Super Patient: Steven Keating Fights Brain Cancer with Data


In 2007, Steven Keating got his brain scanned for fun. “I volunteered for a study,” says Steven, who was then a student at Queen’s University in Canada. “I wanted to help science, and I was curious about seeing my brain.”

He saw more than anticipated—the magnetic resonance imaging (MRI) revealed a dime-sized abnormality in his left frontal lobe. But the researchers couldn’t tell what it was, and he had no adverse symptoms. “They said ‘don’t worry, keep an eye on it,'” Steven, who is now a Mechanical Engineering graduate student at the Massachusetts Institute of Technology (MIT) Media Lab, recalls. A follow-up scan in 2010 wasn’t worrisome either. Continue reading…


Handheld Scanner Could Make Brain Tumor Removal More Complete, Reducing Recurrence

“Cancerous brain tumors are notorious for growing back despite surgical attempts to remove them – and for leading to a dire prognosis for patients. But scientists are developing a new way to try to root out malignant cells during surgery so fewer or none get left behind to form new tumors. The method, reported in the journal ACS Nano, could someday vastly improve the outlook for patients.

“Moritz F. Kircher and colleagues at Memorial Sloan Kettering Cancer Center point out that malignant brain tumors, particularly the kind known as glioblastoma multiforme (GBM), are among the toughest to beat. Although relatively rare, GBM is highly aggressive, and its cells multiply rapidly. Surgical removal is one of the main weapons doctors have to treat brain tumors. The problem is that currently, there’s no way to know if they have taken out all of the cancerous cells. And removing extra material “just in case” isn’t a good option in the brain, which controls so many critical processes. The techniques surgeons have at their disposal today are not accurate enough to identify all the cells that need to be excised. So Kircher’s team decided to develop a new method to fill that gap.

“The researchers used a handheld device resembling a laser pointer that can detect “Raman nanoprobes” with very high accuracy. These nanoprobes are injected the day prior to the operation and go specifically to tumor cells, and not to normal brain cells. Using a handheld Raman scanner in a mouse model that mimics human GBM, the researchers successfully identified and removed all malignant cells in the rodents’ brains. Also, because the technique involves steps that have already made it to human testing for other purposes, the researchers conclude that it has the potential to move readily into clinical trials. Surgeons might be able to use the device in the future to treat other types of brain cancer, they say.”


One-Two Punch for Brain Tumors? New Clinical Trial Opens

Editor’s note: Researchers have launched a new clinical trial—a research study with volunteer patients—to test a new treatment for brain tumors. In the treatment, a patient first undergoes tumor-removal surgery. Then, a harmless virus delivers two new genes to the brain to kill any remaining cancer cells. One of the genes kills tumor cells directly and the other boosts the patient’s own immune system to attack tumor cells. Patients in the trial will also receive standard chemotherapy and radiation. Two patients are already enrolled. The trial is enrolling patients with grade 3 or 4 malignant primary glioma, such as glioblastoma multiforme.

“University of Michigan Health System doctors have started testing a unique new approach to fighting brain tumors — one that delivers a one-two punch designed to knock out the most dangerous brain cancer.

“The experimental approach, based on U-M research, delivers two different genes directly into the brains of patients following the operation to remove the bulk of their tumors.

“The idea: trigger immune activity within the brain itself to kill remaining tumor cells — the ones neurosurgeons can’t take out, which make this type of tumor so dangerous.

“It’s the first time this gene therapy approach is being tried in humans, after more than a decade of research in experimental models.”


Successful Vemurafenib Treatment of Progressive BRAF V600E–Mutated Anaplastic Pleomorphic Xanthoastrocytoma

Editor’s note: Oncologists sometimes suggest a treatment based on specific mutations found in a patient’s tumor. People with metastatic melanoma whose tumors have mutations in the BRAF gene are often treated with the targeted drug vemurafenib (brand name Zelboraf). But BRAF mutations can also be found in other types of cancer. This story tells how a patient with a brain tumor that had a BRAF mutation was successfully treated with vemurafenib.

“The BRAF inhibitor vemurafenib (Zelboraf) is approved for treatment of BRAF-mutated metastatic melanoma. There are reports indicating that vemurafenib may be active in the treatment of intracranial neoplasms with BRAF mutations. As reported in the Journal of Clinical Oncology, Lee et al from Brigham and Women’s Cancer Center successfully treated a BRAF V600E–mutated glioma with vemurafenib monotherapy.

