Science Current Events | Science News | Brightsurf.com
 

Combination therapy may be better than radiotherapy alone to treat aggressive brain cancer

February 29, 2016

(PHILADELPHIA) -- Radiotherapy effectively damages brain tumors but the cancer cells can repair themselves in order to live on. Now, researchers at Sidney Kimmel Cancer Center have tested a strategy that combines radiotherapy with a drug that shuts down the ability of tumor to mend themselves.

Researchers say their 12-patient study, published Jan. 29, 2016 online ahead of print in the Journal of Neuro-Oncology, offer enough promise that a more comprehensive, phase 2 clinical trial should be conducted to test the combination therapy for aggressive, recurrent brain cancer.

"We saw synergy between radiotherapy and the agent, panobinostat. Our findings suggest panobinostat makes radiotherapy much more effective," says the study's senior author, Yaacov R. Lawrence, M.D., of the Department of Radiation Oncology at Thomas Jefferson University's Sidney Kimmel Medical College.

All 12 patients tested had high grade gliomas that had recurred after initial radiotherapy. Eight patients had recurrent glioblastoma, and four had recurrent anaplastic astrocytoma. These two forms of aggressive brain cancer represent almost 70 percent of newly diagnosed gliomas, which are diagnosed in about 10,000 patients annually. Despite response to initial radiation, most patients relapse within two years and overall survival is then limited to a year or less.

"There is no standard treatment for recurrent high grade gliomas. At Jefferson, we have a lot of experience with offering a second course of radiation after a patient relapses, in order to increase survival, but we are excited by the promise of a targeted agent that makes initial and repeat radiotherapy more effective," says co-author Adam Dicker, M.D., Ph.D., FASTRO, Chair and Professor of Radiation Oncology, Pharmacology and Experimental Therapeutics at the Sidney Kimmel Medical College.

Panobinostat, approved for use in 2015 for treatment of multiple myeloma, is being tested in a variety of other cancers. It is a histone deacetylase inhibitor that has been shown to modify expression of about eight percent of RNA molecules produced from genes. Modifying RNA changes protein production, unsetting cancer growth. The drug also turns off RAD51, a DNA repair enzyme, Dr. Dicker says.

Researchers found that the highest dose of panobinostat tested in patients was well tolerated, and they observed improved progression-free survival and overall survival.

"The intent of this study was not to demonstrate benefit of the combination therapy, but to test safety. Still, we did note promising activity, which must be validated in further studies," Dr. Lawrence says.

###

Co-authors all represent Thomas Jefferson University and include first author Wenyin Shi, M.D., Ph.D., Joshua D. Palmer, M.D., Maria Werner-Wasik, M.D., David W. Andrews, M.D., James J. Evans, M.D., Jon Glass, M.D., Lyndon Kim, M.D., Voichita Bad-Ad, M.D., Kevin Judy, M.D., Christopher Farrell, M.D., Nicole Simone, M.D., and Haisong Liu, Ph.D.

The study was funded by Novartis, which developed panobinostat. This funding was to the Sidney Kimmel Cancer Center. No author reports a conflict of interest.

Article Reference: Phase I trial of panobinostat and fractionated stereotactic re-irradiation therapy for recurrent high grade gliomas. Shi W, Palmer JD, Werner-Wasik M, Andrews DW, Evans JJ, Glass J, Kim L, Bar-Ad V, Judy K, Farrell C, Simone N, Liu H, Dicker AP, Lawrence YR. J Neurooncol. Jan. 29, 2016. [Epub ahead of print] PMID: 26821711

Thomas Jefferson University


Related Radiotherapy Current Events and Radiotherapy News Articles


Vismodegib in basal cell carcinoma: Added benefit not proven
Vismodegib (trade name: Erivedge) has already been approved since 2013 for the treatment of patients with locally advanced basal cell carcinoma (BCC) or symptomatic metastatic BCC and has already undergone an early benefit assessment according to the Act on the Reform of the Market for Medicinal Products (AMNOG).

Vitamin A may help improve pancreatic cancer chemotherapy
Around 8,800 people in the UK are diagnosed with pancreatic cancer each year. It is known as the UK's deadliest cancer, with a survival rate of just 3 per cent.

Gene therapy against brain cancer
Only a few days ago, the press (especially in English-speaking countries) enthusiastically announced the publication of a study that described in great detail the genetics of breast cancer, a discovery that according to many marks a breakthrough in the battle against this cancer.

Radiotherapy halves deaths from prostate cancer 15 years after diagnosis
A longitudinal Nordic study, comparing the results of hormone (antiandrogen) therapy with or without the addition of local radiotherapy, shows that a combination of treatments halves the risk of death from prostate cancer 15 years after diagnosis.

