An international team who carry out research into brain tumours from the UK, Germany, the USA and Norway have won the third BIAL Award in Biomedicine, which aims to recognise excellence in biomedical research. The judging panel considers work in biomedicine that has been published within the past ten years and is of outstanding quality and scientific merit.

The team were awarded the €300,000 prize for their study “Glutamatergic synaptic input to glioma cells drives brain tumour progression”, published in Nature in 2019. This has been described as a ‘groundbreaking’ piece of research that furthers the understanding of brain cancer.

The study focuses on glioblastomas, which are the most common type of primary cancerous brain tumour in adults. They are a grade 4 brain tumour, meaning that they are likely to grow rapidly, and they are complex and very difficult to treat. Most patients diagnosed with a glioblastoma have a prognosis of just 12 to 18 months.

This highly aggressive form of brain tumour is considered to be incurable. They can be treated with surgery and radiotherapy, but in most cases the tumour will begin to grow rapidly again. Common symptoms of a glioblastoma include persistent or severe headaches, seizures, weakness or numbness, confusion, and vision or hearing changes.

Currently, one of the most advanced treatments for brain tumours is Gamma Knife Surgery, which involves using specialist equipment to send highly targeted radiation beams at cancerous cells in the brain.

The work of the research team shed light on the progression of glioblastomas and other gliomas in the brain. They discovered that the malignant brain cells ‘hijack’ healthy cells to aid their progression, and this is how they become integrated into the functions of the brain.

This fresh understanding opens the door to potential new treatments for incurable brain tumours, and will potentially lead to further groundbreaking discoveries about brain tumours and other conditions such as epilepsy.

The president of the BIAL Jury Ralph Adolphs commented: “these findings are a major and surprising advance in the understanding of how brain cancer progresses, by describing a new communication channel between neurons and the tumour and by suggesting specific avenues for treatment”.

He added: “this edition’s winning paper represents one key study in cancer neuroscience, illustrating a fundamental and absolutely critical issue in cancer in general. Cancer cells cannot merely proliferate — they have to hijack healthy biological processes and integrate themselves into the normal function of tissues.”

“Nowhere is this more blatant — and surprising — than in the brain tumours studied in the present paper”.

The international research team included scientists from the University of Glasgow. The winning paper was chosen from a field of 70 nominees and was deemed to be the most important research paper published in the past ten years.

Elsewhere, the Association of the British Pharmaceutical Industry (ABPI) have responded to claims from charities and medics that pharmaceutical companies are hampering progress into the research and treatment of brain tumours by failing to provide the required drugs, and through unnecessary regulatory delays.

Hugh Adams from the charity Brain Tumour Research is reported in The Guardian as saying the delivery of new drugs was ‘stifled’ by the industry. He commented: “We need a new framework that treats this disease as a clinical priority.”

Furthermore, Paul Mulholland, a consultant in medical oncology, told a parliamentary enquiry last month:

“There has been no improvement in treatment for 30 years. The key problem … is that we are not doing enough clinical trials. The pharmaceutical industry has not provided the drugs to carry out these trials and has not been interested in the patient group. As such, we need regulatory change to encourage the pharmaceutical industry to invest in finding a cure.”

The enquiry was set up after it was revealed that just £15m of £40m allocated in 2018 for brain tumour research had been awarded, with £6m of this funding being not directly relevant to brain tumour research.

In response, Dr Amit Aggarwal, Executive Director of Medical Affairs at the ABPI said: “Pharmaceutical companies exist to find, develop, and deliver effective treatments for patients and they do already provide medicines for external clinical trials for new uses voluntarily, including for brain cancers.”

“The advantage of voluntary partnerships is that companies and external researchers can share valuable information on the science behind medicines, based on the knowledge that companies already have from previous experience. That information exchange helps create more scientifically sound clinical trials with a better chance of success.”

“Forcing companies to release their products for every request risks undermining public trust in medicines if for example, a medicine doesn’t work for a new use, or worse, something goes wrong in a clinical trial the originator company had no involvement with.”

“For any clinical trial to take place, there must also be a scientific assessment of the likelihood of a trial working, considering the probability of that study meeting the high ethical and evidential standards needed for regulatory approval.”

“Research to test cancer medicines for new uses is happening, and there are many examples of companies doing it themselves, and external researchers doing it with the support of companies.”

“ The ABPI continues to work with regulators to find ways to overcome the scientific and regulatory challenges involved in this type of research and allow more of it to take place.”

The Labour MP Siobhain McDonagh, whose sister Baroness McDonagh died of a glioblastoma last year, is calling for new rules to allow regulatory bodies to fast-track applications for the approval of treatments for rarer cancers, and to require pharmaceutical companies to provide suitable drugs for clinical trials into brain tumours.

If you would like some further information about brain stem tumours and glioblastoma, please contact Mr George Samandouras of Amethyst Radiotherapy.