New research on brain tumours could improve patient diagnosis and treatment options as part of a precision medicine approach. Brain tumours are the leading cause of cancer deaths in children and adults under the age of 40, with 16,000* people in the UK diagnosed with a brain tumour each year.
The study led by the Brain Tumour Research Centre at the University of Bristol in collaboration with the Cancer Research and Cell Biology (CCRCB) at Queen's University Belfast investigated the genetics of brain tumours. The research is published in the Journal of Oncology.
The DNA was extracted from the brain tumours of 41 patients and presence of changes or mutations in the DNA were characterised. Results were described for different types of tumours before and after treatment.
The research outlines the mutations that are particular to different tumour types. This information is important to enable precision medicine, where a patient would receive therapies tailored to the specific DNA mutations in their tumour.
One of the challenges with brain cancer is getting drugs into the tumour beyond the blood-brain barrier. The new study also lists licensed drugs that are already available that could be used as combination therapies to target specific mutations in the future. These drugs can be taken orally and should be better tolerated with less side effects. To ensure patient safety, any new combination therapies would first need to be tested in clinical trials before they would become available to patients.
These findings could pave the way for developing new targeted treatments that are more effective. The research also followed the mutations that develop during brain cancer, which could identify new therapy options to be given as the cancer progresses and help to extend patient survival.
Dr Kathreena Kurian, Associate Professor in Brain Tumour Research at the University of Bristol, who led the research, said: "New treatments are urgently needed for this incurable and devastating disease. This approach should improve patient outcomes and save on prescribing medicines to patients that won't benefit from them, thereby reducing patient exposure to toxic chemicals from chemotherapy, as well as saving the NHS money."
Diagnoses and deaths from brain tumours are increasing (Office for National Statistics, 2019). Despite traditional chemotherapy and radiotherapy treatment, the five-year survival rate for brain cancer patients is 20 per cent, compared with 50 per cent as an average for all cancers*. Some patients who receive chemotherapy, which can have severe side-effects in some patients, do not respond to treatment and other patients respond initially but unfortunately in most cases the cancer grows back.
Professor Kevin Prise, Professor of Radiation Biology from the CCRCB at Queen's University Belfast and co-author, added: "With only five per cent of the national spend on cancer research allocated to brain cancer, there is a pressing need to build capacity and develop research programs for brain tumour research throughout the UK particularly to advance precision medicine. Precision medicine promises to offer more individualised treatments and better outcomes for brain tumour patients."
The work was supported by funding from Brain Tumour Bank and Research Fund, Southmead Hospital Charity at North Bristol NHS Trust, University of Bristol Development and Alumni Relations Office (DARO) and Brainwaves Northern Ireland (NI). Ethical approval for the study was given by BRAIN UK.
Paper
'Clinically actionable insights into initial and matched recurrent glioblastomas to inform novel treatment approaches' by Kathreena Kurian, Hayley Ellis, Darragh McArt, Caitríona McInerney, Kevin Prise in Journal of Oncology [open access]
