Glioblastoma’s unfavorable prognosis is largely due to the high possibility of recurrence combined with limited approved treatments. Several clinical trials with new treatment approaches for recurrent glioblastoma are running at a variety of cancer treatment hospitals, academic and government institutions. They offer hope but create a tough landscape to navigate for patients and caregivers. Some therapies are acknowledged more in popular press while shadowing others with hidden potential.

To this end, the Cancer Treatment Navigator (CTN) team would like to highlight a novel treatment currently in clinical trials for recurrent glioblastoma. It was brought to our attention via an interview with Dr. Priya Kumthekar, MD and Dr. Alexander Stegh, Ph.D. at Northwestern University Feinberg School of Medicine, published last month in OncoTherapy Network. It is called NU-0129 and is a so-called nano-particle. That means super small. NU-0129’s super small size and shape allows it to successfully reach the site of the tumor in the brain. Once there, it interferes with the cancer cell’s biology and stops its growth which essentially can kill the cancer cells. Researchers at Northwestern University are evaluating this drug for its tolerability and ability to get directly to the brain tumor for maximum effectiveness.

On a practical level, rapid advancement in clinical science for cancer treatment has left oncologists strapped for time and resources. Especially when research is required beyond standard hospital protocols for treating most patients. When a clinical trial is considered, very often the clinical trial run by a patient’s hospital ends up being recommended as the best course of action. But that doesn’t mean it is the best choice based on comprehensive research and consideration of all trials running throughout the country. Consequently, one of our main objectives at CTN is to help cancer patients gain access to promising clinical trials based on thorough research and evaluation of published data and compared to the diagnosis, treatment history and specific cancer type of each individual client. Another hurdle that we help overcome is the unnecessarily restrictive eligibility criteria for trial enrollment. Often patients are turned away because many trials only pre-select for very healthy cancer patients to participate. This is done to minimize side effects that might be blamed on the study drug. However, cancer patients are often not healthy, but they still deserve the right to make their own decision about added potential health risks from an experimental medicine. We share the belief with many experts in the field that clinical trials should be for a patient’s welfare and not only for the benefit of a hospital or an individual company’s new blockbuster drug.

One of our main objectives at Cancer Treatment Navigator (CTN) is to help cancer patients gain access to clinical trials. This can improve better disease control and subsequently increase the chance of survival. Multiple factors can contribute to a better survival chance for patients who are accepted into a clinical trial - but why do only about 5% of all cancer patients in the US participate in clinical trials?

An interview with Dr. Mikkael A. Sekeres at the Cleveland Clinic, published last month in Onco Therapy Network, lists some of the reasons of poor clinical trial enrollment.  One of the main reasons is unnecessarily restrictive inclusion criteria.  Cancer patients who ran out of “standard of care” treatment options are becoming sick faster, but clinical trials want healthy patients to participate. “Healthy” and “patient” is an oxymoron and contrary to the reality we live in: Cancer patients are sick! They want to be healthy again! Dr. Sekeres does a great job arguing why many trials are too restrictive by not including “real world -sick- patients”. At CTN, we often say that clinical trials are not designed for the welfare of the patients, they are designed for the “welfare” of the drug that is being tested. 

At CTN we work hard to find solutions for patients who cannot participate in a clinical trial-- for whatever reason. This can be achieved by gaining access to certain experimental therapies that are either still in clinical testing or that are already approved for other indications. Yes, this can be done!

Just think about the many immunotherapy clinical trials with so-called “immune checkpoint inhibitors”. Some of these medications are already approved to treat late stage cancer patients for an increasing number of indications. This allows access to these immunotherapies in the “market place” – access for patients with rare cancers that are not included in any clinical trial, or access for patients who won’t meet the restrictive eligibility criteria for some of these life-saving trials.