Clinical Trials Test Treatments for High-Grade Brain Tumors


With a few exceptions, glioblastoma (GBM) remains largely incurable, and the U.S. Food and Drug Administration (FDA) has approved few treatments for the disease. Surgery (when feasible), radiation, and temozolomide are used in most patients. But even if a newly diagnosed tumor can be surgically excised, recurrences are too common.

In this blog post, I simply list some of the new treatments available in clinical trials for GBM and other high-grade brain tumors. Only drugs that have at least some preliminary results of activity are included, and the list is not meant to be fully comprehensive. The interested reader can judge for herself what might be of interest, keeping in mind that no single treatment is suitable or will work for all GBM patients. Continue reading…


A Patient's Journey: Can High-Grade PIN Be 'Great News'?

Excerpt:

“This summer, I ended a 3-year vacation from prostate biopsies. I expected the best after years of good news.

“In early August, my urologist, Brian Helfand, MD, PhD, of NorthShore University HealthSystem, called me with what he called ‘great news.’

“I wasn’t so sure about that.

“The overall picture was this: Helfand said the pathologist found “no evidence of malignancy” in slide after slide — 13 all told.

“But one biopsy stood out. So the news wasn’t all great.”

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Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Urine Test Improves Prediction of High-Grade Prostate Cancer

Excerpt:

“An experimental urine test that detects genetic changes associated with prostate cancer identified 92 percent of men with elevated PSA (prostate-specific antigen) levels who had high-grade cancers, according to a study published today in JAMA Oncology online.

“ ‘The test has the potential to be a significant improvement over PSA alone in distinguishing between low- and high-grade prostate cancer, especially in the PSA gray zone patient. It could reduce hundreds of thousands of invasive biopsies each year. Given the pain and risks associated with performing a prostate biopsy, that’s not a trivial thing,’ said first author James McKiernan, MD, the John K. Lattimer Professor and chair of urology at Columbia University Medical Center (CUMC) and urologist-in-chief at NewYork-Presbyterian/Columbia. In addition, the test is the only urine-based assay that does not require a digital rectal exam prior to collection and is easily integrated in the clinic environment.”

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Do you have questions about this story? Let us know in a comment below. If you’re wondering whether this story applies to your own cancer case or a loved one’s, we invite you to use our Ask Cancer Commons service.


Kallikrein Markers Improve High-Grade Prostate Cancer Detection, Reduce Unnecessary Biopsies

“A statistical model using kallikrein markers better predicted high-grade prostate cancer in men with elevated PSA levels and reduced unnecessary biopsies compared with PSA level and age alone, according to the results of a prospective analysis.

“ ‘Risk of death from prostate cancer is strongly associated with levels of PSA in blood measured in middle-aged men,’ Hans Lilja, MD, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues wrote. ‘Evidence from randomized screening trials in Europe shows that PSA-based screening can reduce deaths from prostate cancer, but also leads to overdiagnosis and the risk of overtreatment among elderly men with a limited life expectancy.’

“Previous retrospective studies identified four kallikrein markers — free PSA, intact PSA, total PSA and human kallikrein-related peptidase 2 (hK2) — that can predict biopsy outcomes, according to study background.”


Novel Olaparib Combination Shows Activity in Ovarian, Breast Cancers

“A combination treatment composed of the PARP inhibitor olaparib and the investigational PI3K inhibitor BKM120 demonstrated activity and safety for women with triple-negative breast cancer or high-grade serous ovarian cancer, according to study findings presented at the American Association for Cancer Research Annual Meeting.

“High-grade serous ovarian cancer and triple-negative breast cancer are similar in that they often have germline BRCA mutations, have a sensitivity to platinum agents and have high copy number alterations based on The Cancer Genome Atlas, according to study background. Further, preclinical data have suggested olaparib (Lynparza, AstraZeneca) is synergistic with BKM120 (Novartis) and BYL719 (Novartis) in both cancers.

“Ursula A. Matulonis, MD, medical director of gynecologic oncology at the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute and associate professor of medicine at Harvard University Medical School, and colleagues evaluated olaparib plus BKM120 in 12 patients with triple-negative breast cancer and 34 patients with high-grade serous ovarian cancer. Thirty-five patients had germline BRCA mutations.

“ ‘This is one area where we in ovarian cancer are in the forefront,’ Matulonis said during a press conference. ‘We are using an FDA-approved biomarker through germline BRCA status to basically say when a patient is eligible to receive olaparib.’ “


Study Confirms 4Kscore Accurately Predicts High-Grade Prostate Cancer

“A blood test called the 4Kscore results in accurate detection of high-grade prostate cancer. In a prospective study of 1,012 men, this test more accurately predicted the presence of high-grade disease compared with a commonly used risk calculator in men with elevated prostate-specific antigen (PSA) levels.

“The results from this study (Abstract 1) were presented by Sanoj Punnen, MD, a urologic oncologist at the University of Miami in Florida at the 2015 Genitourinary Cancers Symposium.

“In this study, men scheduled for a prostate biopsy were enrolled, regardless of their PSA level or clinical findings, at 26 centers across the United States between October 2013 and April 2014. A total of 231 (23%) high-grade prostate cancers were detected. The 4Kscore showed a higher net benefit in comparison with the PCPTRC at all threshold possibilities for high-grade disease used in clinical practice.

“The test is able to detect aggressive prostate cancer with high accuracy, Punnen told Cancer Network. ‘The area under the curve is better than any other biomarker in this area. There was a significant reduction in biopsies that could be attained if we used this test,’ he said.

“The goal of the 4Kscore is to reduce unnecessary biopsies, as the vast majority of biopsies show either no cancer or a low-grade tumor. These biopsies result in high medical costs, as well as morbidities for the patient.”


Chronic Inflammation Linked to 'High-Grade' Prostate Cancer

“Men who show signs of chronic inflammation in non-cancerous prostate tissue may have nearly twice the risk of actually having prostate cancer than those with no inflammation, according to results of a new study. The link between persistent inflammation and cancer was even stronger for men with so-called high-grade prostate cancer — those with a Gleason score between 7 and 10 — indicating the presence of the most aggressive and rapidly growing prostate cancers.”


Simultaneous Spurts of Mutations Drive Prostate Cancer, Whole-Genome Sequencing Study Finds


A large collaborative research effort shows that prostate cancers may evolve in sudden, brief spurts of many simultaneous genetic mutations that disrupt important prostate cancer genes. Using deep-sequencing techniques and computer modeling, scientists have created a detailed temporal map of how genetic aberrations evolve within prostate tumors. This result differs from the traditional model of cancer resulting from the step-by-step accumulation of individual mutations. The study is published in the journal Cell. Continue reading…