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New therapeutic approach against aggressive brain tumors discovered
The treatment of brain tumors in the form of a primary CNS lymphoma is still extremely difficult and especially patients who do not respond to the first-line therapy or relapse, have a poor prognosis, according to the announcement of the Charité - Universitätsmedizin Berlin. In a recent study, researchers of the Charité now tested a targeted drug for the treatment of CNS lymphomas. The results of their Phase II study published by the researchers in the journal "Journal of Clinical Oncology".
In collaboration with the German Study Group for Primary CNS Lymphomas, the researchers of the Charité have tested the use of a targeted agent for the treatment of CNS lymphoma. "Although the results do not represent a therapeutic breakthrough, they open up new perspectives for patients suffering from CNS lymphoma," says the Charité. Now further research is needed to test the potential uses of the drug in combination with other drugs.
CNS lymphomas are particularly difficult to treat, aggressive brain tumors, against which a new therapeutic approach has been tested. (Image: adri76 / fotolia.com) Treatment of CNS lymphoma so far extremely difficult
Primary CNS lymphomas are rare, particularly aggressive brain tumors that, according to the researchers, at the time of initial diagnosis are usually limited to the central nervous system (CNS), especially the brain and the nerve water. The tissue neoplasms (lymphoid neoplasms) can be suppressed by therapies with cytostatics that cross the blood-brain barrier, or by whole-brain irradiation sometimes over several years and in some cases even succeed in healing. However, around a quarter of patients do not respond to primary therapy, and more than half experience relapse. Their prognosis was so far extremely bad.
Targeted drug tested
However, doctors and scientists of the German Study Group for Primary CNS Lymphomas (G-PCNSL-SG) have now tested the active substance temsirolimus as monotherapy for the unsuccessfully pretreated patients in a phase II study. The targeted use of the drug, which has already shown efficacy with tolerable side effects in other relapsed lymphomas, inhibits a certain signaling pathway (mTOR) in the tumor cells, thereby blocking a mechanism important for the survival of these cells, the researchers report , "Because of its profile of action and the evidence that temsirolimus is able to cross the blood-brain barrier, we wanted to investigate its efficacy in patients with CNS lymphoma," explains Drs. Agnieszka Korfel, senior physician at the Department of Hematology, Oncology and Tumor Immunology of the Charité and head of the clinical trial of the results.
Significant side effects
According to the senior physician, "the substance was found to be remarkably active in relapsed CNS lymphoma." However, the drug was "associated with a not inconsiderable toxicity" in the investigated patient group, Korfel reported on the study results. The study participants included only patients, "in which the disease had progressed or returned after a few or more pre-treatment," said the Charité. Overall, out of 37 participating patients, 20 patients responded well to treatment and some patients had stopped remission for more than five months. But the range of side effects should not be neglected. Among the most common were, for example, the increase in blood sugar, infections and skin rash, the researchers report.
Combination with other active agents makes sense?
According to Dr. Agnieszka Korfel might find it useful to use "temsirolimus in combination with cytostatics or with rituximab and in previous therapies." According to the experts, this should be reviewed in future therapeutic trials. "Against the background of the toxicity of the drug, this should be offered primarily to younger and fit patients and should be accompanied by prophylactic antibiotics," emphasizes Dr. med. Korfel. (Fp)