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Kennedy's Options for Treating Brain Cancer

From Vaccines to New Drugs, Novel Strategies Are Extending Lives of Some Patients

Avastin for Recurrent Glioma

Another possibility is adding the targeted cancer drug Avastin to standard treatment.

Avastin prevents tumors from growing new blood vessels, thereby choking them to death. It is approved to treat metastatic breast cancer as well as metastatic colorectal cancer and advanced lung cancer.

A study revealed at the ASCO meeting this week involved 167 people with glioblastoma who suffered a recurrence after standard treatment. They face a worse prognosis than people with newly diagnosed brain cancer.

The study was funded by Genentech, which makes Avastin.

Results showed that the median overall survival time was 9.2 months in those who received Avastin alone and 8.7 months in those who got Avastin plus the chemo drug with Camptosar.

The most common severe side effects were high blood pressure and convulsions, similar to those observed in other studies of Avastin.

"This is better than anything we have tried before for this group of patients," says researcher Timothy Cloughesy, MD, director of the neuro-oncology division at UCLA.

Based on the results, doctors hope to launch a study of Avastin in newly diagnosed patients in the fall, Gilbert says.

But even before then, doctors can prescribe the drug "off-label" -- that is, for purposes other than its FDA-approved uses -- for patients with newly diagnosed brain cancer if they think it will help, doctors say.

Boosting Temodar's Dosage

Massachusetts General Hospital, where Kennedy is scheduled to have his follow-up treatment, is participating in a study designed to see "whether giving more Temodar over a longer period of time can make these cancers even more treatable and further improve survival," Gilbert says.

It's already been proven that women undergoing chemotherapy for breast cancer live longer and suffer fewer recurrences if the drugs are given more frequently than had been standard practice, he explains.

And while there were worries that the regimen would prove more toxic, that was not the case, researchers say.

"We've shown it works with breast cancer. Now we're hoping it will work in brain cancer as well," Gilbert says.

The study is being conducted in newly diagnosed glioblastoma patients, he says.

A Different Type of Cancer Drug

Yet another possibility is treatment with a novel drug called talampanel. The use of talampanel follows discovery that brain tumor cells release a lot of a substance called glutamate. Talampanel may prevent brain tumor growth by blocking the effect of glutamate.

Stuart Grossman, MD, at John Hopkins and colleagues studied 72 patients with newly diagnosed glioblastoma. Patients were given talampanel in addition to standard chemo and radiation.

The participants lived an average of 18 months, "which is striking," Gilbert says. "This is a strategy well worth pursuing."

The researchers hope to start a larger long study pitting talampanel plus chemotherapy and radiation vs. chemo and radiation alone in the near future.


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