A better way to diagnose and manage neuroendocrine tumors
A recent study reported in the May issue of the Journal of Nuclear Medicine demonstrates that Ga-68 DOTATATE PET/CT scans are superior to In-111 pentetreotide scans, the current imaging standard in the United States for detecting neuroendocrine tumors (NETS), and could significantly impact treatment management.

Improvements to online health information can help reduce barriers to care for pancreatic cancer
The Internet has become a powerful and important resource for daily life. When patients receive a medical diagnosis, particularly a difficult one like pancreatic cancer, the web can be an essential information tool, helping to enable patients to have meaningful discussions with health care providers.

Failure to publish trial results exposes patients to risks without providing benefits
Although the publication of results of clinical trials carried out in the USA within 12 months of their completion has been mandatory since 2007, an astoundingly high number of Phase III radiotherapy trials did not do so, according to new research to be presented at the ESTRO 35 conference today (Saturday).

Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
Researchers have found that treating patients who have early stage non-small cell lung cancer (NSCLC) with a type of radiotherapy called stereotactic body radiation therapy (SBRT) is associated with a small but increased risk of death from causes other than cancer.

Demand for radiotherapy will rise substantially over next 10 years
The demand for radiotherapy across all European countries will increase by an average of 16% between 2012 and 2025, with the highest expected increase being for prostate cancer cases (24%), according to a new study published in Radiotherapy and Oncology.

UT Southwestern research shows 98 percent cure rate for prostate cancer using SBRT
A five-year study shows that Stereotactic Body Radiation Therapy (SBRT) to treat prostate cancer offers a higher cure rate than more traditional approaches, according to researchers at UT Southwestern Medical Center Harold C. Simmons Comprehensive Cancer Center.
More Radiotherapy Current Events and Radiotherapy News Articles

The Physics of Radiotherapy X-Rays And Electrons

The Physics of Radiotherapy X-Rays And Electrons
by Peter Metcalfe (Author), Tomas Kron (Author), Peter Hoban (Author)


The Physics of Radiotherapy X-Rays and Electrons is an updated successor to The Physics of Radiotherapy X-Rays from Linear Accelerators published in 1997. This new volume includes a significant amount of new material, including new chapters on electrons in radiotherapy and IMRT, IGRT, and tomotherapy, which have become key developments in radiation therapy.

Also updated from the earlier edition are the physics beam modeling chapters, including Monte Carlo methods, adding those mysterious electrons, as well as discourse on radiobiological modeling including TCP, NTCP, and EUD and the impact of these concepts on plan analysis and inverse planning.

This book is intended as a standard reference text for postgraduate radiation oncology medical physics students. It will also be of...

The Q Book: The Physics of Radiotherapy X-Rays Problems & Solutions

The Q Book: The Physics of Radiotherapy X-Rays Problems & Solutions
by Peter Metcalfe (Author), Tomas Kron (Author), Peter Hoban (Author)


A Workbook for the "Physics of Radiotherapy X-Rays from Linear Accelerators."

CT Anatomy for Radiotherapy

CT Anatomy for Radiotherapy
by Pete Bridge (Author)


Knowledge of CT anatomy is increasingly vital in daily radiotherapy practice, especially with more widespread use of cross-sectional image-guided radiotherapy (IGRT) techniques. Existing CT anatomy texts are predominantly written for the diagnostic practitioner and do not always address the radiotherapy issues while emphasising structures that are not common to radiotherapy practice. “CT Anatomy for Radiotherapy” is a new radiotherapy-specific text that is intended to prepare the reader for CT interpretation for both IGRT and treatment planning. It is suitable for undergraduate students, qualified therapy radiographers, dosimetrists and may be of interest to oncologists and registrars engaged in treatment planning. All essential structures relevant to radiotherapy are described...

Radiotherapy for Head and Neck Cancers: Indications and Techniques

Radiotherapy for Head and Neck Cancers: Indications and Techniques
by Adam S. Garden MD (Author)


Thoroughly updated to include all of the latest technology and treatment regimens, Radiotherapy for Head and Neck Cancers: Indications and Techniques, 5th Edition remains the reference of choice for radiation oncologists. Timely updates include an increased use of full-color images and significantly more digital content, bringing you fully up to date with state-of-the-art radiation therapy for head and neck cancer. The first section covers general principles, practical aspects of external beam therapy, patient care guidelines, and more, including a new chapter on general principles of target and normal tissue contouring; the second section discusses site-specific indications and techniques. Numerous illustrated case examples make this resource an excellent day-to-day reference for both...

