Because of the large number of different cell types in brain tumors, all of which respond differently to treatment, many patients relapse, and the chances of full recovery are very slim. A new diagnostic test, developed by KU Leuven, indicates from a biopsy whether a treatment can attack all the tumor cells present. This allows each patient to determine in advance which therapy is effective, preventing unnecessary treatments from being initiated. The results of this research appear today in Cellular and Molecular Life Sciences.
Every year, about 1,000 patients in Belgium are diagnosed with glioblastoma, an aggressive brain tumor. Standard treatment starts, if possible, with surgical removal, followed by a combination of radiation and chemotherapy. Because brain tumors are made up of many different types of cancer cells, the chance of relapse is high and that of survival very low, despite possible treatments. Consequently, the need is very high for effective therapies that kill off all cancer cells so that patients can be completely cured.
Previous clinical trials
"In the past, several new glioblastoma therapies were tested, but because only a small number of patients benefited from the treatment, clinical trials were not continued or there was no possibility of integrating them into the treatment regimen," said Professor Frederik De Smet of the Department of Imaging & Pathology at KU Leuven. "However, the patients who did respond well to therapy could really be helped."
The great advantage of our approach is that we do not develop new treatments but reuse already existing ones. So once our diagnostic test is in place, therapies can quickly find their way back to the hospital.
Professor Frederik De Smet
Therefore, the researchers developed a new method to determine the most optimal therapy for each patient using a few of the patient’s tumor cells obtained through a biopsy. They do this by briefly keeping the brain cells in the lab and testing different treatment options on them. "A small number of cells that survive the treatment is already enough to grow a tumor again. Our method allows us to easily examine the effect of a drug on all the cell types present in that patient, allowing us to determine which specific therapy is appropriate for a particular patient," explains Professor De Smet.
Central European test hub
The model was developed for two previously tested treatments and on the basis of experimental animal models. "Before we can use the test in human patients, further clinical studies in the hospital are needed to validate our test," said Professor De Smet. "We are also currently preparing our test with 15 other possible therapies and testing whether this method can also be applied to brain tumors in children."
It often takes a very long time before new treatments are used in the hospital because, after positive results in the lab, they still have to go through several clinical phases. "The great advantage of our approach is that we do not develop new treatments but reuse already existing ones. Previous clinical trials have already shown that they are safe for administration to patients. So once our diagnostic test is in place, the therapies can quickly find their way back to the hospital," said Professor De Smet.
Although, due to cost and special expertise, it will not be possible to perform these experiments in every hospital. "What makes our method unique is the fact that the heterogeneity of brain tumors can be taken into account. Because not every hospital has the right equipment, we want to eventually work with one central European testing hub that can examine the different samples and provide treatment advice to doctors on site."
By testing in advance whether patients will benefit from a particular therapy, no unnecessary treatments or tests are performed. This saves time, as patients immediately receive the most effective treatment, and also ensures that they do not experience negative side effects from (expensive) treatments that turn out not to work after all.
This research was possible thanks to the collaboration with several partners: KU Leuven, UZ Leuven, VIB, Jessa (Hasselt), Sint-Elisabeth (Ukkel), AZ Nikolaas (Sint-Niklaas) and Harvard Medical School and could count on funding from KU Leuven, Fonds Wetenschappelijk Onderzoek (FWO), the QbD chair for Glioblastoma and Kom op Tegen Kanker.
This study used laboratory animals. Read more about KU Leuven’s vision around scientific research using laboratory animals here.
