Glioblastoma multiforme is a deadly brain tumor with few good treatment options. Until recently, physicians had hoped that tackling the cancer with a specific type of chemotherapy to block the growth of new blood vessels in the tumor might be the key. Two recent large clinical trials (both published in the New England Journal of Medicine), however, have suggested that this anti-angiogenic treatment, which starves the tumor of oxygen and nutrients, is largely ineffective.
Stanford radiologist Daniel Rubin, MD, and former postdoctoral scholar Tiffany Ting Liu, PhD, delved more deeply into the issue and came up with a different conclusion. When they categorized the glioblastoma patients from previous studies into subgroups based on diagnostic images of their tumors, they found that some patients did benefit from the treatment, living on average about one year longer than those who were given other classes of chemotherapy drugs. This effect was masked, they found, when all the patients were lumped together in the previous studies.
Their work was published this week in Neuro-Oncology.
From our release:
The researchers used specialized software to categorize each patient into one of two groups based on the degree of vascularization of the patients’ brain tumors. Those whose tumors were more highly vascularized — as determined by an imaging technique called perfusion MRI — were significantly more likely to benefit from treatment with anti-angiogenic therapies than those whose tumors were less well vascularized.
The research emphasizes the importance of properly categorizing tumors with varied biology in order to best personalize treatment for each patient. As Rubin explained in the release:
This is a turning point. We believe we can identify those people that are likely to benefit from anti-angiogenic treatments, and also begin to think outside the box to identify other types of therapies for those who are unlikely to respond. This shows that subtyping cancers like glioblastoma can have a huge impact on how we treat disease.
Previously: The diagnosis behind the diagnosis, Blocking glioblastoma's back-up pathway and You know it when you see it: A precision health approach to diagnosing brain cancer
Image by Thomas Ried, NCI Center for Cancer Research, National Cancer Institute, National Institutes of Health