Achal Singh Achrol, MD, Chief of Glioma Surgery Program at John Wayne Cancer Institute talks about a trial for a new treatment option for patients with glioblastoma.
Interview conducted by Ivanhoe Broadcast News in August 2017.
Tell us about the trial that you’re working on.
Dr. Achrol: This trail is called the Medicina Trial; it involves a bioengineered fusion protein. This is a protein that is specifically designed and engineered to bind to the tumor cells directly. In this case, glioblastoma, this is the most common primary brain tumor. The protein works by looking at this specific type of receptor that are on tumor cells but are not on normal brain cells. That way it can bind directly to tumor cells and bring in a payload which is like a Trojan horse that acts directly on tumor cells and causes the tumor cells to undergo program cell death.
For someone who doesn’t know what cell death is, just a layman’s explanation?
Dr. Achrol: Each cell has an ability to determine that it’s malfunctioning and it goes through a process by which it turns itself off and recycles itself. Tumor cells have an ability to evade that normal process and this protein works to reactivate that signal that these cells are behaving abnormally and they should go through a program that will allow them to be turned off.
What kind of success have you had with the trial?
Dr. Achrol: This is a Phase II trial which means its part of a series of trials aiming to understand whether it’s efficacious. It’s too soon yet to understand whether there is efficacy to this and that will be one of the goals of the therapy. What we do know from the first few patients that we’ve treated is that there are no serious adverse effects, and it’s still too soon to tell in terms of whether there are effects.
Phase II just started then? Pretty new?
Dr. Achrol: That’s right, that’s right. We’re the leading enrollment site nationally for this trial and we’ve treated a total of three patients now. Overall this study has treated six patients.
So far nothing bad; but too soon to say something good?
Dr. Achrol: Absolutely, right.
How did you know that this bioengineered chemical would work?
Dr. Achrol: This protein was engineered to mimic the toxin of a common bacteria that infects our intestines and it actually causes the cell lining of our intestines to go through program cell death. That’s what results in diarrhea and that’s how that bacteria is clinically relevant. That same concept was then utilized to develop this way of targeting cancer cells for the same purpose.
Why just glioblastoma for now?
Dr. Achrol: This bioengineered protein was actually developed here at the John Wayne Institute by Dr. Rand who is a neurosurgeon specifically studying glioblastoma. The concept itself can be applied to other cancers but he had started because he was the neurosurgeon focusing on this particular disease.
So for the purpose of this trial it’s just for glioblastoma?
Dr. Achrol: That’s right for glioblastoma.
What could the future of this be? If this really turns out to work and it looks like it could what’s the future for this?
Dr. Achrol: We’re really excited about the potential of this type of therapy, that’s why we’re participating in the trial. The goal is to try to get away from therapies that are nonspecific and are toxic in nature. Chemotherapies and radiation therapies are relatively nonspecific and they just target a mechanism which is to damage DNA. That’s relatively nonspecific and that’s why we have so many side effects from that. We want to get to targeted precision therapies. This is one tool that is very specific in targeting the tumor, but we try to develop an arsenal of those tools that we can use many different techniques to target a specific patient by their molecular profile.
Who is eligible for this trial and is it still open?
Dr. Achrol: The trial is still open. Any patient with a recurrent glioblastoma should be seen and evaluated for the inclusion criteria. But it would be any patient with a recurring glioblastoma.
What haven’t I asked you that you think is important to include?
Dr. Achrol: Two major concepts that are really changing the field for brain tumors; one is targeted therapies and the other is delivering those therapies to the tumor. This therapy is really interesting because it involves minimally invasive neurosurgery, computational and MRI-guided delivery of therapeutics. What we call convection-enhanced delivery. That is a brand new field and so combining that with this concept of targeting in a precise way, each patient to their unique molecular susceptibilities, is really what makes this trial and the overall concept very exciting.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Achal Singh Achrol & Santosh Kesari
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