New Hope for Glioblastoma Patients
Posted on: August 1, 2015
A couple of years ago I had a patient who was diagnosed with glioblastoma, an aggressive type of brain tumor. She was only 53 years old, and went through a full course of treatment to fight the cancer: surgery, radiation, and temozolomide chemotherapy. For nearly the first year after her treatment she did well, but then the tumor came back. Normally patients with recurrent glioblastoma receive chemotherapy, but she called me to ask if there were any other treatment options that she should consider.
Over 10,000 people in the US are diagnosed with glioblastoma every year. The median survival for glioblastoma patients is 15 months, even with standard therapy. Many patients have a recurrence and are then confronted with similar options: more surgery, more radiation, and/or different chemotherapy. I was particularly interested in helping my patient quickly because people with recurrent glioblastoma have a poor prognosis, with a median survival of less than a year.
While it’s not a silver bullet, there is an interesting new treatment available for patients with recurrent glioblastoma called “Optune.” It does not involve surgery, chemotherapy, or radiation therapy, and instead relies on generating low-intensity electrical fields in the brain called Tumor Treating Fields (called TTF). The TTFs seem to disrupt the ability of the cancer cells to divide so that the tumor cannot grow. Patients getting TTF have to shave their hair and place electrical transducers (similar to EKG pads) on their scalp for at least 18 hours a day. These transducers are hooked up to a device that generates the electrical fields. This is a tradeoff – while patients can avoid some of the side effects of chemotherapy, radiation, and surgery, they have to be willing to wear an apparatus on their head and carry around a 6 pound device.
The FDA approved Optune in 2011 for patients with recurrent glioblastoma based on a study that showed comparable survival between patients treated with chemotherapy versus TTF. Patients in the TTF group reported fewer side effects such as nausea, vomiting, and fatigue. The most common side effect was skin irritation on the scalp due to the transducer pads. Then last month, researchers presented an analysis of 700 newly diagnosed glioblastoma patients who were either assigned to one of two groups: (1) those who received TTF and temozolomide or (2) temozolomide alone. Patients treated with TTF had an improved median survival of 19.4 months, compared with 16.6 months for patients treated with temozolomide alone. The FDA is currently reviewing the data, but Optune may become a treatment for newly diagnosed glioblastoma patients in the future.
Optune shows promise as an alternative to conventional treatments, or as a potential supplement to them. It has different side effects that many patients may find more manageable, and may help to extend patients’ lives in the future.
Christine Chung, MD is a board certified Radiation Oncologist with Diablo Valley Oncology & Hematology Medical Group and practices in Pleasant Hill and Berkeley. Dr. Chung and her colleagues are certified providers of the Optune treatment therapy. For more information, please call 925-677-5041Brain Cancer