Paul Dewar enrols in trial to treat deadly glioblastoma
Quebec neurologist leads study on use of immunotherapy drug
It is too soon for even preliminary results, but a Gatineau drug trial is offering a rare bit of hope for patients with glioblastoma, the deadly brain cancer that struck both late musician Gord Downie and former MP Paul Dewar.
Dewar, who was diagnosed in February, said he enrolled in the trial that involves an experimental immunotherapy drug after a network of friends and family began looking around the world for any drug trials he could participate in. He was surprised to learn there was one in his own backyard.
“Lo and behold, there was a trial across the river,” he said.
For Dewar, participation in the drug trial is an opportunity to make a difference for future patients.
“It doesn’t offer a cure. What it does offer me is trying something out that might be of benefit for the future.”
Neurologist Dr. François Jacques, of Clinique Neuro- Outaouais, who is running the trial, said it is the only one of its kind and has drawn patients from across the country and farther afield.
Patients undergo the standard treatments for glioblastoma, which includes surgery to remove as much of the tumour as possible and rounds of chemo and radiation therapy.
In addition, participants are intravenously administered treatments of the immunotherapy drug Avelumab every two weeks.
In most drug trials, the experimental therapy is not given until standard treatments have failed. In this case, the drug is being offered at the same time.
“We are trying to intervene as soon as possible in the course of the treatment so people have more time to benefit from immunotherapy,” Jacques said. “It takes time to kick in.”
Glioblastoma, the most common primary brain tumour, is a notoriously deadly cancer. That is, in part, because of the way it grows. It is virtually impossible to remove all parts of the tumour surgically. As a result, the standard survival time after diagnosis is about 15 months, although that varies among patients.
To date, there is no treatment that can give patients more time.
Jacques is hopeful immunotherapy might one day change that.
Immunotherapy treatments have been used successfully against other cancers.
Notably, former U.S. president Jimmy Carter, who had advanced melanoma, is now cancer-free, thanks, in part, to immunotherapy treatment he received.
Jacques said he is hopeful glioblastoma is a good candidate to respond to immunotherapy treatment because of the way it suppresses immune systems, which might otherwise detect and destroy cancer cells.
Avelumab, the drug being used in the trial, is a monoclonal antibody. In immunotherapy, monoclonal antibodies can be used to attach to specific proteins on cancer cells, which flags them so the immune system can find and destroy them.
Jacques said he is hoping to do an interim analysis of the drug trial early next year. Currently, 16 people are enrolled and he is aiming for 30.
It has recently been extended from an initial year-long trial to three years.
Jacques, who is working with researchers in Ottawa, said he has already seen encouraging signs, including that the drug is being well tolerated by patients.
Although it will be some time before final results can determine whether there are any benefits, Jacques noted that any improvement in survival rates would have a big impact on patients.
“I think there is significant hope. That is why we are doing it. Glioblastoma is a big user of immunosuppression. If we can counteract that, we should be able to have a big impact.”
For Dewar, who watched a family friend struggle with glioblastoma at the same time Tragically Hip singer Gord Downie was public about his disease, the trial offers some hope for long-awaited advances in treatment.
“This is a really stubborn disease. When you look at (progress in treating) breast and ovarian cancer, they really haven’t made any headway with this cancer, so this gives me some raison d’être in my daily life.”
We are trying to intervene as soon as possible in the course of the treatment so people have more time to benefit from immunotherapy. It takes time.