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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04/02/23 Musella Foundation Copay Program Almost Closed!        

 Our Copay program  already gave out grants to 152 patients this year which puts us on pace for our best (or worst - as it is criminal that our program is even needed) year ever.  Our best year previously was 2021 in which we gave out 311 grants.   

Unfortunately we are running low on funds and will have to close to new and renewal applicants soon. We do not know when or if the program will reopen as we work on donations. This is a life saving program, as many of the recipients tell us they wouldn't take the treatments without our help.  If you would like to help, make a donation and select "copay fund" for where it is to be used!

We have our 5K fundraisers coming up in May - but those funds are dedicated to brain tumor research only. We will award brain tumor research grants in June.  (Researchers can apply now - contact me for details).



03/31/23 Recombinant polio-rhinovirus immunotherapy for recurrent paediatric high-grade glioma: a phase 1b trial        

 We (the Musella Foundation) helped fund this first in kids project.    It was intended to see if it was safe enough to use this treatment on kids - and they found it is. 3 of the 8 patients who received the single CED infusion treatment had at least stable disease for a time. One patient was still alive at the end of the study at 22 months.  These were heavily pre-treated patients who had failed an average of 3.5 lines of therapy before trying this treatment.  Although this group of kids did much better measured from first recurrence to death than the average survival expected, it is hard to tell how much of that is due to this treatment as they had so many other treatments as well.  More research is needed.



03/28/23 Dopamine receptor D2 regulates glioblastoma survival and death through MET and death receptor 4/5        

 The experimental drugs Onc201 and Onc206 work on this pathway.   We need to get them approved so we could use them in combinations.




03/24/23 The first-in-class ERK inhibitor ulixertinib shows promising activity in mitogen-activated protein kinase (MAPK)-driven pediatric low-grade glioma models        

 This experimental drug is available via expanded access through xCures (I am a paid consultant for xCures) https://clinicaltrials.gov/ct2/show/NCT04566393



03/17/23 FDA Approves Dabrafenib Plus Trametinib for Pediatric BRAF V600E-Mutant Low-Grade Glioma        

 This shows the importance of having genetic testing done on your tumor.  The BRAF V600E mutation is rare, but when found, this drug combination is useful.  This mutation is more commonly found in kids with low grade brain tumors, but also sometimes in adult glioblastoma. Although approved for kids with low grade tumor, it can be used off label for adults and kids with high grade tumors when they have this mutation.



03/15/23 Drug offers renewed hope to brain cancer patients        

 This drives me crazy. About 20% of the patients have a major response and at least 1/3 of the patients are helped somewhat with onc-201 alone. This is for dmg and dipg, where no drug has ever shown a response before. The logical next step is to try the combinations we think will make it work for most patients. There are small trials underway to slowly test a few combinations. However, instead of concentrating on making it work better, they decide to waste years, lots of money, and kill patients with a literal sugar pill placebo controlled trial. Shows a complete lack of understanding of what is needed. Drugs like this should be fda approved so every patient can get easy access and we can learn how best to use it.

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03/15/23 Hoops For Hannah Brackets Deadline        

This is a fundraiser for brain tumor research. And lots of fun!   



03/15/23 Servier's Pivotal Phase 3 INDIGO Trial Investigating vorasidenib in IDH-Mutant Low-Grade Glioma Meets Primary Endpoint of Progression-Free Survival (PFS) and Key Secondary Endpoint of Time to Next Intervention (TTNI)        

 I love to see research on low grade gliomas.These tumors are usually ignored and excluded from most brain tumor trials. Although they do not discuss the numbers, it is great to see they met the endpoints.  



03/13/23 Head to the Hill 2023        

 We partner with the National Brain Tumor Society to advocate for issues that affect brian tumor families.    If you would like to help, read the attached notice and volunteer to go to Washington, DC to visit your congress people!   No experience needed. It is a lot of fun and it will make a difference!



03/12/23 Newly-diagnosed high grade glioma surgery with Carmustine wafers implantation. A long-term nationwide retrospective study        

 Impressive 5 year survival of 10% with Gliadel Wafers.  This has been approved in the USA for a long time - this is the long term results. They do not mention controls, but historically, the accepted 5 year survival is about 4%.  Doesn't sound like much by itself but it may buy time for other treatments to work, and possibly be useful in combination therapies.  



03/12/23 Aurora B Kinase Inhibition by AZD1152 Concomitant with Tumor Treating Fields Is Effective in the Treatment of Cultures from Primary and Recurrent Glioblastomas        

 They show a significant benefit when combining these 2 treatments in the lab.  Each had a strong effect by themselves, but the combination was much better.    As noted in the article, it should first be trested if AZD1152 gets to the tumor in the right concentration - might be a good combination to try in a phase 0 trial.



03/08/23 Novocure Announces Reimbursement of Optune® for the Treatment of Newly Diagnosed Glioblastoma in France        

 Optune is finally available in France!   It is a shame that it took so long.  



