Researchers at McGill University Health Centre (MUHC), Montreal have developed a new clinical approach to enhance the efficiency of treatment for glioblastomas, which increased the average survival time to 22 months.
The findings from this promising Phase II clinical trial have been published in the International Journal of Radiology Oncology.
Glioblastomas are the most common and aggressive brain tumours found in adults. With an average survival period of 12-18 months, new and more advanced treatments are urgently needed to prolong survival. The current standard treatment protocol is to remove as much of the tumour as possible, before chemotherapy and radiotherapy are given.
However, glioblastomas are 'diffuse' tumours meaning they have thread-like tendrils that extend in to other parts of the brain making it difficult to remove it all. The chemo-radiation is therefore needed to remove those cells which can't be reached by surgery.
After surgery patients need at least a four to five week recovery period before starting radiotherapy. Unfortunately during this time any remaining tumour cells continue to grow and some cells can be resistant to chemotherapy and radiotherapy.
In this clinical trial involving 50 patients, researchers gave chemotherapy to patients prior to radiotherapy. This type of therapy, known as neo-adjuvant chemotherapy, prevents the tumour from progressing during the recovery period.
Neo-adjuvant chemotherapy was followed by Hypofractionated Accelerated Radiation Therapy (HART). When standard radiotherapy is administered, it is fractionated or split up in to small daily doses that are given over a number of weeks. HART is instead given over a fewer number days with a slightly larger dose given each day, to increase the efficiency of the treatment. The team believe that they had better control over the tumour and that HART better targets the resistant cells which are responsible for tumour recurrences.
“Glioblastomas are very difficult to treat. These tumours grow and spread quickly throughout the brain, making it very difficult to completely remove with surgery," said Dr George Shenouda, Radio-Oncologist at MUHC and lead author of the study.
“50 per cent of the patients in our study have survived two years since their diagnosis – this is very encouraging and we are very positive about the outcome," says Dr Shenouda.
While these initial results are very promising, additional research is needed. A larger-scale Phase III will be the next step to confirm these findings.
In the past few years the research community have significantly advanced their understanding of the genetic causes that drive the growth of these aggressive tumours. These developments are enabling researchers to discover new drug targets and therapies that can enhance quality of life and prolong survival, with the potential to supersede existing treatments like chemotherapy.
As a Charity we will continue to invest in only the highest quality research that aims to double the survival of patients and halve the harm to those that are affected.