Gliomas are the most common type of brain tumor in adults. There are 4 main types of gliomas: ependymoma, astrocytoma, oligodendroglioma, and glioblastoma. Within each type of glioma there are grades that indicate the severity of the tumor. Glioblastoma is the most aggressive form of brain cancer with an average survival of less than 10 months after recurrence. It’s been decades since new treatments have come out for gliomas and there is a desperate need for new and innovative ways to treat these tumors. Luckily in the past year there has been some promising glioma research and results.
Vorasidenib
Recently a drug called Vorasidenib was studied in a clinical research study for certain subtypes of gliomas. The results of this trail were very promising. Results of the clinical trial were published in the New England Journal of Medicine on June 4th, 2023: “The team found the drug vorasidenib more than doubled progression-free survival in people with recurrent grade 2 glioma with IDH1 and IDH2 mutations. Compared with people who received a placebo, those who took vorasidenib went for nearly 17 more months without their cancer worsening, delaying the time before they needed to begin chemotherapy and radiation (Mellinghoff et al.).”
According to the New England Journal of Medicine, in a study of 331 people with the disease, the drug was effective in lengthening the period of time before the patients’ cancer worsened, and with no observed adverse effects. In patients with grade 2 IDH-mutant glioma, vorasidenib significantly improved progression-free survival and delayed the time to the next intervention.
BAY 2402234
Last fall (2022) the National Cancer Institute published the results of 2 new studies that show promising results for brain tumors with certain mutations. Through these studies we have learned that some gliomas become dependent for their survival on one of the ways that cells produce pyrimidine nucleotides (components of DNA). The tumor’s dependence on this process creates a vulnerability that we may be able to exploit.
One study focused on diffuse midline gliomas, which occur most often in children. The other study focused on gliomas with mutations in the IDH1 or IDH2 genes, which tend to occur in adults. In both studies, a drug called BAY 2402234 penetrated the brains of mice with gliomas and shrank their tumors. At the time this article was published researchers were going to begin clinical trials for this new drug.
This is positive news especially considering I have a glioma with an IDH1 mutation. However, the drug research process is extremely complicated, costly, and time-consuming. It will likely be years before we hear more on this drug.
Cannabinoids
The University of Birmingham in the UK is conducting a major clinical trial for aggressive brain tumors. An oral spray containing cannabinoids will be used to treat recurrent glioblastoma at two different sites in the UK. It is a 3 year, phase II clinical trial known as ARISTOCRAT. The study is funded by The Brain Tumour Charity and coordinated by the Cancer Research UK Clinical Trials Unit at the University of Birmingham. It will investigate whether combining nabiximols and chemotherapy can help extend the lives of people diagnosed with recurrent glioblastoma.
This study will recruit more than 230 glioblastoma patients at 14 NHS hospitals across England, Scotland and Wales in 2023 including Birmingham, Bristol, Cambridge, Cardiff, Edinburgh, Glasgow, London, Liverpool (Wirral), Manchester, Nottingham, Oxford and Southampton.
In 2021, a phase I clinical trial in 27 patients found that nabiximols could be tolerated by patients in combination with chemotherapy, and has the potential to extend the lives of those with recurrent glioblastoma.
Are clinical trials for me?
Unfortunately at this time I am not eligible for any clinical trials, and I won’t be until my cancer progresses. This is something I struggle with, but I guess the way it works is that when you have an occurrence (or recurrence), that’s when your medical team automatically searches for any studies you may be eligible for. I was not eligible for anything when I first came to my oncology treatment team. When my cancer grows again, that’s when they would again search to see if I’m eligible for anything.
Because I’m still young and my tumor is considered low grade, my team would not recommend I participate in early phases of any clinical trials. Glioblastoma patients are definitely given the focus/priority when it comes to clinical trials as the prognosis for those patients is not good. I always recommend talking to your treatment team about studies you may be curious about.
FDA and clinical trials
The FDA estimates that on average it takes 8.5 years to study and test a drug before it could become available to the public. And, the FDA has full control over if they’ll even release it to the public or not. Typically a drug starts with early laboratory and animal testing. If it moves through that, it would move to clinical trials which have 4 phases. Someone of my age with a lower grade brain tumor would not be recommended to participate in early phases of a clinical trial.
It can feel frustrating at times not knowing everything that’s being looked into. One thing I do every so often to feel more in the loop is to look at clinical trials that are going on. I even look in other countries, especially the UK:
For example, here are some things I know are being researched now for Grade II Astrocytomas, just by looking through clinical trials:
- Antineoplaston therapy
- Everolimus in conjunction with Temozolamide
- Antigen-peptide vaccinations
- Optune
- Lysate vaccines
- Chloroquine
- Varlilumob and IMA950
Stay tuned for future posts about the latest in glioma research.
♡ Hailey
Questions? Comments? Suggestions?