Brain Tumours: new Therapy surprisingly successful
Patients survived substantially longer
The combination of two drugs produces a critical improvement in the treatment of certain brain tumours. This has been demonstrated by researchers at Bonn University working in co-operation with German and Swiss colleagues in a current study. They treated 39 patients who had been diagnosed with a so-called gliablastoma. The patients survived on average 23 months; with the standard therapy the mean overall survival would have been 14.6 months. Glioblastomas are the most aggressive and most common brain tumours. Left untreated, they prove fatal within just a few weeks. The study has been published in the Journal of Clinical Oncology (doi: 10.1200/JCO.2008.19.2195).
Even today, glioblastomas are uncurable something which even the new combination therapy cannot change. Nevertheless, Professor Dr. Ulrich Herrlinger of Bonn UniversityŽs Schwerpunkt Klinische Neuroonkologie speaks of an outstanding success: This unusually marked extension of the survival time has surprised even us. Our results offer the opportunity to improve our grip on this aggressive form of cancer. Now, further investigations involving a larger number of patients are needed to optimise this therapy. Planning for this is already in hand in Bonn.
Up to now, doctors have treated glioblastomas using radiotherapy with concomitant chemotherapy. The gold standard for this for the last few years has been the active agent temozolomide. This is still celebrated as the most important breakthrough in the treatment of glioblastomas. The researchers combined this preparation with the drug lomustine. At the same time, the patients were given radiotherapy. The 39 patients treated with this combination survived the tumour for an average of 23.1 months. With the standard therapy, this time is over one third shorter. Seven patients even survived for over four years.
Genes decide the Success of the Therapy
It appears that certain changes in the genotype of the tumor are critical for the success of this therapy. Patients with a certain genetic modification in their tumor survived on average a good 34 months, Ulrich Herrlinger declares. The other patients did not have any benefit beyond effects brought about by pure radiotherapy at least, not in the dosage we tested. For our combination chemotherapy it is possible that a simple gene test could decide for whom this therapy might be of benefit. One disadvantage of the new method are the side-effects. However, these mostly occur during the several months of the treatment phase. After that they normally disappear completely, and the patients have no further long-term side effects, Herrlinger stresses.
Working in co-operation with the Life&Brain-Zentrum in Bonn, the search is now on for even more effective therapies. Amongst other things, we now want to use primary cell cultures from original tumours to study precisely what the drugs we used in the study really effect and how we can further enhance their effect, Dr. Martin Glas, one of the authors of the study, declares.
Long-Term Survival of Patients With Glioblastoma Treated With Radiotherapy and Lomustine Plus Temozolomide. Martin Glas, Caroline Happold, Johannes Rieger, Dorothee Wiewrodt, Oliver Bähr, Joachim P. Steinbach, Wolfgang Wick, Rolf-Dieter Kortmann, Guido Reifenberger, Michael Weller, and Ulrich Herrlinger. Journal of Clinical Oncology, Februar 2009
Prof. Dr. Ulrich Herrlinger
Leiter des Schwerpunkts Klinische Neuroonkologie
Neurologische Universitätsklinik Bonn
Telefon: 0228/287-19887 oder -15736