Harnessing Immunotherapy to Treat GBM
LVHN offers phase 3 clinical trials that may impact long-term survival
Each year, 40 to 60 Lehigh Valley Health Network (LVHN) patients are diagnosed with Gioblastoma multiforme (GBM), which arises from cells that comprise the supportive tissue of the brain. Although it’s considered a rare cancer, GBM is one of the most common primary brain tumors in adults.
For the past 50 years, treatment advances have slowly impacted survival. For example, in October 2015, the FDA approved the NovoTFF medical device (shown at right) for both newly diagnosed and recurrent GBM patients. The device, worn on a cleanly shaven head, generates an electrical field that disrupts molecules to prevent cancer cells from dividing. In studies, NovoTFF increased GBM survival by an average of four months (30 percent). Still, few GBM patients survive 12 to 16 months past the diagnosis date.
However, LVHN is at the forefront of a promising new development that may impact longterm survival. “We’re on the leading edge with respect to the way brain tumors are treated,” says P. Mark Li, MD, PhD, LVHN’s chief of neurological surgery.
New therapy frontier
LVHN is one of the first U.S. medical centers to offer two phase 3 clinical trials for patients newly diagnosed with GBM to test the effectiveness of anti-PD-1 immunotherapy, which takes the brakes off the immune system so that the body can clear cancer cells.
“LVHN is enrolling patients in two trials involving the same drug,” says LVHN neurooncologist Tara Morrison, MD, the study’s co-principal investigator. In one trial, which is currently recruiting patients, those with a specific genetic marker (MGMT promoter methylation) will be randomized to receive standard chemotherapy (temozolomide), radiation and anti-PD-1 immunotherapy infusions versus temozolomide and radiation, but no immunotherapy. Those without MGMT promotor methylation will be randomized to receive radiation and immunotherapy versus radiation and temozolomide.
Already successful in treating lung and stage 4 melanoma, immunotherapy now has the potential to treat brain and other cancers. “Anti-PD-1 immunotherapy, in combination with radiation, is similar to self-vaccination,” says LVHN radiation oncologist Alyson McIntosh, MD. “We’ve seen with melanoma that, when anti-PD-1 therapy is combined with radiation, a distinguishing feature of the tumor – the antigen – is released into circulation. Anti-PD-1 therapy takes the brakes off of the immune system so that the body’s T cells know exactly what to target.”
Multidisciplinary infrastructure
LVHN, a member of the MSK Cancer Alliance, is uniquely qualified to offer these elite immunotherapy clinical trials. “We’re a largevolume center with the multidisciplinary infrastructure – including specially trained physicians in all aspects of brain tumors – to care for these patients,” Li says. “That’s unusual to find outside of large academic medical centers.”
Through the Alliance, LVHN cancer patients have access to MSK’s network of leading-edge clinical trials, which will allow them to get the latest treatments before they’re available elsewhere.
To refer a patient to an LVHN clinical trial, call 610-402-CARE.