Two new brain tumour papers

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 I am publicising only two very recent papers on new brain tumour trials and therapies, but I do it with important qualifications and differing reasons.

It's interesting that the first has taken so long, not only to have this trial done but to get it into the public arena. The fact is that it takes time and money to get to this point. If it's to be done properly, with intelligence, planning and post-number-crunching, then a good case must be made for investing in all of this.

Even more confusing is the conflicting evidence, and I'm living proof of it. The story on the first says that Avastin offers only 'extra weeks' on average for GBM victims.* In my case, a person in his 60s, Avastin has given me an extra two years or more so far, although it is clear that I am at the stage where the 'cure' becomes the 'poison'.

It's done its job. I can't ask for more, but the fact that it's an unbreakable pact between Avastin and me may explain in part why I did not opt for it months before I did – a question I've been asked several times. There are other reasons as well, but I won't go into them further here.

My point is that this report can have a negative impact on decisions by Governments to extend PBS subsidy to drugs like Avastin, if those who decide these matters think 4.5 months is not worth the $20,000+ expense. This means many may miss out on significant reasonable quality of life extension simply because they can't afford tens of thousands of dollars to see if it's useful for them. The benefit as in my case, is measured in years, not months. This could well be the case for others, like young parents.

In the first case, Avastin is in use in Australia, obviously, or I wouldn't be here now. In the second piece of research, it is likely that because it is only in the trials stages in the US, it won't be of any benefit to those in Australia who have brain tumours now. This is not to say that it has no long-term value, of course, but often hopes are raised, only to be dashed. 

I have taken chunks from these articles but you should read the originals at the sites indicated, as they say important things I leave out. I offer them to you to help move debate along as to new therapies and how they might work. As I said, please read the full article if you want a real understanding of its substance.

The first is a British study, the second American. Three dots [...] indicates where parts of the original article have been omitted. My sincere thanks to all involved.

Article 1 

Drug offers brain cancer victims extra weeks of normal life

By Victoria Fletcher

Patients with incurable brain tumours could be given new hope thanks to a drug currently used on bowel cancer, a study suggests.

Glioblastoma multiforme (GBM) kills more people under 40 than any other cancer... the most common and most dangerous of brain tumours.

Unlike other cancers, which are more likely to strike as patients get older, GBM is just as prevalent in patients who are young and healthy.

Unfortunately, the average sufferer will only survive for 14 months after diagnosis... and 2,500 die from their tumours annually.

However, a new trial published yesterday shows patients can be given an extra four-and-a-half months without their condition worsening** if they also receive the drug Avastin.

The trial on 911 men and women suggests Avastin can slow the growth of the tumour, giving patients a few more months of relatively normal life before the tumour grows so big that it starts to destroy their ability to speak, their behaviour, their memory and their movement.

...  'Giving them a few extra months to [prepare] before they deteriorate and cannot speak is important. This is an endpoint in itself, even if this drug does not improve overall survival rates.'

...At the moment, patients diagnosed with GBM are usually offered surgery to remove the tumour, followed by cycles of chemotherapy and radiotherapy. For most, however, relapse is inevitable and half will have died from the disease within 14 months. Around 25 per cent will manage to survive for two years, while fewer than ten per cent live for five years.

Avastin, which is made by the pharmaceutical giant Roche, works by reducing blood supply to the tumour and slowing its growth. It is already used to treat colorectal, breast and ovarian cancers.

Some patients in the UK already receive Avastin to treat recurrent forms of brain cancer, because it is not yet approved for this use on the NHS....  'In principle, anything that slows the progression of GBM has to be a good thing,' he said.

 'But this disease is such a minefield and it's important to remember different patients are affected differently, depending on which side of the brain [and the location D.W.] the tumour is found.

 'My wife was climbing mountains after she was diagnosed but then the tumour progressed and it was on the left of her brain, so it affected movement, personality and memory.

 'I would want any new drug to ensure it gives patients four more months when they can climb mountains and not four more when the disease has already robbed them of their speech and memory.'

It currently takes the average GP three months to diagnose GBM.

This is because symptoms include severe headaches, vomiting and blurred vision, which can be attributed to other conditions such as migraine. Sufferers may also experience an itchy head and feel as if something is running across their scalp.

Article 2

Brain cancer breakthrough: Experimental vaccine trains immune system to target remaining tumor cells after surgery

November 14, 2012 by John Murray....

UC Irvine oncologists are looking for new ways to treat glioblastoma multiforme, the deadliest type of brain cancer. While surgery followed by chemotherapy and radiation is the current standard of care, it doesn't fully eliminate the cancer. The goal is to develop an additional therapy that seeks out and destroys the cancer cells that inevitably remain.

Dr. Daniela Bota is testing whether enlisting the immune system to fight the tumor can complement surgery, drugs and radiation and improve a patient's odds of surviving....

"Cancer cells are like crabgrass: Once they take root, they're hard to eradicate.... The immune system is powerful, but it must be trained to recognize these cancer cells before it can do its job."

Enter the experimental glioblastoma vaccine. Think of it as a personal brain cancer smoothie: Pulverized pieces of a patient's surgically excised tumor are blended in a laboratory with his or her own white blood cells. When injected back into the body, the concoction programs the individual's immune system with new targets – any remaining cancer cells....

A previous trial demonstrated that this vaccine is safe and, in some cases, doubled patients' median survival after diagnosis from 15 months to about 31 months....

A glioblastoma vaccine does not eliminate the need for brain surgery, which is also required to collect the cancer cells used in the "smoothie."...

"Everyone responds differently, but immunotherapy has a great chance to be the next leap forward in cancer treatment," Bota says. 

Provided by University of California, Irvine

There is much more I could say on this, as it leaves many things open-ended. Another time perhaps – but lastly, and the most important thing – every case is different, depending on a variety of factors.

I may not comment on any or all comments, but others should feel free to discuss this in the comments section.

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*Am I allowed to use the terms 'victims' and 'sufferers' for those struck down by GBMs? Some people object on the grounds that they are negative terms. Well guess what? It's not a positive disease! The terms are deadly accurate, so I'll use them if I like.

**In my case, my condition improved substantially – and immediately.

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