Vaccines, Genetically Engineered Viruses and Other Emerging Therapies for Glioblastoma (Podcast)

Glioblastoma is one of the most aggressive malignant brain tumors. It grows fast, spreads like a spiderweb and is difficult to treat due to its heterogeneous nature.

Manmeet Ahluwalia, MD, Associate Director of Cleveland Clinic’s Brain Tumor and Neuro-Oncology Center, has spent more than a decade working on clinical trials for patients with glioblastoma and other brain tumors.

In the newest episode of Cleveland Clinic’s peer-to-peer Neuro Pathways podcast, Dr. Ahluwalia discusses recent research in glioblastoma. He also presents emerging treatments, such as targeted therapies and immunotherapies, that may help patients live longer and with a better quality of life. The podcast touches on:

• Signs and symptoms of glioblastoma
• The current standard of care
• How targeted therapies are developed
• How immunotherapies, including vaccine-based approaches and genetically engineered viruses, work
• Bench research findings that are spurring new clinical trials
• What Dr. Ahluwalia would recommend to a family member newly diagnosed with glioblastoma

Click the player below to listen to the podcast now, or read on for a short edited excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

Excerpt from the podcast

Dr. Ahluwalia: In cancer, we have used chemotherapies for decades and gotten a fair amount of mileage out of those toxic treatments. But we also have realized that those drugs tend to be pretty tough on patients and there’s only so much chemotherapy patients can take. So in the last decade or two, our efforts have been more focused on genomically based and immunotherapy-based approaches.

Here at Cleveland Clinic, we have multiple clinical trials that are focusing on both. Genomically based approaches are where we profile patients’ tumors and use a particular drug depending on what genetic pathway alteration is driving the particular tumor. We also have trials that are using immunotherapy drugs like pembrolizumab and nivolumab, the most cutting-edge immunotherapy drugs targeting the anti-PD-1 pathway.

We also have had a fair amount of success with vaccine-based efforts. We have a vaccine, SurVaxM, which targets survivin, a cell-survival protein present in most glioblastomas. We’ve seen some very interesting and encouraging results that have led the FDA to grant this vaccine orphan drug status.

We have an upcoming trial where we’re combining an immunotherapy with the vaccine. With one immunotherapy-based approach we can get, say, X amount of success, and we’re getting Y amount of success with a different approach. Can we now combine X and Y and get even more synergy between the two approaches?

And then we’ve been working with a genetically engineered virus, Toca 511. We have a large 900-patient trial that will be starting towards the end of this year, led by some of the investigators here at Cleveland Clinic who are working with multiple investigators at some of the key centers in the United States.

Overall we are very excited about these promising new options, which are definitely helping our patients have more opportunities than standard of care affords them. More importantly, in some of these therapies, like the vaccine, we have seen minimal toxicity. Patients can get the vaccine for years compared to a chemotherapy, which you tend to stop maybe six months or a year later because of all the myelosuppression that occurs.