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IBTA E News December 2012
Dear Friend
AVAglio: Results were announced at the SNO (Society for Neuro Oncology) Conference of the Phase III AVAglio study comparing Avastin (bevacizumab) in combination with radiation and temozolomide versus radiation and temozolomide plus placebo in patients newly diagnosed with glioblastoma. The Avastin arm showed a 36 percent reduction in the risk of disease worsening or death which can also be referred to as a 56 percent improvement in PFS or a 4.4 month improvement in median PFS. Interim results for overall survival did not reach statistical significance (HR=0.89; p=0.2135). Final data on overall survival are expected in 2013. Secondary endpoints included a number of relevant health-related quality of life measures; an additional benefit was that patients in the Avastin arm required less corticosteroids.
Cancer-killing viruses and brain tumours: Researchers have revealed that the use of viruses to treat brain tumours may be less effective than expected. A study found that: “...within hours of oHSV (oncolytic Herpes simplex) infection of glioblastomas in mice, activated natural killer (NK) cells are recruited to the site of infection. This response substantially diminished the efficacy of glioblastoma virotherapy... These results demonstrate that glioblastoma virotherapy is limited partially by an antiviral NK cell response involving specific NCRs, uncovering new potential targets to enhance cancer virotherapy.”
Public service announcements: In the November E News we reported on community or public service television announcements (PSAs) from The Netherlands and Australia. The Brain Tumour Foundation of Canada has advised us of three outstanding PSAs they have made in collaboration with David Rey, an award winning Canadian film maker and other filmmakers from Canada and the USA. David's brother died of a brain tumour in 2011.
Successful search for UK mother and young son with a brain tumour: A seven year old boy who had recent surgery for a medulloblastoma prompted a nationwide hunt when his mother “fled” with him because she opposed doctor’s recommendations that the boy should have radiotherapy. The mother and her son have since been found and the woman has explained that she had been told that radiotherapy would "fry" her son's brain, that she believed in alternative therapies, that she was on her way to obtain hyperbaric oxygen therapy for him, and did not carry a mobile phone because it could affect her son's health. A High Court judgement on whether the boy’s mother could stop him having radiotherapy has been adjourned until 18 December. The episode touches on communication issues between doctors and patients, as well as parents' rights and accepted treatment modalities which were also raised in a very similar case in the USA involving an eight year old girl with a medulloblastoma and reported in the August IBTA E News Meanwhile, Dr Mustafa Khasraw (Australia) is publicising a COGNO survey of doctors of their treatment of adult medulloblastoma. The results are immediately available to all doctors who complete the survey and will be available to non-doctors when the survey has been finalised.
New Zealand brain tumour patient faces deportation: A British family who have lived in New Zealand for seven years face deportation because the father has a brain tumour. Immigration NZ acting general manager Bruce Burrows said their application for residence was rejected because Mr Crystal was no longer actively in business and was "likely to impose significant cost or demands on New Zealand's health services". Friends and neighbours have been helping the family with cash and other donations.
Circulating Microvesicles from Glioblastomas: A study published recently in Nature Medicine has demonstrated that microvesicles (miniscule cell particles) shed by brain tumour cells can be reliably detected in human blood using nanotechnology and nuclear magnetic resonance (NMR) technology. The study authors state: “This platform could provide both an early indicator of drug efficacy and a potential molecular stratifier for human clinical trials.”
Swallowing and voice problems after neurosurgery: Experts from Johns Hopkins (USA) are recommending that patients who have had “benign” vestibular schwannoma tumours resected from the base of the brain should be given early post-surgical assessment within 24 hours for trouble chewing, swallowing food and speaking normally. Timely assessments like this, doctors say, can minimise later complications.
ASCO Annual Clinical Cancer Advances Report: ASCO has issued this report which is now available for free download (6.10 Mb) from the Journal of Clinical Oncology. Dr Mark Gilbert of the University of Texas MD Anderson Cancer Center in the US has contributed a chapter on “Central Nervous System Cancers” and has chosen to highlight as "notable advances" the genetic marker discoveries for anaplastic oligdendrogliomas, the relevance of MGMT alteration status for choosing RT or chemotheraphy for elderly patients with GBM and high grade astrocytoma, and the relevance of Bayesian-based trial design and factorial design for trials involving rare diseases.
The World’s Tallest Woman: According to Russian newspaper Pravda, Chinese woman Yao Defen, who is listed in the Guinness Book of World Records as the tallest woman in the world, has died at age 40 from a brain tumour (possibly a pituitary tumour?). Yao Defen was diagnosed with a brain tumour as a teenager.
