A man has seen his deadly brain tumour shrink by half thanks to a new radioactive therapy, which experts hope will eradicate the disease.
Doctors at University College London Hospitals NHS Foundation Trust (UCLH) are running a clinical trial to treat glioblastoma, a type of cancer which kills most patients within 18 months.
Their aim is to cure the disease through injecting low levels of radioactivity directly into the tumour to kill off cancer cells.
At the very least, they hope to offer patients an ongoing form of treatment.
Paul Read, a 62-year-old engineer from Luton, is the first patient to take part in the trial and has seen his tumour shrink in half in a matter of weeks.
A second patient has also just started the therapy.
For the procedure, surgeons removed as much tumour as possible before implanting a small medical device called an Ommaya reservoir under the scalp, which connects to the tumour via a small tube.
The nuclear medicine team at UCLH then inject a drug – ATT001, an Iodine-123 labelled PARP inhibitor – directly into the tumour, delivering small amounts of radioactivity.
The drug, which is given weekly for four to six weeks, is very potent over short distances, causing lethal damage to tumour cells while sparing healthy tissue.
I was fully expecting the tumour to return due to its aggressive nature. I know the outcome isn’t great and I was happy to explore anything else
Mr Read, who has recurrent glioblastoma, first noticed a very severe headache last December that would not shift.
Two weeks later, his wife Pauline thought he may have had a stroke because his face looked like it had dropped on one side.
The couple went to A&E at Luton and Dunstable University Hospital, where a scan revealed a large mass on Mr Read’s brain.
He was admitted to the National Hospital for Neurology and Neurosurgery in Queen Square, London, and told the devastating news he had glioblastoma.
On December 27 last year, Mr Read underwent surgery to remove as much of the tumour as possible, followed by radiotherapy and chemotherapy.
However, in July, doctors told him the sad news that his tumour was growing again.
I’m not frightened by any of this. We are all dealt a hand of cards and you don’t know which ones you are going to get
Mr Read was then offered a place on the new CITADEL-123 trial at UCLH, having previously agreed to take part in clinical research.
He said: “I was fully expecting the tumour to return due to its aggressive nature. I know the outcome isn’t great and I was happy to explore anything else.
“This trial was a lifeline, as the likelihood of survival according to the data was a year or less for me.
“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.
“Possibly a little more tired, but overall, I am feeling very good.
“I’m not frightened by any of this. We are all dealt a hand of cards and you don’t know which ones you are going to get.
“It will be wonderful if this treatment helps me and if it doesn’t, it doesn’t.
“I am more than happy – even it if doesn’t benefit me, it may benefit someone else down the line.
“So I have got nothing to lose and everything to hope for.”
The trial was designed by UCLH consultant medical oncologist, Dr Paul Mulholland, who is also the chief investigator.
It is sponsored by Ariceum Therapeutics, a private biotech company developing radiopharmaceutical products for hard-to-treat cancers.
Dr Mulholland told the PA news agency the treatment so far has been very straightforward.
“The radioactivity in the drug targets the tumour cells specifically – it’s a tiny amount of radioactivity,” he explained.
It doesn't spread to the rest of the body, so using a targeted - directly into the tumour - approach makes sense
“Because it’s targeted directly to the tumour cells, it’s very powerful at killing them.
“So far, in the first patient, their tumour has reduced by 50% in size.
“We’ve just gone through his scan results with him and his end of treatment scan shows a reduction in the tumour, which is really quite remarkable for somebody whose tumour is so aggressive.”
Medics are treating one patient a month in the first phase of the trial but will expand it to include more patients.
Dr Mulholland said: “We have to aim to cure this disease. There’s reasons why we can cure it because this disease occurs in the same location in the brain.
“Primary brain tumours do not metastasize around the body and generally stay in the same location in the brain.
“It doesn’t spread to the rest of the body, so using a targeted – directly into the tumour – approach makes sense.”
Dr Mulholland said the dose of radiation will be increased throughout the trial and the plan is then to combine the drug with an immunotherapy – which trains the body’s own immune system to kill cancer – with up to 40 patients treated.
The advantage of this treatment is that it is focused and hopefully there will be little toxicity to the rest of the body
“Potentially this is a very powerful approach and I’m already extremely pleased with the results from the first patient,” he said.
“It is our aim to find a treatment or a combinations of treatments that will cure patients.
“Once we’ve recruited the first 14 patients we will then be combining with immunotherapy and will recruit a further 26 patients.
“We are aiming to transform treatment for this type of cancer.
“It could also be an ongoing treatment – it could certainly be given for more than six weeks.
“However, this is a first in-human study so we’ve been cautious in our approach and are only treating patients for six weeks.
“The advantage of this treatment is that it is focused and hopefully there will be little toxicity to the rest of the body.”
The National Brain Appeal charity has long-supported Dr Mulholland’s work, while Labour MP Dame Siobhain McDonagh, who lost her sister, Baroness Margaret McDonagh, to glioblastoma is also backing the trial.
Dame Siobhain is campaigning for a new target of 200 glioblastoma patients entering clinical trials each year and for drugs licensed for other tumours to be trialled on brain tumours.
