The Huntsman Cancer Institute at the University of Utah participated in a clinical trial that found a new combination therapy plan helped people with grade 3 recurrent astrocytoma, an aggressive form of brain cancer, live longer.
Astrocytoma is an extremely challenging diagnosis for both patients and physicians, as the range of treatments and efficacy are limited. It is incredibly rewarding to be involved in a study like STELLAR, which has demonstrated a combination therapy that has significant benefit and offers incredible potential for patients with this particular diagnosis.”
Howard Colman, MD, PhD, co-chief of the Neurological Cancer Center at the Huntsman Cancer Institute, Jon M. Huntsman Chair Professor in the Department of Neurosurgery at the U, and principal investigator of the STELLAR trial
The Phase 3 trial by Orbus Therapeutics evaluated the effectiveness and safety of a treatment plan using a combination of the drug eflornithine, a compound that targets an enzyme to inhibit the proliferation of cancer cells, and the oral chemotherapy lomustine, which is used to treat various brain cancers.
The international trial involved 343 patients from 74 hospitals and clinics in North America and Europe, including the Huntsman Cancer Institute. All patients had to have received prior radiation and chemotherapy, as well as disease recurrence after treatment.
The study initially enrolled patients who had a type of brain tumor called anaplastic astrocytoma. But as medical definitions changed, the study ended up including three types of brain tumors: glioblastoma, grade 3 IDH-mutated astrocytoma and grade 4 IDH-mutated astrocytoma.
Astrocytomas are primary brain tumors that can form in the brain or spine. IDHa mutated gene thought to drive the transformation of normal cells in the brain into tumor cells, is the most common driver of astrocytoma tumors. Glioblastoma is a different type of astrocytoma that is more aggressive and does not involve mutations in IDH gene.
In the STELLAR trial, the experimental group of patients received oral eflornithine in combination with lomustine. The other half, the control group, received lomustine alone.
Among all patients, the study found no difference in overall survival rates between the control group and the experimental group. There was also no benefit of eflornithine for grade 4 patients IDH-mutated astrocytomas or glioblastoma.
But for grade 3 patients IDH-mutated astrocytoma, the new treatment helped them live much longer – about 35 months compared to 24 months with the standard treatment.
Colman and his team also looked at each group’s progression-free survival rates, which measure how long it takes for a patient’s disease to get worse after starting treatment. For grade 4 patients IDH-mutated astrocytoma or glioblastoma, there was no significant improvement. However, as in overall survival rates, patients with grade 3 IDH-Mutational astrocytoma in combination therapy did better. Patients taking lomustine alone had a median progression-free survival rate of 7.2 months. In patients who received the combined lomustine and eflornithine therapy, the median was more than double, at 15.8 months.
“This is a groundbreaking development. Advances in brain tumor therapy are critical to overcoming this difficult diagnosis for Huntsman Cancer Institute patients and patients across the country,” said Neli Ulrich, PhD, MS, chief scientific officer and executive director of the Comprehensive Cancer Center at Huntsman Cancer Institute and Jon M. and Karen Huntsman at the U. “With each breakthrough in the treatment of astrocytoma, we move closer to transforming uncertainty into hope. Through federally funded cancer research and strong public-private partnerships, we are accelerating scientific discovery and bringing new, powerful 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, as well as the Huntsman Cancer Foundation.
The results of the study were published in Journal of Clinical Oncology.
