Dr Nel Syed who conducts research at our Centre of Excellence at Imperial College London has, this GBM Awareness Week, called for a new way of looking at the problems posed by glioblastoma multiforme (GBM).
The complexity, diversity and rapid growth of a GBM tumour means it is very difficult for researchers to develop treatments that can be effective for a patient with this diagnosis. Unfortunately, the diffuse nature of GBM also explains why some tumour cells will almost always be left behind following surgery and will continue to grow.
Dr Syed echoes the comments of many cancer specialists in believing that we must focus, not just on the tumour but the tumour site too – its microenvironment. If therapeutics, including immunotherapy, can be used in combination with standard of care (most often Temozolomide) then we can aim for the microenvironment to revert to a ‘hot,’ anti-tumour state post-surgery thus preventing recurrence. She said: “Essentially we need both to reawaken the immune system and to develop therapies that alter the microenvironment so that immunotherapy can work.”
However, Dr Syed also believes that now is the time to develop new thinking to tackle this fearsome foe. She said “Analysis of the microenvironment has a part to play much earlier in the process. We have focused too much just on the tumour in the past but we need to know more about the role of these supporting cells outside of the tumour – why are they behaving so badly at the very first stages of the disease? I believe the new biomarkers we are identifying here are the road to a blood biopsy for GBM from which we can achieve earlier diagnoses and immediate treatment can begin with new therapeutics in combination with standard of care.
“Over the next five years I am excited at the prospect of our work being able to treat newly diagnosed patients better and then hopefully we will avoid recurrence – this must be the best way to improve patient outcomes, to treat quickly – possibly one day even before the disease has taken hold, so preventing the tumour developing rather than halting the growth of an established tumour or resorting to the surgeon’s knife.
“Immunotherapy, blood biopsies and early-stage scientific research, of the type we undertake here, all have their part to play in the route to a making a GBM diagnosis less terrifying and the prognosis better.”
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