New radiotherapy trial to challenge current standard of care for GBM patients

2 min read

The Guardian has reported that the NHS has begun a world-first clinical trial of a pioneering treatment technique aimed at extending the lives of people with glioblastoma (GBM).

The trial, taking place at the Christie NHS foundation trust in Manchester, sees detailed MRI scans and highly targeted radiotherapy used before surgery with the aim of reducing the likelihood of tumours growing back quickly, thereby helping patients live longer.

Currently, NHS standard of care treatment sees patients offered surgery first, followed by radiotherapy and chemotherapy. Treatment options, as well as patient outcomes, have not improved significantly in decades.

The trial – called POBIG (PreOperative Brain Irradiation in Glioblastoma) – is at an early stage, however, radiation oncologist Dr Gerben Borst, who is leading the team of specialists running the trial, said the results so far had been “very encouraging”.

He said: “Remnant tumour cells remain growing, potentially even more aggressively post-surgery in the recovery period, before the patient is given the standard course of radiotherapy. Therefore, better strategies are desperately needed to target all tumour cells at an earlier stage.”

Patients in the trial, which our sister charity brainstrust and The Brain Tumour Charity helped design, will have an MRI scan to help the surgeons best estimate where remnant cells are most likely to be left after they operate. A single dose of radiation is aimed precisely at that area. Patients then have surgery followed by radiotherapy and chemotherapy, as is standard practice.

“As a tumour is likely to respond better to radiotherapy before the operation, we hope, by giving highly targeted radiotherapy before surgery, to stop the tumour from growing back so quickly to improve outcomes and extend lives,” added Dr Borst.

Dr Matt Williams, Consultant Clinical Oncologist at Imperial College Healthcare NHS Trust, said: “POBIG is an interesting trial in itself, but also because it marks the start of a UK-wide effort to develop window studies for brain tumour patients. For example, we are developing an idea that combines pre-operative radiotherapy (like POBIG) with a drug to see if that makes the treatment more effective.”

Dr Williams is working with Dr Nel Syed at our Centre of Excellence at Imperial College London, to develop a clinical trial protocol which will progress Dr Syed’s work on arginine deprivation in GBM tumours. Similarly to the POBIC trial, radiotherapy will be provided before surgery. However, the drug ADI-PEG20 will be provided in combination with the radiotherapy in order to reduce the supply of arginine to tumour cells sensitising them to radiotherapy, making it more  effective.


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