Meet the team testing well-known medications for brain cancer treatment trial

Clinical Study Co-ordinator, Frances FitzJohn, and Clinical Study Doctor, Dr David Young.

In the Hutt Hospital outpatients clinic, Dr David Young and Frances FitzJohn are the face of the GMRI team treating patients with devastating brain cancer, glioblastoma. They are trialling the novel cancer treatment developed by the GMRI, consisting of a blend of commonly used medications. The 3-year clinical trial started earlier this year. If successful, this approach could transform the way cancer is treated, potentially prolonging life and improving life quality.

When Executive Director Dr Swee Tan was recruiting a doctor to run the clinical trial, he asked local GP Dr David Young. That is because the medications used in the trial are commonly prescribed by GPs. If the trial is successful, patients with this cancer could potentially be treated by GPs in the community rather than in hospital.

‘If I can manage the treatment, other GPs will be able to too,’ David says.

David is excited to be involved in the trial that could revolutionise treatment for glioblastoma. If proven successful, it could reduce or remove the need for invasive, expensive hospital treatment, providing low-cost treatment at home.

Call for patients goes nation-wide

The 3-year trial began in March. At the time of writing one patient is being treated, and seven others are being assessed. In total, the investigating team plans to recruit 25 patients for the trial.

Trial co-ordinator Frances FitzJohn, who works alongside David, has received inquiries from many patients who wish to be involved. When Stuff interviewed Dr Tan about the trial in June 2018, patients got in touch from around New Zealand and overseas. David and Frances are in contact with them and their GPs and cancer specialists.

Read the June 2018 article on Stuff about the glioblastoma treatment trial

‘We anticipate recruiting patients mainly from the mid-central and central North Island and upper South Island, because of the convenience of travelling to Hutt Hospital,’ David says. ‘If patients who live further afield are willing to travel — and it’s a lot for the first 3 months — we’ll assess them.’

Common medications trialled for treating cancer

In the trial, patients with glioblastoma are given a combination of medications, most of which GPs prescribe daily for common conditions. They are medications usually used for high blood pressure, inflammation, pain, and diabetes. Numerous studies have shown that, coincidentally, these drugs improve the outcome of cancer patients.

The GMRI research team has demonstrated the presence of cancer stem cells — the proposed origin of cancer — in 14 types of cancer. The team has found that these cells have a common regulatory system, the renin-angiotensin system that is blocked by medications used in the trial. This trial is the first to study the effects on cancer by targeting cancer stem cells using this approach.

Trial begins when other treatments end

To be eligible for the trial, a glioblastoma patient must have exhausted conventional treatment options — chemotherapy, radiotherapy, and surgery. Or further treatment is considered unlikely to be beneficial. Sadly, glioblastoma progresses swiftly. Half of the patients die within 14 months of diagnosis. And of those whose cancer recurs after conventional treatment, half die within 6 months.

David says that when people ask to be included in the study, the team is careful not to offer false hope. ‘We tell patients and their family that while our approach is sound based on our lab work and published data, the benefit of our novel cancer treatment is as yet unproven — hence this trial.’

For the first 12 weeks, patients visit David and Frances every two weeks to have their condition monitored, blood tests taken, and the dose of the medications increased. By week 12, patients are on the full medication regime, and return for check-ups every 3 months.

‘If used properly, the drugs have few side effects,’ David says. ‘We keep a very close eye on their health to make sure there are no side effects from the medications. That’s why we monitor the patients closely.”

Frances enters data from each visit into the GMRI’s custom-built database for the trial. As the trial co-ordinator she maintains contact with everyone involved, manages the clinic appointments, and keeps everything running smoothly.

Patients could have a better quality of life

At regular intervals, David and Frances also assess the patient’s quality of life. That’s crucial, David says. ‘The treatment may prolong life. But more importantly, it may maintain or improve the quality of life.’

Sponsors are funding patient scans

Each patient needs four state-of-the art brain scans – FET PET scans before and during the course of the trial. Pacific Radiology Limited, who will perform the scans, will cover the cost. Cyclotek Pharmaceuticals Limited are providing the radioisotope for the scans free of charge.

Read more about the glioblastoma treatment study