A new clinical trial is offering hope for patients with recurrent glioblastoma, an aggressive form of brain cancer. The trial, led by University College London Hospitals NHS Foundation Trust (UCLH), utilizes a novel radioactive therapy that has shown early promise in shrinking tumors. In a recent case, a patient's tumor was reduced by half in just weeks after starting the experimental treatment.
The CITADEL-123 trial involves a targeted approach to deliver small amounts of radioactivity directly to the tumor. Surgeons implant an Ommaya reservoir under the scalp, connected to the tumor via a small tube. The nuclear medicine team then injects ATT001, a drug designed to repair DNA damage in cells, into the tumor weekly for four to six weeks. This targeted delivery aims to cause lethal damage to tumor cells while minimizing harm to healthy tissue.
Paul Read, the first patient in the trial, experienced a significant reduction in his recurrent glioblastoma tumor. Diagnosed with the aggressive cancer after initial treatment failed, Read was offered participation in the CITADEL-123 trial. "This trial was a lifeline, as the likelihood of survival according to the data was a year or less for me," he said. "I am delighted to be given the opportunity to be part of this trial and I have not experienced any side effects from the injections."
Targeted Approach
Dr. Paul Mulholland, UCLH consultant medical oncologist and designer of the trial, emphasized the rationale behind the targeted approach. "Primary brain tumors do not metastasize around the body and generally stay in the same location in the brain," he explained. "It doesn't spread to the rest of the body, so using a targeted - directly into the tumor - approach makes sense."
The treatment regimen involves weekly injections of ATT001 for four to six weeks. The drug delivers small amounts of radioactivity directly to the tumor site, causing DNA damage and cell death. The advantage of this method is that it minimizes exposure of healthy brain tissue to radiation, potentially reducing side effects.
Future Directions
The trial aims to treat up to 40 patients, with a new patient being treated each month. Researchers plan to increase the radiation dose throughout the trial to optimize its effectiveness. Additionally, they intend to combine ATT001 with immunotherapy, which harnesses the body's immune system to fight cancer cells. This combination therapy could provide a synergistic effect, further enhancing the treatment's ability to control tumor growth.
While the early results are encouraging, Dr. Mulholland cautioned that the trial is still in its early stages. "This is a first-in-human study so we've been cautious in our approach and are only treating patients for six weeks," he said. Further research is needed to determine the long-term efficacy and safety of this novel radioactive therapy. Glioblastoma remains a significant challenge in oncology, and new treatment options are urgently needed. This trial represents a promising step forward in the fight against this devastating disease.
