Immunotherapy and Combined Treatments Offer Hope in Glioblastoma

Penn neurosurgeon pointing at glioblastoma on brain scan.

Senators Ted Kennedy and John McCain died nine years apart on the very same day, August 25—and they died of the very same form of aggressive brain cancer, glioblastoma. During the days and weeks following these deaths, many Americans found themselves wondering, what is glioblastoma, how common is it, and what is being done to treat it?

Glioblastoma is the most common form of malignant brain cancer, representing just over 15 percent of all primary brain tumors, according to the American Brain Tumor Association. A primary brain tumor is one that originates in the brain, unlike a secondary brain tumor, which develops elsewhere in the body and spreads to the brain.

In addition to being the most common, glioblastoma tumors are also the most lethal. Roughly 15,000 new cases of glioblastoma are diagnosed every year, with average glioblastoma survival rates resting somewhere in the 11-to-15-month timeframe. Senator John McCain died 13 months after his glioblastoma diagnosis.

Penn Medicine is on the frontlines in the fight against brain tumors like glioblastoma. Our Penn Brain Tumor Center performs the most brain tumor surgeries in Pennsylvania. What’s more, few health systems in the United States have the diverse team of experts and advanced treatment options that Penn has.

While finding a cure for glioblastoma remains a distant goal, medical experts are hopeful that the many novel treatment approaches and clinical trials at Penn will eventually lead to longer life expectancy for patients.

Immunotherapy—A Game-Changer in Brain Tumor Treatment

The world’s first gene-based cancer therapy, immunotherapy—or CAR-T cell therapy—is being heralded as a game-changer in the treatment of aggressive cancers like glioblastoma. The Penn Brain Tumor Center has few peers when it comes to this innovative approach to cancer therapy.

An intravenous drug treatment administered similarly to chemotherapy, immunotherapy enhances the effects of the immune system. When cancers like glioblastoma develop in the body, they suppress immune responses. This means the body’s T-cells—the cells that act on behalf of the immune system—fail to activate in the presence of cancer cells. Immunotherapy reprograms those T-cells and empowers them to hunt down and kill tumor cells. It’s basically a jumpstart to the immune system.

Approved by the FDA for use in patients with pediatric leukemia and adults with non-Hodgkin lymphoma, immunotherapy is currently in clinical trials for glioblastoma. For many neurosurgeons at the Penn Brain Tumor Center, the recent immunotherapy trials are a beacon of hope in the treatment of malignant brain tumors.  

Combining immunotherapy with more traditional treatment approaches, like chemotherapy and radiation therapy, could be the key to a greatly improved glioblastoma prognosis. The hope is that the average life expectancy for patients with glioblastoma—around 14 months—will significantly expand due to therapies like CAR-T.

Fortunately for patients, that sort of progress is possible at the Penn Brain Tumor Center and Abramson Cancer Center, according to Donald M. O’Rourke, MD, and Arati S. Desai, MD, who are leading the immunotherapy research efforts here at Penn.

“Penn is the only institution in the United States doing this kind of therapy right now. We’re in the lead in terms of what we can do, mainly because of the infrastructure here at Penn. We have a huge facility in immunology,” said Dr. O’Rourke.

Over the next five years or so, Dr. O’Rourke predicts that, “the research and treatment for glioblastoma, the real cutting-edge breakthrough, is going to be coming through the use of the immune system.” Which makes immunotherapy “an area we’re intensely exploring.”

To hear more about immunotherapy for glioblastoma, watch the following video, featuring world-leading neurosurgeons Dr. O'Rourke and Dr. Grady and brain tumor oncologist Dr. Desai:

Innovative Glioblastoma Treatments at Penn

In addition to novel treatment options like immunotherapy, the Abramson Cancer Center and Penn Brain Tumor Center have a full arsenal of medical and surgical approaches for treating glioblastoma. These approaches include more traditional methods such as radiation therapy, chemotherapy, and surgical resection.

But even traditional methods benefit from some innovative twists. That’s where advanced imaging tools and other state-of-the-art surgical technologies come in.

  • TumorGlow®: Surgical resection—whether it’s a full or partial resection—of a glioblastoma tumor is now being aided by “TumorGlow®,” a form of intraoperative molecular imaging (IMI) that uses a fluorescent dye to make cancerous cells glow. Taking on a neon hue, the malignant tissues are more identifiable, ensuring that surgeons find and remove as much of a tumor as possible. 
  • Brain Mapping: Similar to TumorGlow®, Penn’s lush neuroradiology program uses advanced imaging tools to develop individualized brain maps, helping neurosurgeons to avoid speech and motor areas of the brain when removing difficult tumors.
  • Proton Therapy: A cutting-edge form of radiation therapy, this procedure delivers a highly focused proton beam to a tumor while greatly limiting any exposure to neighboring brain tissues. Penn’s Robert’s Proton Therapy Center is the largest and most advanced facility of its kind in the world.  
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The Focus on Cancer blog discusses a variety of cancer-related topics, including treatment advances, research efforts and clinical trials, nutrition, support groups, survivorship and patient stories.

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