Combination therapy may increase survival rates in brain cancer patients

Researchers found that a combination of vaccine and chemotherapy sessions may help boost both progression-free survival and overall survival rates for patients suffering from glioblastoma, a malignant tumour affecting the brain or spine.

In a clinical trial, 11 patients received a vaccine targeting cytomegalovirus (CMV) antigen pp65, combined with high-dose chemotherapy (temozolomide).

The results demonstrated a median progression-free survival of 25.3 months and a median overall survival of 41.1 months in eight patients.

The researchers said, in the remaining three patients, the disease was progression-free for more than seven years after diagnosis.

Lead author Kristen Batich from the Duke University in North Carolina, US said, "The clinical outcomes in glioblastoma patients who received this combination were very striking".

The typical median survival for glioblastoma patients is less than 15 months.

To overcome these poor numbers, the researchers took advantage of CMV's affinity for glioblastoma, with the viral proteins being expressed in roughly 90 per cent of these tumours.

They used the CMV as a proxy for glioblastoma, while targeting the virus with pp65-specific dendritic cells to spotlight the tumour for the immune system.

Previous work had shown that TMZ generates profound lymphopenia or the loss of immune cells, which offers a unique opportunity to retrain the immune system, Batich explained.

The researchers administered dose-intensified temozolomide (TMZ) as a strategy to further enhance the immune response.

Batich said, "The dose-intensified temozolomide induces a strong state of lymphopenia. With that comes an opportune moment to introduce an antigen-specific vaccine, which redirects the immune system to put all hands on deck and fight that target".

The finding was published in the journal Clinical Cancer Research.

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Tiny carrier can help treat brain tumour

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 A nanocarrier engineered to be small enough to get past the blood-brain barrier could be targeted to deliver a chemotherapeutic drug more efficiently to tumour cells in the brain, a new study reveals.

The blood-brain barrier is a protective barrier designed to keep a stable environment within and surrounding the brain. In experiments, the researchers found that the new method resulted in increased killing in the targeted cells.

"I was very surprised by how efficiently and well it worked once we got the nanocarrier to those cells," said Ann-Marie Broome from Medical University of South Carolina in the US.

The findings potentially point the way to a new treatment option for patients with certain conditions, such as glioblastoma multiforme (GBM), the focus of this study. 

 Glioblastoma multiforme is a devastating disease with no curative options due to several challenges, Broome said.
The brain tumour has a significant overall mortality, in part due to its location, difficulty of surgical treatment and the inability to get drugs through the blood-brain barrier.
In 40 percent of cases, standard treatments will extend life expectancy four to seven months. 

 That led the researchers engineer a micelle that is a phospholipid nanocarrier, "a bit of fat globule," to deliver a concentrated dose of the chemotherapy drug temozolomide (TMZ) to the deadly tumour cells.


"Micelles of a certain size will cross the blood-brain barrier carrying a concentrated amount of TMZ," Broome explained about how the nanotechnology works.

The study was published online in the international journal Nanomedicine - Future Medicine.

In medicine, Broome said, researchers construct nanocarriers that are stable and stealthy. "Your immune cells can't attack them. They remain hidden.

"When the package gets to where it's going, nanotechnologists have various methods to get the micelles to release their payloads -- one way is to use the acidic nature of a rapidly growing tumour," she said.