Unusual treatment shows promise for kids with brain tumors

15 April, 2021
Unusual treatment shows promise for kids with brain tumors
For decades, a deadly kind of childhood cancer has eluded science’s best tools. Now doctors have made progress with an unusual treatment: Dripping millions of copies of a virus straight into kids’ brains to infect their tumors and spur an disease fighting capability attack.

Twelve children treated this way lived more than twice as long as similar patients have previously, doctors reported at an American Association for Cancer Research conference this week and in the New England Journal of Medicine.

Although almost all of them eventually died of their disease, a few are alive and well many years after treatment -- something nearly unheard of in this example.

“This is the first step, a critical step,” said the study’s leader, Dr Gregory Friedman, a childhood cancer consultant at the University of Alabama at Birmingham.

“Our goal is to boost on this,” possibly by trying it when patients are first diagnosed or by combining it with other therapies to boost the disease fighting capability, he said. The patients in the analysis received the experimental approach once they failed other treatments.

The analysis involved gliomas, which account for 8% to 10% of childhood brain tumors. They’re usually treated with surgery, chemotherapy or radiation nonetheless they often recur. Once they do, survival averages just under six months.

In such cases, the disease fighting capability has lost the opportunity to recognize and attack the cancer, so scientists have already been seeking ways to make the tumor a brand new target. They turned to the herpes virus, which in turn causes cold sores and spurs a solid immune system response. A suburban Philadelphia company called Treovir developed cure by genetically modifying the virus so that it would infect only cancer cells.

Through tiny tubes inserted in the tumors, doctors gave the altered virus to 12 patients ages 7 to 18 whose cancer had worsened after usual treatments. Half also received one dose of radiation, which is considered to help the virus spread.

Eleven showed evidence in imaging tests or tissue samples that the treatment was working. Median survival was just over a year, a lot more than double what’s been observed in the past. As of last June -- the cutoff for analyzing these results -- four were still alive at least 18 months after treatment.

Tests also showed high levels of specialized disease fighting capability cells within their tumors, suggesting the treatment had recruited the help needed from your body to attack the condition.

No serious safety issues were seen, though there have been several procedure-related issues and mild unwanted effects including nausea, vomiting, diarrhea and fatigue.

Jake Kestler had the procedure when he was 12.

“It went perfectly. He lived for a year and four months after that,” long enough to celebrate his bar mitzvah, go along with his family to Hawaii and visit a brother be born, said his father, Josh Kestler, a financial services executive from Livingston, NJ.

Jake died April 11, 2019, but “we've no regrets whatsoever” about trying the treatment, said Kestler, who along with his wife has started a foundation, Trail Blazers for Kids, to help expand research.

“It’s a devastating disease for these patients and their families,” and the first results suggest the virus treatment is helping, nonetheless they ought to be verified in a larger study, which doctors are planning, said Dr Antoni Ribas, a cancer consultant at the University of California, Los Angeles, and president of the group holding the conference.

Friedman said studies are continuing in adults as well, and plans are in the works for other styles of childhood brain tumors. U.S. government grants and many foundations paid for the study, and many doctors have financial ties to Treovir.

Only 1 similar virus therapy is currently approved in america -- Imlygic, also a modified herpes virus, for treating melanoma, the most serious type of skin cancer.