This may be the most important paper of the year so far!    This is the preliminary results of the clinical trial of Optune combined with Pembrolizumab (Keytruda) along with Temozolomide for adults with newly diagnosed Glioblastoma.   The results are impressive. They compared these patients to matched patients from the ED-14 trial - which was the large phase 3 trial of Optune plus Temozolomide for newly diagnosed patients.   By adding Keytruda to Optune plus Temozolomide, the median overall survival was 25.2 months, compared to 15.9 months without the Keytruda. This is from the time Optune was started - which was about 3 months from diagnosis - so add 3 months to those numbers to compare to other treatments!   That is very impressive and worth trying.   All of the components are approved, but Keytruda is not approved for brain tumors so you might have insurance issues.   If you have problems, talk to us and we can sometimes help.  Our copay assistance program can help pay for Optune and Temozolomide for you but not the Keytruda yet.

This article shows that for elderly or frail glioblastoma patients, there is a way to cut the treatment time in half, from 30 treatment days (5 days a week for 6 weeks) to 15 treatment days, and up the dosage per treatment and get about the same results.  This makes it much more convient for the patient and probably saves a lot of money.     Currently for this group of patients, they do use the 15 treatments but at a lower dose with worse results. This shows the higher dose is safe and works better!

 They are vague on which drug this is, but it sounds exciting.  Dr Debinski is one of my favorite brain tumor researchers.  He was involved in the development of the drug cintredekin besudotox.  That "Smart Bomb" targeted drug was supposed to seek out and kill cells that had IL13 expressed on their surface.   Unfortunately, it is a large molecule and could not be given oral or IV, so they tried convection enhanced delivery.  At that time, CED was not advanced enough and most patients did not get the drug to the entire tumor bed.   The target was also found on some normal cells, so it had some toxicity.

   Dr Debinski has been refining the concept over the years.  I do not know the details of the current drug, but my guess would be he picked 4 targets that are only (or mostly) found on tumor cells, attached to a toxin,  so it should work on all Glioblastomas, and use modern CED technology that will let the drug get to the right place in all (or most) cases.  I wish him luck.  If you have a dog with a Glioblastoma, this might be worth a try. They are working on dogs for the next 2 years then will start human trials.

 This is a fun event. No purchase or donation needed (but appreciated).   Follow the link to the event, register with your email address and make up a password. After you log in, you will be asked for the group password, which is sammyhusky    

Then just pick which teams you think will win each match!   First prize is $1,000!

You need to do this by tommorrow 3/16/22.  Do it right now!

 This vaccine trial is one of my favorites. They had pretty good early results!

 This fascinating article talks about a few important things:  They used a deep brain stimulator to try to mimic tumor treating fields.   These are used to treat diseases like Parkinson's disease with implanted electrodes and batteries.   It may be a more convenient way to  administer tumor treating fields if they can solve a few problem such as getting the correct distribution of fields and battery life to treat a large area - as this study was only in the test tube on a small area. Of course it is way more invasive - has surgical risks as well as the risk of having a device inside your brain.  No sure if it is worth the risks compared to Optune - where the problem is having to shave your head,  have electrodes stick to the scalp and carrying around the device and battery.

  This paper also shows that either method also works better with drugs.  They show a big improvement combining the tumor treating fields with Temodar even on unmethylated MGMT patients.  They also mention a big beneift combining with Mebendazole, which is a drug used to treat worm infestations and some brain tumor patients claim it helps the tumor.

They show gene array profiles which opens the door to more targeted treatments being used in combination.

And finally they show that some tumor cells are more sensitive to frequencies other than the stock 200 kHz - opening the door for future versions where the frequency can be tuned to your specific profile of tumor cell size.  Or perhaps a system that varies the frequency over all of the cells sizes found in the tumor so the tumor couldn't escape the treatment by evolving a larger or smaller cell size.

Overall - very interesting and opens up a huge need for further research! Good work!

