Brain cancer patients with the poorest prognosis, those with a type of deadly tumor known as glioblastoma multiforme, may survive longer with a drug that chokes off a tumor’s blood supply.

According to a new study by researchers at Duke’s Preston Robert Tisch Brain Tumor Center, a combination of Bevacizumab ( Avastin ) and a standard chemotherapy agent, may increase the amount of time patients with glioblastoma multiforme can survive without tumor growth, and may significantly increase their overall survival.

“ For this study, we looked at patients whose tumors had returned after initial treatment, and we found that this drug combination could significantly improve outcomes for these people, who are typically given about three to six months to live, ” said James J. Vredenburgh, at Duke University and lead investigator on the study.

The researchers published their findings in the Journal of Clinical Oncology.

In this pilot study, researchers administered a combination of Bevacizumab and Irinotecan ( Camptosar ), a standard chemotherapeutic agent, to 35 patients whose glioblastomas multiforme had returned. Each patient had already been treated with a standard therapy regimen, possibly including surgery, radiation and chemotherapy.

Almost half saw no tumor progression after six months, and almost 80 percent were still alive six months after diagnosis.

Patients with recurrent glioblastoma multiforme who are treated with standard therapies, such as chemotherapy alone, have tumor progression at six months in about 75 percent of cases and fewer than 50 percent are alive after six months.

“ Historically, when glioblastoma multiforme recurred, there had typically been very little else we could do,” said Vredenburgh. “ We had one patient on this trial who had been already been told to get his affairs in order; he started the trial and over a year later he’s still here, so this is very promising.”

Bevacizumab has been heralded as a success in treating several types of cancer, including colorectal and lung cancers. It is one member of a class of drugs called anti-angiogenics, which work by stunting the otherwise rapid growth of blood vessels that feed a tumor’s growth and spread.

“ We speculate that Bevacizumab and Irinotecan each attack a particular characteristic of the tumor independently or they work together, with the Bevacizumab suppressing the growth of blood vessels which makes the tumor more susceptible to the chemotherapy,” Vredenburgh said. “ Further studies will tease out the exact mechanism of the therapy’s success and we also hope to study the effectiveness of this treatment in patients with newly diagnosed glioblastoma multiforme.”

About 8,000 to 10,000 new cases of glioblastoma multiforme are diagnosed each year in the United States, and glioblastomas multiforme account for about half of all primary brain tumors. Less than 30 percent of patients diagnosed with primary glioblastoma multiforme are alive one year after diagnosis, and after 10 years, only 2.3 percent are still alive.
Even when glioblastoma multiforme are effectively treated with surgery or medicines, they return in more than 90 percent of all cases.

Source: Duke University Medical Center, 2007

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