Revolutionary Clinical Trial Offers Hope for Children Battling Rare Brain Tumors
In a groundbreaking development, researchers from University College London (UCL) and Great Ormond Street Hospital have unveiled promising results from a Phase II clinical trial aimed at treating BRAF mutated low-grade pediatric gliomas. Gliomas are cancerous brain tumors originating in glial cells, the supportive cells of the brain.
The findings, published in the New England Journal of Medicine and the Journal of Clinical Oncology, mark the first clear clinical benefit of combining Dabrafenib and Trametinib (Novartis) therapies for BRAF mutated low- and high-grade pediatric gliomas, respectively.
Traditionally, children with low-grade gliomas undergo full surgical removal, but for cases where surgery is not possible, additional treatments like chemotherapy become necessary. Unfortunately, these patients often face multiple relapses, disease progression, and severe side effects.
The randomized TADPOLE-G study treated 73 children with BRAF mutated low-grade gliomas (BM-LGG) with Dabrafenib and Trametinib, comparing their outcomes to 37 patients receiving standard chemotherapy drugs. The combination therapy not only reduced chemotherapy side effects but also significantly improved the overall response rate by over four times, extending the median progression-free survival from 7.4 months with chemotherapy to 20.1 months with the new treatment.
This breakthrough follows the publication of results from the same study focusing on patients with BRAF mutated high-grade gliomas (BM-HGG). The dual treatment led to a remarkable 56% response rate among the 41 participating children, a substantial improvement compared to previous chemotherapy trials, with a median duration of response of 22.2 months.
Professor Darren Hargrave from UCL Great Ormond Street Institute of Child Health and GOSH emphasized the transformative potential of targeted drug therapies, stating, “The results of these studies highlight how targeted drug therapies can offer patients new treatment avenues that not only improve outcomes but reduce the side effects often associated with cancer therapies.”
The BRAF mutation, identified as a cancer driver in the early 2000s, has seen success in treating melanoma and non-small cell lung cancer in patients with this mutation. Present in around 15-20% of pediatric low-grade gliomas and 5-10% of high-grade gliomas in children, the BRAF mutation became the focus of these groundbreaking trials.
The trials demonstrated the effectiveness of the combination therapy in treating pediatric gliomas, providing hope for better outcomes and reduced side effects. The evidence from these trials is being used in a NICE scoping review to evaluate the clinical and cost effectiveness of the treatments, with the US FDA already approving the treatment for children with low-grade glioma.
The global collaboration involved 58 sites across 20 countries, emphasizing the significance of joint efforts to advance research on rare cancers. Gerrit Zijlstra, Chief Medical Officer at Novartis UK, expressed their commitment to developing targeted therapies based on the unique genetic features of patients’ tumors, addressing a critical need where treatment options are limited.
These groundbreaking results offer a ray of hope for children facing rare gliomas, showcasing the power of collaborative research in advancing treatments for rare cancers.