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
University´s 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
Kontakt:
Prof. Dr. Ulrich Herrlinger
Leiter des
Schwerpunkts Klinische Neuroonkologie
Neurologische Universitätsklinik
Bonn
Telefon: 0228/287-19887 oder -15736
E-Mail: [Email protection active, please enable JavaScript.]