Therapeutic developments: Memantime - A drug usually prescribed to Alzheimer’s patients has been shown to slow cognitive decline in metastatic brain tumour patients. Everolimus - A Phase III study, reported in The Lancet conducted with 117 patients (infants to adults) with tuberous sclerosis complex (TSC) has concluded that “...the mTOR inhibitor everolimus substantially and significantly reduced the volume of subependymal giant cell astrocytomas” (SEGAs) in persons with tuberous sclerosis complex (TSC). Geron - Geron Corporationannounced that the company has discontinued development of GRN1005, its peptide-drug conjugate designed to treat cancers in the brain. "Going forward, the company will focus on the development of imetelstat, its telomerase inhibitor, in hematologic myeloid malignancies and in patients with solid tumors that have short telomeres." Novocure - The European Journal of Cancer’s (EJC) Editor-in-Chief Lex Eggermont has chosen eight key papers published in the journal in the third quarter of this year. One of them is the article by Roger Stupp et al about the Novocure TTF device and physician's choice of chemotherapy for recurrent GBM. 5-ALA fluorescence guided neurosurgery - Neurosurgeon Dr Lindy Jeffree has advised the IBTA that 5- aminolevulinic acid has been recommended for listing on the Queensland (Australia) list of approved medications. There is also a trial involving 5-ALA led by Dr Colin Watts in the UK. Cotara - Peregrine Pharmaceuticals announced that it had made significant developments in agreement with the US FDA for the design of a single registration trial (involving up to 300 patients) for its drug cotara for recurrent GBM. Zeiss - Zeiss has been reported as planning to extend the use of its 3D neurosurgery technology in Europe, Canada and other areas..
Pregnancy and meningiomas: Meningiomas have been known to occasionally grow dramatically in pregnant women. A study published in the November issue of Neurosurgery concludes that: “...pregnancy-associated meningiomas located in the skull base are likely to require surgical intervention for visual complaints and cranial nerve palsies. The rapid tumor growth is more often due to potentially reversible hemodynamic changes rather than hormone-induced cellular proliferation.”
Chemo brain; and Meditation with Art Therapy: Chemotherapy can induce changes in the brain that may affect concentration and memory, according to a study of breast cancer patients presented at the annual meeting of the Radiological Society of North America (RSNA). Using positron emission tomography combined with computed tomography (PET/CT), researchers were able to detect physiological evidence of "chemo brain", a common side effect in patients undergoing chemotherapy for cancer treatment. Comment - if they were able to identify this phenomenon in breast cancer patients how much more likely would its occurrence be for brain tumour patients receiving therapies that target the brain? In another study of breast cancer patients which may also have implications for brain tumour patients, US researchers combined creative art therapy with a Mindfulness-based Stress Reduction (MBSR) program for women with breast cancer and showed changes in brain activity associated with lower stress and anxiety after the eight-week program.
Conference deadlines and dates: The 2013 Biennial Pediatric Neuro-Oncology Basic and Translational Research Conference, organised by SNO with assistance from the Pediatric Brain Tumor Foundation, will be held in Ft Lauderdale, Florida from 16 to 17 May 2013. The deadline for abstract submissions is 4 February 2013. Another conference involving SNO and the AANS/CNS Section on Tumors, deals with "Multidisciplinary Approaches to Meningiomas" and will be held in New Orleans on 27 April 2013. The joint EORTC-EANO-ESMO "Trends in Central Nervous System Malignancies” conference will be held in Prague, Czech Republic from 22 to 23 March 2013. The early rate registration closes 11 January 2013 and the abstract submission deadline is 11 February 2013. The Asian Society of Neuro Oncology conference, 21 to 24 March 2013 will be held in Mumbai, India. Last date for abstract submission is December 23, 2012 and various registration deadlines can be found here. The IBTA plans to attend both the Mumbai and Prague conferences. The 24th Congress of the Latin American Society of Paediatric Oncology will be held in Bogota DC, Colombia, during 4to 6 April 2013. There will be a brain tumour workshop on 3 April and a parents' support meeting on 4 April.
EU Clinical Trials Regulation: Together with 25 other prominent UK and European organisations, the IBTA has signed a formal statement in support of the proposal for a Clinical Trials Regulation released by the European Commission.
ECCO Oncopolicy Forum: The IBTA participated in a recent Oncopolicy Forum in Brussels organised by the European CanCer Organisation (ECCO) which involved more than 100 leaders in European cancer policy. Videos featuring interviews with some of the delegates including IBTA Co-Director Kathy Oliver can be accessed here.
Thank you for your continuing support.
Our best wishes for a happy holiday season.
Denis Strangman (Chair and Co-Director)
International Brain Tumour Alliance IBTA
www.theibta.org
Kathy Oliver (Co-Director)
PO Box 244, Tadworth, Surrey
KT20 5WQ, United Kingdom
Tel:+ (44) + (0) + 1737 813872
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