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Kennedy's Options for Treating Brain Cancer

From Vaccines to New Drugs, Novel Strategies Are Extending Lives of Some Patients
By
WebMD Health News
Reviewed by Louise Chang, MD

June 3, 2008 (Chicago) -- After Sen. Edward Kennedy recuperates from surgery for brain cancer at Duke University Medical Center he will begin targeted radiation and chemotherapy.

Kennedy, 76, has a type of brain tumor called a malignant glioma. The standard treatment for glioblastoma, the most common form of glioma, is the chemotherapy drug Temodar during and after radiation.

Studies have shown that half of people given the combination of radiation and Temodar live nearly 15 months vs. 12 months for radiation alone. But the range is variable, says Mark R. Gilbert, MD, professor and deputy chairman of the department of neuro-oncology at the University of Texas M.D. Anderson Cancer Center in Houston.

At the annual meeting of the American College of Society Oncology (ASCO) here this week, Gilbert and other brain cancer specialists reported on some experimental therapies that Kennedy and his doctors may also be looking into.

Experimental Vaccine Improves Survival

One possibility is experimental treatment with a cancer vaccine that bolsters the patient's immune system to attack the tumor.

Patients given the vaccine, known as CDX-110, typically live twice as long as those not given the vaccine, according to the results of two small studies.

One study involved 23 patients with newly diagnosed glioblastoma tumors who had undergone surgery, radiation, and Temodar treatment.

Half of patients treated with the injectable vaccine lived an average of 33.1 months. In contrast, people receiving standard treatment typically live for an average of 14 or 15 months, says John H. Sampson, MD, a neurosurgeon at Duke University.

The study also showed the vaccine extended the time to tumor recurrence after surgery. Tumors came back an average of 16.6 months later in the vaccine group vs. the standard 6.4 months for patients given radiation and chemo, Sampson says.

The vaccine was generally well tolerated, with the most common side effect being soreness at the site of injection he says.

In the second study, half of the 21 patients given the vaccine lived for 26 months, says Sampson.

The findings are promising enough that researchers plan to move to the next stage -- a larger trial comparing patients given the vaccine to those who don't get it. The trial will involve about 90 patients at more than 20 cancer centers across North America.

"The data are very striking, but it's very preliminary," says Gilbert, who participated in the research. He notes that to qualify for the study, there has to be no signs of tumor regrowth on an imaging scan after surgery, radiation, and chemo.

"The problem with glioblastoma is that some patients do very well and some do very poorly. By definition, the patients in this study are good-prognosis patients in that they had no signs of tumor growth after standard therapy. So until the larger head-to-head comparison is done, we can't say with certainly that the vaccine extends lives," he tells WebMD.

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