Authors: Heather Jones, Future Science Group
For World Cancer Day (4 February 2020), we look back at some of the biggest neuro-oncology breakthroughs of the year, covering developments in diagnostics, cancer biology research and novel therapies. Boosting cancer research is an essential part of slowing the progression of the disease. We hope you enjoy our selection.
There’s a growing body of research investigating the possibility of developing liquid biopsies to detect cancers. Researchers from the University of Sussex (UK) discovered that the content within small extracellular vesicles in biofluids could mirror the phenotypic signature of glioblastoma cells, suggesting that bodily fluids, such as blood, could be a simple and quick way to test for the disease, rather than a biopsy.
The following November, a team from the Abramson Cancer Center of the University of Pennsylvania (PA, USA) discovered that levels of cfDNA in the blood correlated with how patients will progress following a glioblastoma diagnosis. Unexpectedly, analysis also revealed that the mutations identified from genetic sequencing of solid tissues and liquid biopsies were different, suggesting that liquid biopsies may provide complementary information regarding the molecular or genetic makeup of each tumor. This could be very valuable when it comes to prescribing combination therapies for patients with glioblastoma.
In the same month, researchers announced the results of a trial in which chemical analysis, coupled with an artificial intelligence (AI) program, tested for brain tumors in 400 patients who had possible symptoms. Using the technology, the team were able to correctly identify 82% of brain tumors and 84% of individuals who did not have a brain tumor. Because of the accuracy and non-invasiveness of the test, it offers the potential to test people with suspicious symptoms and quickly identify those in need of an urgent brain scan, ultimately speeding up diagnosis and getting patients treated as quickly as possible.
AI technology has also been investigated in imaging. A study published in Nature Medicine examined the diagnostic accuracy of brain tumor image classification through machine learning using a technique known as stimulated Raman histology. The technology allows surgeons to see essential features not typically observed in standard histologic images. The technology was tested on brain tumor biopsies and results for both AI and the pathologist interpretation were comparable, suggesting a future for the method in both surgery and the lab to aid decision making.
Cancer biology and pathology:
A breakthrough discovery was made last September when researchers from Stanford University (CA, USA) uncovered a mechanism used by high-grade gliomas to drive their growth. According to the team, these tumor cells form synapses that hijack and amplify electrical signals from healthy nerve cells. Further analysis revealed that the cancer cells strongly increased the expression of genes that are involved in forming synapses. This study could potentially aid research into therapies for preventing tumor growth, including the use of existing drugs that block electrical signalling.
Researchers from the University of California (CA, USA) revealed last February that pembrolizumab could be effective in treating people with recurrent glioblastoma. The trial assessed 35 patients with recurrent and surgically resectable glioblastoma, 16 of whom received pembrolizumab before surgery and 19 whom received the drug post-surgery. Those who received the drug before surgery survived by almost twice the time of those who were treated after surgery. Researchers concluded that treating patients with the immunotherapy before surgery could activate the impaired T cells, rather than after surgery when the T cells have been removed. The results from this study could help in deciding which combination of drugs could be most successful for each individual patient.
In August 2019, researchers from Brigham and Women’s Hospital and the Dana-Farber Cancer Center (both MA, USA) revealed promising results from their Phase I trial investigating a novel treatment method (veledimex plus hiL-12) for glioblastoma. The novel method aims to expose only the tumor site to the interleukin hiL-12 to prevent toxicity. The results showed that patients taking low doses of corticosteroids with a 20 mg dose of veledimex had a higher overall survival rate.
At the end of 2019, researchers at Northwestern University (IL, USA) demonstrated, using mice, that ultrasound therapy could be used to allow drugs to cross the blood–brain barrier in the treatment of glioblastoma. The standard therapy (paclitaxel) for the disease was also successfully altered to eliminate toxicity. The results from the ultrasound therapy revealed a fivefold increase in the amount of drug in the brain, along with extended survival among brain tumor-bearing mice that were treated with the combined paclitaxel and ultrasound.
To find out more about developments in oncology research, visit Oncology Central