 This is the first case I heard of where a brain tumor patient was able to get a treatment under the "Right To Try" laws.  I do not know what the costs are (if anyone finds out - please let me know).  This is one of the more exciting vaccines. It is made with fresh tumor sample from the patient AND with tumor samples from 3 other people with the same tumor type. The idea is that should allow the vaccine to hit any of the current targets in your tumor, but also prevent the tumor from mutating around the vaccine - since the most common mutations were picked up from the donors!

The first grant is for the development of a new type of vaccine for the treatment of brain tumors.  The second is a project to try to make it easier to find the correct clinical trials.  It is not just a matching service - it is a system where clinical trials will be explained and reviewed so we have more information to go on when selecting a clinical trial!

They should have done this a long time ago. I hope this becomes available for patients soon.  The delivery method should be approved separately from the drugs used - so we can mix and match drugs based on a patients' genetic profile.

Although this article is about checkpoint inhibitors in lung cancer, the same might apply to brain tumors.  It has already been shown that steroids may decrease the effectiveness of other brain tumor treatments. Unfortunately, there are times when steroids are needed so we can't just discontinue them. (Note: if on steroids - you can not just stop cold turkey - they have to be weaned off on a specific schedule or you can die!)

This article shows that most GBMs overexpress IL-13Rα2  and that this may be involved in making the tumor invasive, proliferation and angiogenesis.  There are a few experimental treatments that target this marker.  ICT-107 was a vaccine that showed remarkable results in a few subgroups of patients but "failed" their pivotal trial  and is no longer in development.  GB-13 is in preclinical testing and hopefully will get into clinical trials soon..

This study identifies a few promising combinations of readily available drugs.  However, it also shows that it is hard to predict which combinations will work in an individual.  Different cell lines reacted different ways, and sometimes made the tumor grow faster instead of helping.  More research needs to be done but I think this is a step in the right direction.  They may be able to find readily available (and sometimes cheap) drugs that can be added to the standard treatments to make them work much better.

This sounds like a great program. We have been helping patients get access to experimental treatments for a while and it takes a lot of time on our part, the doctor’s part and the drug companies' part.  I hope that this will smooth things over.

If anyone tries it, please let me know how it works out!

 Dr Brem is another one of my favorites.  They offer proton beamm radiation and immunotherapy trials including CAR-T cell which is one of the most promising new treatments.

I have written a lot about this drug (Onc-201) lately - I am excited about it and we (the Musella Foundation) have a special interest in it because we gave grants to help them get this far!  This study shows that it may also be good to treat many other types of tumors that overexpress the target!  Right now for brain tumors it is in clinical trials for DIPG and high grade gliomas that have the H3 K27M mutation - which usually occurs in younger people with tumors in the midline of the brain.