There are 2 important points from this study:

1. They tested a rat model to see if olaparib can cross the blood brain barrier. This is a standard test that is used for most drugs.  They found that this drug does not cross the blood brain barrier in rats.  Then they tested in people by giving the drug before a surgery and testing the tumor sample removed and found that 100% of the time it does cross the blood brain barrier and gets into the human brain.   This shows that we really can't trust the mouse models for BBB penetration and we need these human tests.

2. Olaparib is a PARP inhibitor (which is approved for other types of cancer so it is readily available off label) and they found that in the test tube it acts as a radiation sensitizer at the concentrations they found in the human testing of tumor samples. They report 36% of patients with recurrent glioblastoma were progression free at 6 months, which shows it has some effect and needs to be studied further to see how best to use it!

 This is a new type of greeting card that can be hung on a wall - like in a hospital - then easily removed and reused.

There is a discount code in the press release and they will donate to the Musella Foundation when you use that code!

 Dr Brem is one of my all time favorite brain tumor doctors and is up to date and involved in the latest high tech treatments for brain tumors. Should be a great webinar!

 This interesting study looked at what would happen if you remove small parts of the skull using burr holes to allow the tumor treating fields better access to the tumor.   There was no control group to compare but they reported pretty good results with overall survival of 15 months (after start of trial - which is for recurrent glioblastoma).  I love these studies that look at ways to make current treatments better. Now they have to build upon these results and try other combinations.

 This study shows a small improvement with Optune by itself compared to standard treatments.  Enough to show Optune does have a positive effect but not enough to use Optune by itself for recurrent Glioblastoma (or to use the standard treatments either).  Further study is needed combining Optune with other treatments to make meaningful gains in survival.

 This is just in the test tube.. but looks promising.

 As far as I know this is the first well designed trial to test if 6 or 12 months of Temodar is better.  They said 6 months is better. The outcome is the same but the side effects are significantly worse in the 12 month group. 

There have been previous reports saying the opposite but they were poorly designed retrospective studies that did not take into account people who stopped at 6 months did so because they weren't doing as well those who chose to continue to 12 months.  The current study took people doing well at the end of the 6 months and randomized them so half got 6 additional months and half stopped at 6 months. 

 I love these kinds of projects.   I think the cure is going to be a combination of treatments that work together to eliminate the cancer. I doubt we will get a magic bullet single treatment that would do it.   The Anti-cd47 antibody is experimental which makes it hard to use in new combinations.  It has been shown to be safe and help somewhat in other cancers.   I am working on a change in the laws to allow drugs like that to be approved in a new pathway, called conditional approval, which would allow us to not only try combinations like this now, but it also requires that all of the people who used these conditionally approved drugs to be followed in a registry to see how the drug and combinations work so we can home in on the ultime cure decades sooner!

 Please help and take both surveys. The first one needs both patients and caregivers to each take their own survey. The second one can be anyone, but you can enroll your entire family and circle of friends.   Please help promote both on social media!

This article looks at alternate dosing schedules for Temozolomide.   They think an every other day schedule might be better than the standard that they use in their country (which is different than what is standard here in the USA).   This is only a computer modeling and has not been tried in people yet. I like to see research on using our existing treatments better.  This should be tested in lab animals first, then if successful, a human trial. 

 They expect to release the results of their DCVAX trial around June / July.   DCVAX is a custom made vaccine which uses a patient's tumor tissue.  The tumor sample has to be fresh or stored in a special way. See http://virtualtrials.com/pdf2018/dcvaxfreeze.pdf.  If you are going to have a surgery it might be a good idea to store the tumor sample so if DCVAX is a success and gets approved, you can then have the vaccine made.  There are companies like https://storemytumor.com/ that can freez and store it for you.  

My thoughts are that this vaccine will show a big improvement in overall survival, but so will their control group, most of whom also had the vaccine.  

Lessons Learned in Using Laser Interstitial Thermal Therapy (LITT) for Treatment of Brain Tumors: A Case Series of 238 Patients From A Single Institution         LITT is a a minimally invasive procedure using laser energy delivered through a catheter, under MRI guidance to destroy tumor or radiation necrosis.  It can sometimes be used when an open surgery is too dangerous and is much easier for the patient than a traditional surgery.  This article shows how important experience is when using this relatively new technique.  The first 100 patients they used it on had a much higher (15.5% vs 4.4%) chance of permanent motor deficits than the subsequent group of 138 patients.  Some of the difference might also be explained by advances in the equipment and software.

This should be another interesting webinar.  Dr Wong ran some of the clinical trials for Optune and has a tremendous wealth of knowledge on the subject.
 

Disclaimer: Novocure is a sponsor of the Musella Foundation

 In the old days, every brain tumor patient was put on medication to prevent seizures even if they never had any.    That trend is reversing and now this study shows that the research does not support using it routinely on all patients!  

 Interesting observation - all patients should have their tumors tested and not just assume they are all the same!

 This is a small study from Turkey which shows that stereotactic radiosurgery is safe and well tolerated and may improve the progression free survival time as well as overall survival. It is not randomized and is small so it needs to be validated but this is another piece of evidence showing that we should consider stereotactic radiosurgery at the time of recurrence.  Stereotactic radiosurgery is a form of radiation therapy that is focused on a target. It can be used even after the maximum dose of standard radiation. There are a few tools that can be used to do it. The one mentioned in the article is Cyberknife but this should apply to all of the tools that can perform fractionated stereotactic radiosurgery

This should be of interest to all of our members!  Bring all of your questions!

 Our copay assistance program is now open, but it might close quickly, so if you think you could use help with your costs for the covered treatments, apply.    Never feel bad about asking for help. That is what we are here for. In these times of the outbreak, money and access to treatments becomes harder. For the duration of the outbreak, we may relax, on a case by case basis, the maximum family income criteria for those hard hit.  If you exceed the maximum family income, contact us by phone or email (the contact info is on the website) and describe your situation before applying.

This is an excellent presentation. I learned a few things I did not know before.  I do not think I have ever seen any information on this topic ever before. If you have brain cancer or any other type of cancer, this is a must view. 

     They reported a huge improvement in median overall survival for recurrent / recalcitrant Anaplastic Astrocytoma. 1,136 days for this experimental treatment compared to 590 days for the standard Temozolomide. That is more than double.    This is given by convection enhanced delivery. This drug is a new TGF-Beta antisense drug.   It should theoretically work for a wide variety of cancers and is also being studied for use against the COVID-19 virus.