Two people with advanced brain cancer of the kind that killed MP Tessa Jowell have responded well in a small trial to an experimental combination of chemotherapy and immunotherapy drugs. In one case, the life-threatening tumor appears to have disappeared.
Doctors at the Cancer Research Institute and Royal Marsden Hospital in London cautioned that this was a very early investigation, but said it was unusual to have such a good response in patients in an initial trial.
Ten patients were enrolled in the phase I trial called Ice-Cap. They had advanced glioblastoma, a brain tumor similar to the one that also killed US President Joe Biden’s son Beau.
Two of the patients responded to the immunotherapy agent atezolizumab combined with ipatasertib, a new precision drug that may be able to unmask tumors to the immune system. Most of the patients chosen for the trial had tumors with defects in a gene called Pten, and in four cases, including the two that responded so well, the Pten gene didn’t work at all.
Ipatasertib blocks a molecule called Akt. Scientists presenting their findings at the annual meeting of the American Association for Cancer Research say that cancers that lack a functional Pten gene use growth signals involving Akt to grow and spread, which explains why the patients with Pten defects could benefit more from the combination.
Hamish Mykura, 59, of West Sussex, has seen his tumor disappear from the scans. He was diagnosed with glioblastoma in August 2018 and referred to the Royal Marsden for treatment, including chemotherapy and radiation therapy, with surgery at St George’s Hospital. When the treatment stopped working and the cancer started growing in August 2019, she joined the Ice-Cap trial. Twenty months later, Hamish has no visible cancer.
“The emotional journey that I have been on in the last few years has been dramatic and considering the seriousness of my diagnosis, it is amazing that I am still here,” he said. “In fact, within a few months of the trial, I felt like all hope was gone as it seemed like my cancer had started to grow again. However, surgery revealed that the growth was actually inflammation caused by the drugs attacking the tumor – they were working. Since then, I have been in an excellent position with the scans indicating that my cancer is stable.
Dr. Juanita López, study leader, said: “Brain cancer is capable of evading the immune system in complex ways and, until now, immunotherapy has not worked. However, by discovering the disease with a new drug called ipatasertib, this study suggests that we could make some brain cancers vulnerable to atezolizumab.
“We believe that our findings open the door to further development of what could become a revolutionary treatment option for some patients with aggressive glioblastoma brain cancer. Glioblastoma patients have very low survival rates and even fewer new treatment options are emerging, so any advancement in outcomes would be very welcome. “
George is Digismak’s reported cum editor with 13 years of experience in Journalism