Glioblastoma is an aggressive form cancer that has a meager survival rate. Sadly, despite hundreds of research studies, no fully effective treatment options have been found. New research from the Translational Genomics Research Institute (TGen) at UC San Francisco has found that RNA and DNA sequencing of tumors could offer some hope to patients who have been diagnosed with this form of brain cancer.
By detailing the RNA and DNA of a particular tumor, much information can be gained. Precision medicine, where each patient's treatment is tailored genetically to their specific disease is at the forefront of glioblastoma research. In the study conducted at TGen, 16 patients had their tumors mapped, down to its particular genetic code. The information gained in that mapping was then passed on to the patient's oncology team so they could render "informed treatment." Informed treatment means that the doctors have a wealth of details on the type of tumor and can fight it with better options.
Dr. Sara Byron, Research Assistant Professor in TGen's Integrated Cancer Genomics Division and the study's lead author, explained, "To our knowledge, this is the first report of a prospective profiling study in recurrent glioblastoma to show patients with extended time to progression following treatment with genomics-informed therapy. This is a primary example of the benefits of genomics-driven precision medicine being applied for patients with aggressive and refractory tumors."
With glioblastomas, not only are they aggressive, but they are usually located deep in the brain tissue and accessing them surgically is not always possible. Surgeons must decide how much surrounding tissue can be removed without further endangering the patient. Even if a tumor is partially removed, and chemo and radiation are used, most glioblastoma tumors come back.
Like anything, the timing is crucial. Not only must the tumor be genetically mapped, but the patient's entire genome must be as well. Only then can the doctors look at the genes and figure out the best way to fight it. There are 20,000 genes in the human genome, so it's no easy task to sort them all out. In the study at TGen, the analysis and recommendations were carried out in less than 35 days after the surgery which is a "clinically acceptable time frame" according to the researchers.
Of the patients who received this genetically tailored treatment, two of them experienced more than a year with no tumor recurrence and no new tumor growth. One of those two was a patient whose tumor had recurred. After the first round of treatment for this patient, recurrence happened about seven months after the initial surgery. With the informed treatment, survival for this patient was progression-free for 21 months.
Finding effective drugs is another concern for glioblastoma patients. The blood-brain barrier keeps toxic agents away from the brain, but then lifesaving cancer drugs cannot get through. Having more genetic information on a patient means that drugs can be better matched to the specific tumor's genetic code. Only three medications, temozolomide, nitrosoureas, and bevacizumab, are FDA approved for this form of brain cancer. The video below has more information on this new approach to glioblastoma treatment, take a look.