The Center for Neuro-Oncology is a leader in the implementation of precision medicine for brain tumors. Our collaborative, multidisciplinary team of physicians and researchers has continued to push the boundaries for more precise research to improve treatment for brain cancer patients.
We conducted the first randomized clinical trial of immunotherapy to show a benefit in glioblastoma patients. In the 2014 trial, rindopepimut, given along with the anti-angiogenic drug Avastin, significantly improved the survival of patients whose tumors carried the mutation known as EGFRvIII, which is found in about one-third of glioblastoma tumors. Through this approach, we can deliver effective treatment and potentially prevent the malignant transformation that could impact the patient’s prognosis.
Following the success of this trial, we are conducting clinical trials of new drugs targeting PI3 kinase, one of the most critical pathways in glioblastomas, and IDH1, one of the most common mutations in grade II and III gliomas. We are also researching the biology of tumor stem cells, which are resistant to treatment, to identify the best medications to eradicate them.
Our researchers are also leading a study of NeoVax, a “personalized neoantigen cancer vaccine,” which is already in testing for melanoma at Dana-Farber. The NeoVax vaccine is made with “tumor-specific antigens” that correspond to the unique set of mutations present within each individual patient’s tumor cells. It’s been shown that these highly-specific antigens can stimulate a potent, focused immune response.
If the vaccine proves effective, it will be combined in further trials with immune checkpoint blockers that target proteins PD-1 and PD-L1 to remove the brakes that cancer uses to suppress an immune response. New drugs that attack these checkpoints have had dramatic and long-lasting results in some patients with advanced, metastatic melanoma.
For meningiomas, our researchers completed large-scale genomic sequencing that identified two DNA mutations – SMO and AKT1 – that appear to drive the growth of some of the more aggressive types of meningiomas. As a result of this research, we are developing clinical trials of therapies targeting these mutations.