World-first clinical trials will investigate whether an experimental immune therapy developed by pioneering Australian melanoma scientists could fight an aggressive form of brain cancer, after researchers discovered an increased abundance and variety of cancer-fighting cells in the targeted tumour.
Scientists involved in the project have cautioned the therapy must be rigorously tested in a large cohort of newly diagnosed glioblastoma patients before it can be considered a breakthrough.
Professor Georgina Long hopes the approach she has pioneered to treat melanoma can be used to fight glioblastoma.Credit: Wolter Peeters
In a first-of-its-kind treatment that attracted global headlines, Melanoma Institute medical director and University of Sydney Professor Georgina Long translated the immune therapies she pioneered for melanoma into an experimental treatment for her colleague, Professor Richard Scolyer, after he was diagnosed with glioblastoma (unmethylated IDH wild-type) – a highly aggressive and lethal brain cancer.
A peer-reviewed paper published in the international journal Nature on Friday is the first scientific insight into the treatment, and will mean Long can “hand the baton” to scientists at Melbourne’s Brain Cancer Centre.
Long said previous unsuccessful trials had been limited by needing to test one drug at a time, rather than the combination immunotherapy used to radically increase survival rates in both stage 3 melanoma and melanoma that has spread to the brain.
“The whole idea of leveraging the immune system to fight a cancer – any cancer – came from melanoma,” Long said. “What this trial will do is establish whether this approach is feasible or effective for the treatment of glioblastoma.”
What the study found
Long’s hypothesis was that delivering triple-hit immunotherapy before surgery, rather than after, would deliver a greater immune response.
A study on one patient cannot conclude whether a drug works, but researchers were buoyed by the results. Cancer-fighting immune cells were more plentiful, diverse and active in tissues taken from the tumour treated with immunotherapy.
They found one drug had bound to T-cells within the tumour, indicating it could cross the “blood-brain barrier” that prevents some molecules from entering the cerebrospinal fluid.
“That’s pretty magnificent,” Long said. “We’re seeing these big fat molecules can actually get into the tumour.”
Scans taken 17 months after the treatment, which was followed by conventional surgery and radiotherapy, showed no evidence of recurrence.
People with glioblastoma have an average survival time of 12 to 18 months. Only one in four patients survive more than one year, and less than 5 per cent survive more than three years.
What happens next
The trial, spearheaded by leading Melbourne neuro-oncologist Dr Jim Whittle, could be launched within a year. Details are being finalised but only newly diagnosed glioblastoma patients will be recruited.
Whittle said the developments were exciting, but the trial would not be appropriate for everyone.
“The community that surrounds this disease needs options urgently and that is reflected in our work every day,” he said.
A waiting game
Scolyer, who, alongside Long, was named 2024 Australian of the Year and published his memoir in October, has provided regular social media updates on his treatment.
In a post earlier this month, Scolyer said his most recent scans showed some changes “which could be an effect of my previous treatment or recurrent brain tumour”.
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