A new treatment plan is giving hope to people with a hard-to-treat brain cancer called grade 3 astrocytoma. This cancer grows quickly and often comes back after treatment.
It is hard to manage, and options for care are limited. But a new study, with help from the Huntsman Cancer Institute at the University of Utah, shows that a combination of two drugs may help patients live longer.
Dr. Howard Colman, a brain cancer expert at Huntsman, helped lead this study, which is part of the STELLAR clinical trial. He says it is exciting to see results that offer new possibilities for patients who have very few choices.
The study, published in the Journal of Clinical Oncology, tested two drugs. One is called eflornithine, which stops cancer cells from growing by targeting a certain enzyme. The other is lomustine, a type of oral chemotherapy already used for treating brain tumors.
In total, 343 patients joined the international study. They came from 74 hospitals and clinics across North America and Europe, including the Huntsman Cancer Institute. All patients had received earlier treatment, including radiation and chemotherapy, and their cancer had come back.
At first, the study focused on one kind of brain cancer called anaplastic astrocytoma. But during the study, doctors changed how they define brain tumors. So the trial ended up including three types: glioblastoma, grade 3 IDH-mutant astrocytoma, and grade 4 IDH-mutant astrocytoma.
Astrocytomas are tumors that begin in the brain or spinal cord. Some of them have changes in a gene called IDH. These changes are thought to cause healthy brain cells to become cancerous. Grade 3 IDH-mutant astrocytoma is still aggressive but responds better to treatment than glioblastoma or grade 4 IDH-mutant astrocytoma.
In the trial, half of the patients got only lomustine. The other half received both lomustine and eflornithine. Overall, there was no difference in survival for people with glioblastoma or grade 4 tumors. But for those with grade 3 IDH-mutant astrocytoma, the results were different.
These patients lived much longer on the new combination treatment. Their average survival was about 35 months, compared to just 24 months for those who received only lomustine.
The study also looked at how long the disease stayed stable before getting worse. This is called progression-free survival. Again, the combination therapy showed better results. People with grade 3 tumors who got both drugs had a median progression-free survival of 15.8 months, while those who got only lomustine had 7.2 months.
Dr. Neli Ulrich, chief scientific officer at Huntsman, says this is a big step forward. Treating brain cancer is very difficult, so every new option matters. This new treatment gives patients and doctors more hope.
In conclusion, while the new drug combo did not help patients with the most severe brain cancers, it did make a real difference for those with grade 3 IDH-mutant astrocytoma. It helped them live longer and kept their disease from getting worse as quickly.
The findings suggest that adding eflornithine to lomustine may become a new standard treatment for this group of patients. However, more studies are needed before this treatment can be widely used. Still, it’s a hopeful step forward in the fight against brain cancer.
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