The NHS has launched a new clinical trial testing ipilimumab immunotherapy in glioblastoma patients, following an extraordinary case where a patient remains completely tumor-free more than two years after treatment. The Win-Glio trial will recruit 16 patients over 18 months at University College London Hospital's National Hospital for Neurology and Neurosurgery.
The trial was prompted by the remarkable response of Ben Trotman, who was diagnosed with glioblastoma in October 2022 at age 40. Now 43, Trotman shows no signs of tumor recurrence 2 years and 8 months after receiving ipilimumab treatment, with quarterly scans continuing to show clear results.
Unprecedented Response in Aggressive Brain Cancer
"It is very unusual to have a clear scan with glioblastoma, especially when he didn't have the follow-up surgery that had been planned to remove all of the tumour that was initially visible on scans," said Dr. Paul Mulholland, consultant medical oncologist leading the trial who treated Trotman. "We hope that the immunotherapy and follow-up treatment Ben has had will hold his tumour at bay – and it has so far, which we are delighted to see."
Glioblastoma carries an extremely poor prognosis, with most patients dying within 12-18 months of diagnosis, and some surviving just nine months. Trotman's sustained response represents a significant departure from typical disease progression, particularly given that he did not undergo the planned surgical resection of remaining tumor tissue.
Strategic Timing of Immunotherapy Administration
The Win-Glio trial employs a novel treatment sequence, administering ipilimumab before patients receive standard radiotherapy and chemotherapy. This approach aims to harness the immune system when it is at peak strength, before being compromised by conventional treatments.
"The crucial element of this trial is that patients will have their immune system boosted by the drug before they have any other treatment, when they are fit and well enough to tolerate the immunotherapy," explained Dr. Mulholland. Following immunotherapy, patients proceed to standard care consisting of radiotherapy and chemotherapy.
Trial Background and Funding
The current study follows a previous ipilimumab trial in glioblastoma that closed due to insufficient recruitment. The new trial, dubbed "Margaret's Trial," was established in memory of Baroness Margaret McDonagh, who died from glioblastoma in 2023.
Dame Siobhain McDonagh MP, the Baroness's sister, led a fundraising campaign that raised over £1 million to cover trial costs. "My beloved sister Margaret was appalled to discover that there had been no advances in brain cancer treatment for decades when she was diagnosed with glioblastoma," said Dame Siobhain. "Changing this was Margaret's final campaign and one that I have continued in her memory."
Patient Impact and Future Directions
Trotman's case has provided hope for both his family and the research community. He married Emily two months after receiving immunotherapy treatment, and their daughter Mabel was born in April. "Getting this diagnosis was the most traumatic experience. We were grappling with the fact that Ben had gone from being apparently perfectly healthy to having months to live," said Emily Trotman. "Had we not met Dr Mulholland, that would have been it for us."
Dr. Mulholland emphasized the broader implications of the research: "We're taking everything we have learned from previous trials into this new study and we are already planning follow-on trials. My aim is to find a cure for glioblastoma."
The National Brain Appeal currently funds two research positions supporting Dr. Mulholland's work. Treatment will be conducted at the NIHR UCLH Clinical Research Facility and the National Hospital for Neurology and Neurosurgery. Patients interested in the Win-Glio trial should discuss participation with their consultant.