03/08/23 Weil Cornell Medicine webinars on Advances in Brain Tumor Research and Treatments        

 This is from our friends at Weil Cornell Medical Center in NYC.      These webinars are very informative and give you a chance to ask questions of the experts!



03/07/23 Learnings from Pilot Study: Creating Treatment Templates to Serve More Glioblastoma Patients        

We partner with Cancer Commons to run our patient navigation program.   Any cancer patient can (and should) take advantage of the program!   We have had some remarkable outcomes, even when others have already given up hope. 



03/06/23 Musella Foundation Copay Program now open to new and renewal patients!        

 Our program is open again. Hopefully it will remain open for a about a month before we run out of money again!  But don't count on that. If you think you could use help, apply as soon as possible!  Once accepted, you get 1 year to use the money, starting 3 months before you are approved and ending 9 months after approval. 



03/06/23 Foundation stirs controversy by charging cancer patients $83,000 for unproven but promising experimental drug        

This article really doesn't seem to understand our situation when dealing with a malignant brain tumor.   Every patient that goes through our patient navigation program is given a vaccine as one of the suggested options.   There are a few clinical trials for vaccines, but they are very difficult to get into.  The vast majority of these patients can not get into these trials, and if they do get in, then they have to contend with a placebo control on most of them, so they might not even get the vaccine.   One of my friends started the foundation named in the article to help solve  this problem.  We had many patients going outside the USA to get access to vaccines, which is not only expensive but difficult for many brain tumor patients.   Ideally, this foundation would find a way to get funding for these patients but right now there is no funding other than requiring the patient to pay the costs.   Under FDA rules, unapproved treatments accessed under expanded  access can only charge the actual cost of the treatment. This was not meant to be  for profit. All of the available vaccines were evaluated and they selected the personalized neoantigen synthetic long peptide vaccine which was created at the Washing University School of Medicine.    Based on your molecular pathology report, a team of experts figure out which of the markers are most likely the drivers of the tumor, and create a unique vaccine just for your particular case.  This is an expensive process and undergoes a lot of quality control before a patient can get it.  

So it brings up an ethical dilemma:  Is it fair to provide a promising experimental treatment only to those that can afford it?   Or is it better not to do it at all?  Keep in mind this is no more expensive that most other treatments that are being used - the problem comes up because insurance usually does not pay this and it does pay for the other treatments.  So it is a problem with our system, not with the vaccine.  This is the reason I am supporting the Promising Pathway Act. Under the current system, the cost to take this vaccine into the standard (or even accelerated) FDA approval pathway would take at least 7-10 year and cost anywhere from $500 million to over a billion dollars.   Under the Promising Pathway Act, we could cut that down to maybe 2-4 years and $5 to $10 million.  Still expensive but much easier to raise than under the standard pathway. 

Bottom line: This is a promising treatment and it is better to have access than not have access, even if it cost a lot of money. We need to find a way to help patients pay treatments like this.



02/10/23 Immunotoxin-aCD40 therapy activates innate and adaptive immunity and generates a durable antitumor response in glioblastoma models        

 The Musella Foundation gave a $50,000 grant back in 2010 to get this project going.  Used by itself, it has pretty good results in a phase 1 trial:3 patents (out of 43) had long term partial responses of 54,34 and 28 months after a single injection of the treatment.  They think combining it with a checkpoint inhibitor will make it work better, and it did in mice.  It cures GBMs in mice, but now they have to prove the combination helps in people. There is a clinical trial of this combination for recurrent malignant glioma going on at Duke.  See https://clinicaltrials.gov/ct2/show/NCT04547777 for details. The concept makes a lot of sense. Hope it pans out.



02/10/23 A Critical Analysis of Neuro-Oncology Clinical Trials        

 These authors make an excellent point:  The clinical trials system needs to be updated.  We should create a standardized database - perhaps using clinicaltrials.gov - to hold the patient level data in a trial.  The control groups' de-identified data should be available to researchers to use for external contemporaneous control groups.  Most trials do not accrue completely - too many lives are wasted in a control group, when this database could eliminate or minimize the need for control groups.    The FDA should scrutinize clinical trial design and make suggestions at the start. In practice, they seem to rubber stamp trial design at the start, but then when it comes time for approval, they rip apart the trial design that they originally approved.   Perhaps trial designs should go before a board of neuro-oncologists which help transform the trial into a better design so we do not waste lives.



02/08/23 Dose-dependent efficacy of bevacizumab in recurrent glioblastoma        

 We need more research into this.  Dr Virgina Stark Vance was the first neuro-oncologist to use Avastin for Glioblastomas.  It was scary using it for the first time because the blood vessels in a glioblastoma are messed up and there is a fear that Avastin might cause bleeding into the brain.  So she used 5mg/kg  which was 1/2 of the standard dose  used for Colon cancer at the time. She had remarkable results.   Then many trials were launched to confirm the activity that she saw.  Most of them used the 10mg/kg dose that was popular for Colon Cancer.  The results showed an increase in response rate and progression free survival but no increase in overall survival. However, Dr Vance continued to use the lower dose, which she feels has better outcomes. This study confirms that. 



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