This is exciting.   The checkpoint inhibitors were miraculous for other types of cancer but did not seem to help brain tumors because brain tumors are immunologically "cold".  This paper says that Optune can help turn the tumor into a "hot" tumor, which makes it more amenable to treatment with checkpoint inhibitors.   Early research seems to show it works. More research is needed to figure out the optimal timing and dosages but this is the type of thing we can do from within our patient navigation program and registry!  So if you are thinking of trying the combination, join our program first so we can track it! https://virtualtrials.org/xcelsior.cfm

[Disclaimer: Novocure is a sponsor of the Musella Foundation]

 Duh!  They obviously did not trust the results of the EF-14 Optune trial, which had about 700 patients so they repeated it in a small group of 9 (of the worst prognostic group)  patients and had the same finding.  What a waste of a trial. They should have tried some new combinations to find ways to make it work better, not repeat what was already done better.   This was probably an excuse to delay paying for it.  UK patients and charities should be demanding that their health system to pay for Optune.  

[Disclaimer: Novocure is a sponsor of the Musella Foundation]

 Synthetic control groups are the key to progress.  They should work better than the 100 year old current system, and would allow the elimination of placebos!  A win / win. I wish them luck.

We (Our partnership with Cancer Commons, the Musella Foundation and xCures) are also working on synthetic control groups!  

[Disclaimer: Plus Therapeutics is a sponsor of the Musella Foundation]

 Interesting article about our patient navigation program and our collaboration with xCures and Cancer Commons. A small clarification - the Musella Foundation not only identified the compassionate use program mentioned in the article, but we created, paid for it and ran it with our partners!

 They had one patient (out of 19) who is alive and tumor free 8 years after the single treatment.  Four other patients had a partial response.  These are pretty good results for a phase 1 trial.

 This report is very sad. In the Philippines, the average survival of Glioblastoma is only 7.6 months.   Only 15% of the patients even got chemoradiation. Nobody gets Optune. The major factor seems to be 83% of the patients were in the low income group.   Most of the world is probably in the same position.  We are lucky here in the USA that most patients have access to the approved treatments that they need.   Of USA patients who can get access to Optune, the average survival is over 2 years. 

We need more and much better treatments, but we also need to keep in mind the costs.  Brain tumor treatments are very expensive and most of the world just can not afford it.  I know that is a bigger problem than we can even hope to tackle, but what we can do is change our system to make the treatments much cheaper.  Our Promising Pathway Act should drastically cut the cost of new treatments as it cuts the time and expense of getting FDA approval while increasing the amount of research done on the treatments!

 I have seen this happen so often. A patient comes to the USA for treatment, only to be hit with huge bills and either can't get the treatment or it doesn't work.  Rarely, it does work out great and I have seen a few  miracles, but most of the time it doesn't work. The article says that the answer is more funding for research.  I completely disagree. I think the answer is to change the system so that once a treatment looks promising enough that people around the world are clamoring for it and willing to pay hundreds of thousands of dollars, the treatment should become approved and be able to be sold to patients.  Of course all of the patient have to be followed as if they are in a clinical trial so we learn how best to use (or not use) the treatment.

 This type of research adds to our understanding of how Glioblastomas grow. They found that the mutated EGFR (Epidermal Growth Factor Receptor)  can not distinguish between the 7 different proteins that bind to it - the mutated EGFR sees them all as if they are Epidermal Growth Factor which causes the cell to grow and divide quickly.  Whereas a normal wild type EGFR some of the proteins that bind to the receptor inhibit growth.  This may explain why just using an EGFR inhibitor by itself doesn't really work with Glioblastomas.   It may block the growth signal, but it still doesn't allow the growth inhibitors to work normally.  So the next generation of EGFR targeting drugs have to figure out a way to not only block the growth signals but to trigger the inhibitory signals as well!  Excellent work!

This is a very interesting video about this man's battle and how he dealt with the stress of a diagnosis of a malignant brain tumor and then the recurrence of the tumor.

 These results are interesting. They had a complete response and 2 durable partial responsed out of the 30 patients in arm d of the trial (which is the highest dose arm).  It is very hard to get a complete response in recurrent glioblastoma.  The good part is this drug, Selinexor, is approved for other types of cancer, so can be used off label for brain tumors now (although cost may be a problem).  By itself it obviously is not good enough but may play a part in a rational combination therapy.  They examined the gene expressions that changed as a result of the treatment with this drug.  This opens the door to experiment with drugs that target the expressions that increased after Selinexor. All drug research should try to measure these gene expression changes.

 This is fascinating.  They found that the placement of arrays makes a huge difference. Most of the recurrences were outside of the area of the brain that got a high dose of Tumor Treating Fields.  This supports the concept that the array placement should be updated at the time of recurrence to cover the new areas or perhaps should be designed at the start of treatment to cover the most likely areas of spread as well as the current tumor.