International Brain Tumour Awareness Week (28 October - 4 November)

International Brain Tumour Awareness Week is held from 28 October to 4 November 2023. It aims to raise awareness of the challenges of a brain tumour diagnosis and the need for increased research efforts.

We hear from Professor Keyoumars Ashkan, Professor of Neurosurgery and Lead Clinician for Neuro-Oncology and Dr Ahmad Kamaludin, Clinical Research Fellow Neuro-Oncology, about ongoing research studies that can help with brain tumour diagnosis and treatment.

What is the importance of brain tumour research from your perspective?

Advancing our understanding of brain tumours through research is vital for improving treatment options and enhancing patients' quality of life. This is especially true for aggressive brain tumours like glioblastoma multiforme (GBM), the most lethal primary central nervous system tumour. With a survival rate of only 15 to 17 months and a 5-year survival rate of 5%, finding new treatment options is important. The current treatment options for newly diagnosed brain tumours including surgery, radiotherapy, and chemotherapy, have remained unchanged for the past 20 years, resulting in stagnant survival and mortality rates.

Developing effective treatments for complex brain tumours like GBMs is challenging due to their invasive nature, resistance to chemotherapy, and diversity. However, extensive research has led to significant progress in profiling GBMs based on specific mutations and patterns unique to each tumour, paving the way for personalised treatment options. Immunotherapy, such as DCVax, is an emerging option for mobilising the patient's immune system to fight against the tumour. 

Introduction to DCVax, patient benefits, expectations and potential outcomes 

DCVax is a new treatment option for GBM that uses a patient's immune system to fight cancer cells. It involves using dendritic cells, the master cells of the immune system, to educate the immune system to attack cancers. The treatment is well tolerated with few side effects, and it targets the spectrum of antigens in the patient's tumour by using the patient's tumour tissue to educate the immune system. 

A Phase 3 clinical trial investigating the use of DCVax was published in JAMA Oncology in November 2022. The trial showed that DCVax improved the average overall survival of patients with methylated subtype of GBMs by 9 months (30.2 months vs 21.3 months) and of patients with unmethylated subtype of GBMs by about 3 months (19.3 months vs 16.5 months) when compared to the external control group. The 5-year survival rate was also higher in the DCVax group (13%) than in the control group (5.7%). Interestingly, the survival benefit was particularly pronounced in older patients. 

The robust survival benefit of DCVax suggests that it should be considered for inclusion in the standard of care treatment for GBMs, especially given that no new systemic treatment since 2005 has demonstrated any significant survival benefit. Currently, DCVax is going through the process of appraisal required to obtain regulatory approval in the UK to make it available as part of the care for GBM patients.