  Design and Shielding of Radiotherapy Treatment Facilities
by David Eaton (Author)


The aim for this book is to be a single point of reference for all aspects of shielding design and radiation protection advice to the construction and modification of radiotherapy facilities. The book assembles a faculty of national and international experts on all modalities including megavoltage and kilovoltage photons, brachytherapy and high energy particles and on conventional and Monte Carlo shielding calculations. Their consensus and expertise is reflected through the list of chapters, but the editors have also ensured a consistent message throughout the text, by face-to-face discussion and thorough editing.

Radiotherapy for Head and Neck Cancers: Indications and Techniques

Radiotherapy for Head and Neck Cancers: Indications and Techniques
by K. Kian Ang MD PhD (Author), Adam S. Garden MD (Author)


Long established as a staple reference for all radiation oncologists, Radiotherapy for Head and Neck Cancers: Indications and Techniques is now in its Fourth Edition. This completely updated edition presents the state-of-the-art protocols currently used at the MD Anderson Cancer Center and thoroughly explains the principles, nomenclature, and clinical use of intensity-modulated radiotherapy (IMRT). The first section discusses the practical aspects of external beam therapy, brachytherapy, and endocavitary beam therapy and offers guidelines on patient care before and during radiotherapy. The second section provides detailed coverage of site-specific indications and techniques.

Short Course Breast Radiotherapy: A Comprehensive Review of Hypofractionation, Partial Breast, and Intra-Operative Irradiation

Short Course Breast Radiotherapy: A Comprehensive Review of Hypofractionation, Partial Breast, and Intra-Operative Irradiation
by Douglas W Arthur (Editor), Frank A. Vicini (Editor), David E. Wazer (Editor), Atif J. Khan (Editor)


This comprehensive handbook on the implementation of short course radiotherapy for the treatment of breast cancer is intended as an up-to-date resource for the clinician. The book opens with a series of chapters on underlying principles and diverse relevant topics, including pathologic anatomy of early-stage breast cancer, radiobiology of accelerated breast irradiation, quality assurance and radiation safety, surgical considerations in partial breast irradiation, and impact of oncoplastic surgery on adjuvant radiotherapy. Individual sections are then devoted to hypofractionated whole breast radiotherapy, accelerated partial breast irradiation, and intraoperative radiotherapy. Each section includes details of patient selection, physics, techniques, data, and toxicity.  The reader is...

Stereotactic Body Radiotherapy: A Practical Guide

Stereotactic Body Radiotherapy: A Practical Guide
by Andrew Gaya (Editor), Anand Mahadevan (Editor)


This is a single, comprehensive handbook for clinical oncology trainees and consultants, covering the basic aspects of stereotactic radiotherapy systems and treatment.

Medical Imaging and Radiotherapy Research: Skills and Strategies, 1e (Evolve Learning System Courses)

Medical Imaging and Radiotherapy Research: Skills and Strategies, 1e (Evolve Learning System Courses)
by Aarthi Ramlaul MA B.Tech. Rad. N.Dip. Rad. (Editor)


All you need to successfully undertake a research project! This exciting new book provides radiography students and practitioners with the key skills and strategies required to undertake research within medical imaging and radiotherapy. Quantitative and qualitative research methods are covered and guidance given on the entire research process - from literature researching, information management and literature evaluation, through to data collection, data analysis and writing up. Specific instruction is given on the structure and presentation of dissertations, writing articles for publication and on presentation skills for presenting at conferences. Tailored to meet the specific needs of radiography students plus practitioners undertaking researchIncludes practice tips and pitfalls to...

Radiation Therapy for Head and Neck Cancers: A Case-Based Review

Radiation Therapy for Head and Neck Cancers: A Case-Based Review
by Murat Beyzadeoglu (Editor), Gokhan Ozyigit (Editor), Ugur Selek (Editor)


This evidence-based guide to the current management of cancer cases at all head and neck sites will assist in the appropriate selection and delineation of tumor volumes/fields for intensity-modulated radiation therapy (IMRT), including volumetric modulated arc therapy (VMAT). Each tumor site-related chapter presents, from the perspective of an academic expert, several actual cases at different stages in order to clarify specific clinical concepts. The coverage includes case presentation, a case-related literature review, patient preparation, simulation, contouring, treatment planning, treatment delivery, and follow-up. The text is accompanied by illustrations ranging from slice-by-slice delineations on planning CT images to finalized plan evaluations based on detailed acceptance criteria....

© 2017 BrightSurf.com