Advances in medicine are very often the result of a group effort. This is certainly true of brain tumor research, where physicians and scientists in several specialties work together.
Neurosurgeons from Columbia University Medical Center/NewYork-Presbyterian Hospital, Drs. Jeffrey Bruce, Guy McKhann and Michael Sisti, show just how true this is in a pair of recent articles on advances, based on their studies, in the treatment of glioblastoma—an aggressive type of brain tumor.
In the first study, published in the journal Oncotarget, Dr. Bruce, in collaboration with Columbia cell biologists and physicians in Ulm, Germany, reported on the ways certain chemicals might be used together to eliminate cancer cells.
Glioblastoma is one of the most common brain tumors in adults. Tumors arise in the body when normal cells turn rogue and multiply rapidly, causing the tumor to grow out of control. The fast growth of glioblastoma cells makes this tumor especially deadly.
Glioblastoma is also difficult to treat. Usually doctors use a combination of surgery, radiation and chemotherapy (medicines that kill cells or inhibit their growth). This is largely because the tumor cells use a variety of different chemical reactions— known as pathways—to increase their numbers and resist being eliminated by the body. They are also more resistant to chemotherapy drugs.
The researchers looked at giving a combination of chemotherapy drugs to a laboratory culture of tumor cells to interrupt multiple pathways. One drug known as ABT263 has already been used in experimental trials to treat cancer. The other drug, named TIC10/ONC201, is a newer medicine that is being developed for use in cancer treatment.
Given together, the medicines were able to inhibit pathways that cause new tumor cells to grow. In addition, they were able to activate “good” pathways in the cells that cause apoptosis, or tumor cell death.
Usually, if chemotherapy is used, a single drug is involved. The research by Dr. Bruce and his associates indicated that ABT263 and TIC10/ONC201 might be developed into promising drugs for combination chemotherapy. Ideally, this treatment would have the potential to be more effective than using a single chemotherapy drug.
In another article, published in Neurosurgery, Drs. Bruce, McKhann and Sisti, along with their colleagues in Columbia’s Departments of Neurological Surgery, Radiation Oncology, and Neurology, examined the timing of radiation therapy–how soon after surgery the radiation treatments were given–and its impact on the survival of patients with glioblastoma.
The researchers reviewed data on 447 adult patients with glioblastoma who were treated at Columbia from 1996 to 2014. The treatment involved surgical removal of all or part of the tumor, plus radiation therapy (using radiation to kill tumor cells). In some patients, chemotherapy (medication to kill tumor cells) was also used.
When the researchers first inspected the results, it appeared that delaying radiation therapy beyond 21 days from the time of surgery improved survival rates. On closer examination of the data, however, the doctors noted that the people receiving earlier radiation therapy had a poorer prognosis to begin with.
For example, those who were older and those who had less of their tumor surgically removed were less likely to do well; these groups tended to receive radiation therapy without delay. When controlling for this risk, delaying radiation therapy did not make a difference.
We still don’t know the best timing for glioblastoma radiation therapy. Given the tumor’s special challenges, it seems only right that multiple physicians and scientists would be involved in researching the most effective ways to treat it. The ongoing research by Columbia University neurosurgeons confirms their commitment to finding the best treatments for this aggressive tumor.
Image Credit: © [Sergey Nivens]/Adobe Stock
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