Of Vera Martinella
The results of a trial of a new treatment led to a rapid reduction of the tumor, but the study involved only three patients (and two soon had a recurrence)
It is a trial on only three patients, but the results give rise to hope for progress in the treatment of one of the most difficult tumors to treat, the cerebral glioblastoma. It is necessary, however, great caution in evaluating the outcomes of an American study just published in the scientific journal New England Journal of Medicine, because it is the first time that a CAR-T therapy (which has already revolutionized the history of some blood tumors, making patients with just a few months to live a candidate for a possible cure) is tested in this neoplasm. And because the number of research participants (only three) cannot lead to any definitive conclusions.
The study and the results
«We are faced with preliminary results of an ongoing experiment obtained after proposing the experimental treatment to three patients with glioblastoma – he explains Enrico Franceschi, director of nervous system oncology at the IRCCS Institute of Neurological Sciences of Bologna -. In these patients, CAR-T therapy was performed, which specifically takes the name of CARv3-TEAM-E T. This is a therapy in which T lymphocytes (“soldiers” of our immune system responsible for defending us from diseases) are taken from the patient's blood and then genetically modified to recognize specific targets on the tumor cells to be affected. In this study, T cells were targeted against a protein expressed on glioblastoma cells called EGFRvIII and reinserted into the patient's brain ventricles. These CAR-T cells had also been trained to recognize and kill specifically cancer cells». After the treatment the researchers found a rapid reduction in tumor size in all three participants, but only one patient maintained this benefit for more than three months, while the other two developed disease regrowth within two months of the first infusion.”
Current therapies
Why is studying important? «The data suggests the possibility that CAR-T could have a role in the future in the treatment of brain tumors, and specifically against glioblastoma which today often has a severe prognosis – replies Franceschi -. Certainly the fact that the neoplasm recurred early in two out of three patients means that we still have to understand some mechanisms through which the cells are able to escape the T lymphocytes. It had already been reported in 2016, again in New England Journal of Medicine, a good response of a glioblastoma to a CAR-T therapy directed against a different target, the interleukin 13 receptor alpha (IL13Rα2), confirming the potential efficacy of these therapeutic approaches. However, they still need to be evaluated in more depth therapeutic targets as well as the infusion routes of these cell therapies.” What should patients now facing a glioblastoma diagnosis know? «Today the optimal treatments include surgical resectionthe radiotherapy and the chemotherapy – concludes the expert -. However, it is extremely important to have information on molecular framework of each patient's glioblastoma (i.e. the genetic characteristics, ed) both to better understand the prognosis and to evaluate the possible use of targeted drugs».
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