Barcelona Glioblastoma is the most aggressive brain tumor, it has a very poor prognosis and there are no effective treatment options. Immune therapies are a possible way to tackle this cancer, according to two studies, one of them in the journal The New England Journal of Medicine and another a Nature. The research is complementary and opens the door to future treatments for this type of cancer. One of the teams, consisting of researchers from Massachusetts General Hospital and the Dana-Farber Cancer Institute, has achieved “considerable and rapid” tumor regression with an experimental immunotherapy in a patient who had failed chemotherapy and radiation therapy. worked The other, led by the Perelman School of Medicine at the University of Pennsylvania, has managed to keep a participant from showing signs of tumor progression for seven months. In both cases, however, the scientists emphasize that these are findings from a phase 1 clinical trial and admit that more research is needed to make this an accessible therapeutic option.
The experimental therapy used by the two groups of researchers is based on the CAR-T (from the English chimeric antigen receptor-T), which consists of creating a drug with cells from the same patient: white blood cells (T lymphocytes) are extracted from the patient, genetically reprogrammed in the laboratory to recognize tumor cells, and re-infused to neutralize the cancer. So far, this immunotherapy has been approved in Spain to treat leukemia and there are studies evaluating its effectiveness against breast cancer, other blood cancers such as multiple myeloma, lymphomas and lupus.
Researchers at Massachusetts General Hospital and Dana-Farber Cancer Institute enrolled three patients with glioblastoma in the trial to test this experimental immunotherapy. One participant, after a single infusion of CAR-T cells, experienced an 18.5% reduction in tumor size as early as the second day of treatment. When 69 days had passed since the infusion, this had already decreased by 60.7%. The 72-year-old continued to improve his response and in total benefited from a single treatment for more than 150 days. This patient gained between five and six more months of life.
The other two patients in the trial did not do so well and ended up suffering relapses. According to the authors, in these two cases where the glioblastoma broke back it was because the CAR-T cells they infused into the patients did not last for weeks after treatment. Thus, the authors are committed to continuing their research and increasing the duration of the therapeutic effect. For example, with a different preparation with chemotherapy or with additional doses of CAR-T.
“We haven’t seen it before”
The other team, led by neuro-oncologist Stephen Bagley of the University of Pennsylvania, used CAR-T cells and found that the size of the tumors was also reduced. One participant’s glioblastoma started growing again within a month, but another has shown no signs of tumor progression for seven months. “The results are promising, but the goal is to generate longer-lasting responses,” says Bagley. It was exciting, he says, to see how the tumors shrank the first day after CAR-T therapy: “We hadn’t seen that before.” However, of the remaining four participants, one dropped out of the trial and tumors have not recurred in the remaining cases, who continue to receive treatment.
Both studies are relevant because they lay the groundwork for a promising drug to help glioblastoma patients. Neurosurgeons face several challenges with this type of cancer, such as the fact that they are very diffuse in shape. In fact, this complicates the surgical removal of tumor cells, as these can often be mixed with healthy tissue. Surgery, but also chemotherapy and radiation therapy, are usually the only treatment options, but the benefit is usually partial and short-lived. “[Aquest estudi] It lends credence to the potential power of CAR-T cells to make a difference in solid tumors, especially brain,” says the neurosurgeon at Massachusetts General Hospital in Boston and lead author of the article in the New England Journal of Medicine, Bryan Choi.
2024-03-14 15:19:33
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