“The patient was a 41-year-old man with WHO grade 2 anaplastic pleomorphic xanthoastrocytoma with a BRAF V600E mutation who developed radiographic progression despite surgery, radiation, and treatment with temozolomide. The patient was initially observed with serial imaging for approximately 2 years until magnetic resonance imaging (MRI) showed increased surrounding enhancement. Treatment with temozolomide was followed by radiographic progression after two cycles.”


Confronting the Most Aggressive, Evasive, and Cunning of All Brain Tumors

“Cody Mahan and his family didn’t think they would have to deal with cancer again so soon.”After graduating college, Mahan, 23, had earned a prestigious Department of Defense SMART scholarship and had just started working at Warner Robins Air Force Base. He was looking forward to a promising engineering career.

“In December, he started to experience headaches and then pain in his neck. His family took him to a hospital close to where they lived in Tennessee, suspecting meningitis. Doctors discovered a tumor on the right side of his brain. ‘It was quite a shock,’ says Cody’s mother, Lisa. ‘It was the furthest thing from our minds when we went to the ER.’

“They had thought cancer was behind them. As a teenager, Mahan had ALL () and had received full cranial radiation as part of his treatment. At the time, this was a standard prophylactic for patients with ALL. The radiation, his family suspects, may have led to the development of the brain tumor. In fact, is one of the only known risk factors for developing a brain tumor.”

Editor’s note: This well-written story describes a new approach to glioblastoma surgery.


Agenus Brain Cancer Vaccine Nearly Doubles Survival Rate in Study

“Agenus Inc said its experimental cancer vaccine helped brain tumor patients live nearly twice as long compared with those who received standard of care treatment…

“The drug, when given in addition to standard treatment, extended median overall survival in 50 percent of newly-diagnosed glioblastoma multiforme (GBM) patients to two years in a mid-stage study.

“GBM patients, who tend to succumb to the disease within one year, are usually treated with a combination of radiation and the chemotherapy drug temozolomide.”

Editor’s note: Prophage is a new “cancer vaccine” that might boost a patient’s own immune system to help fight cancer. Cells from each patient’s tumor are used to personalize Prophage specifically for the patient. This article discusses results from a clinical trial testing Prophage in volunteer patients with glioblastoma multiforme (GBM). Some of the patients in the trial were treated with Prophage in combination with standard radiation and chemotherapy treatment, while for comparison, others were treated only with standard radiation and chemo. The results showed that adding Prophage to standard treatment can help some patients live longer.


Systemic Chemotherapy Is Effective in SCLC with Brain Metastases

Between one-tenth and one-fourth of patients with small cell lung cancer (SCLC) have brain metastases (cancer that has spread to the brain) when they are first diagnosed and up to half will develop them at some point during the course of their disease. There have not been many studies on the use of systemic chemotherapy (ie, chemotherapy in which drugs are allowed to circulate throughout the body) in these patients, but research suggests that it is an effective first- or second-line treatment. Systemic chemotherapy is especially recommended for SCLC patients with brain metastases who do not yet show symptoms.


Ipilimumab Could Treat Small Melanomas in the Brain

A study in The Lancet shows that the drug ipilimumab could treat melanomas that have spread to the brain, particularly in people who do yet not have neurological symptoms. Of 51 such patients treated with ipilimumab, 12 had tumors in the brain that shrank or did not get worse and 14 had tumors outside the brain that shrank or did not get worse. Ipilimumab (Yervoy) is an immune system booster that the FDA has approved for treating advanced melanomas.

Primary source: http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2812%2970090-6/abstract


Drug Targets Two Common Melanoma Mutations

An experimental drug could help control some melanomas that have BRAF or NRAS mutations, according to a report at an American Society of Clinical Oncology meeting. Tumors shrank or did not get worse in 8 out of 35 patients with the most common BRAF mutation (V600E), and in 6 out of 28 patients with NRAS mutations. This is the first targeted treatment for melanomas that have NRAS mutations. BRAF and NRAS mutations can activate a protein called MEK that is involved in cell division. The experimental drug, which is called MEK162, is a MEK inhibitor. The side effects of MEK162, which included diarrhea, rashes and swelling, were manageable.