New combination treatment offers significant benefits for people with recurrent grade 3 astrocytoma

New combination treatment offers significant benefits for people with recurrent grade 3 astrocytoma

The Huntsman Cancer Institute at the University of Utah, USA, participated in a clinical trial that found a new combination treatment plan helped people with recurrent grade 3 astrocytoma, an aggressive form of brain cancer, live longer.

Astrocytoma represents an extremely challenging diagnosis for both patients and physicians because the range of treatments and effectiveness are limited. It is incredibly rewarding to be involved in a trial like STELLAR, which has demonstrated a combination treatment that has significant benefit and offers incredible potential for patients with this specific diagnosis.”

Howard Colman, MD, PhD, co-director of the Neurologic Cancers Disease Center at Huntsman Cancer Institute, Jon M. Huntsman Presidential Professor in the Department of Neurosurgery at the U and principal investigator of the STELLAR trial

Orbus Therapeutics' Phase 3 trial evaluated the effectiveness and safety of a treatment regimen containing a combination of the drug eflornithine, a compound that targets an enzyme to inhibit tumor cell proliferation, and the oral chemotherapy drug lomustine, used to treat various brain tumors.

The international study involved 343 patients from 74 hospitals and clinics in North America and Europe, including the Huntsman Cancer Institute. All patients were required to have previously received radiation and chemotherapy and to have had disease recurrence after treatment.

The study initially involved patients suffering from a type of brain tumor called anaplastic astrocytoma. However, as medical definitions changed, the study eventually included three types of brain tumors: glioblastoma, grade 3IDH-mutated astrocytoma and grade 4IDH-mutated astrocytoma.

Astrocytomas are primary brain tumors that can form in the brain or spine.IDHA gene that mutates and is thought to drive the transformation of normal cells in the brain into tumor cells is the most common cause of astrocytoma tumors. Glioblastoma is another type of astrocytoma that is more aggressive and does not involve mutations in the cellIDHGene.

In the STELLAR study, the experimental patient group received oral eflornithine in combination with lomustine. The other half, the control group, received lomustine alone.

Across all patients, the study found no difference in overall survival rates between the control and experimental groups. There was also no benefit of eflornithine for grade 4 patientsIDH-mutated astrocytomas or glioblastomas.

But for patients with grade 3IDH-Mutant astrocytoma, the new treatment helped them live much longer - about 35 months compared to 24 months with standard treatment.

Colman and his team also took into account each group's progression-free survival rates, which measure how long it takes for a patient's disease to worsen after starting treatment. For patients with grade 4IDH-mutated astrocytoma or glioblastoma, there was no significant improvement. But, as with overall survival rates, patients with grade 3IDH-Mutant astrocytomas improved with combination therapy. Patients taking lomustine alone had a median progression-free survival rate of 7.2 months. In patients taking the combination therapy of lomustine and eflornithine, the median duration was more than twice as long, 15.8 months.

"This is a groundbreaking development. Advances in the treatment of brain tumors are critical to overcoming this difficult diagnosis for patients at the Huntsman Cancer Institute and patients across the country," says Neli Ulrich, PhD, MS, scientific director and executive director of the Comprehensive Cancer Center at the Huntsman Cancer Institute, and the Jon M. and Karen Huntsman Presidential Professor of Cancer Research in the Department of Population Health Sciences at the U. "With each breakthrough in the treatment of astrocytoma, we come closer.” We transform uncertainty into hope. Through federally funded cancer research and strong public-private partnerships, we are accelerating scientific discovery and bringing new, effective treatments to the patients who need them most.”

This clinical trial is supported by the National Institutes of Health/National Cancer Institute, including Cancer Center Support Grant P30 CA042014, and the Huntsman Cancer Foundation.

The results of the study were published inJournal of Clinical Oncology.

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