A new UK-based trial is set to investigate the use of a cannabis-based drug for treatment of brain cancer.
The study, led by Leeds University, will explore the use of Sativex alongside chemotherapy to treat recurrent brain tumours.
Glioblastoma Brain Tumours
Recurrent glioblastoma is the most aggressive form of brain tumour. Around 2200 patients are diagnosed each year in the UK and average survival is just 10 months from first diagnosis.
This brain tumour cell growth is fast, and diffuse, with thread-like tendrils that extend into other parts of the brain.
There have been few developments in treatment for this disease in recent years, so hopes for this trial are high. If successful, this could be the first new treatment since temozolomide chemotherapy in 2007.
Sativex
Sativex (Nabiximols) is an mouth spray containing 1:1 THC (Delta-9-tetrahydrocannabinol) and CBD (cannabidiol). It is produced by GW Pharma and is licensed across Europe to treat the muscle spasms caused by multiple sclerosis.
It is one of two cannabis-based medications produced by GW Pharma. The other is Epidiolex, licensed for use in two types of rare childhood epilepsy.
There are claims that Sativex could be useful for a variety of conditions including pain control and Parkinson’s. However, its high price tag means that access to the drug is currently limited to a few very specific cases.
Sativex Trial Phase 1
Interest in using THC and CBD to treat tumours has been growing in recent years. Whilst there is no clinical evidence, there is persistent anecdotal evidence that high doses of THC can shrink tumours.
In 2019, a phase one trial took place involving 27 glioblastoma patients with aggressive brain tumours. The aim of the study was simply to assess the safety of giving Sativex and temozolomide together, not whether Sativex would increase life expectancy.
Results, however, were good and suggested that the patients who received both Sativex and chemotherapy did better than those who just received chemo. In fact, some patients lived up to a year longer than those who had received the placebo.
Real hope for glioblastoma sufferers
Professor Susan Short is the Professor of Clinical Oncology and Neuro-Oncology at Leeds University and the principal investigator on the new trial.
She thinks there is real hope: “The treatment of glioblastomas remains extremely challenging. Even with surgery, radiotherapy and chemotherapy, nearly all of these brain tumours re-grow within a year, and unfortunately there are very few options for patients once this occurs.
“We think that Sativex may kill glioblastoma tumour cells and that it may be particularly effective when given with temozolomide chemotherapy. “It may enhance the effects of chemotherapy treatment in stopping these tumours growing, allowing patients to live longer. “That is what we want to test in the study.”
A world first
This three-year phase II trial – named ARISTOCRAT – will be the first of its type in the world, funded by the Brain Tumour Charity and coordinated by Cancer Research UK Clinical Trials Unit at the University of Birmingham.
15 NHS (UK National Health Service) hospitals will be carrying out the treatment. The team hope to start recruiting more than 230 patients across the UK in early 2022, subject to sufficient funds being raised.
The study will measure whether using Sativex alongside chemotherapy could extend patients’ lives, slow down progression of the disease or improve quality of life.
Photo: The Rambling Man and Kim Ratcliffe
Brain Tumour Charity campaign
The trial is to be funded by the Brain Tumour Charity, who have launched a major appeal in order to raise £450,000 needed to fund the three-year scheme.
It has been backed by Olympic gold medallist Tom Daley, whose father died from a brain tumour in 2011, at just 40 years old.
Now a father himself, Tom is a keen supporter of the charity and has produced a video to promote the fundraiser. In the video, Daley says: “We are reaching out to all you individual heroes and supporters, to help fund this groundbreaking trial”
“When you donate, you’ll receive a link for your social media badge of honour. Join our community, spread the word and help us pave the way to beating brain tumours.”
Hope for the future
Dr David Jenkinson, Interim CEO at The Brain Tumour Charity, which is funding the trial, said: “We hope this trial could pave the way for a long-awaited new lifeline that could help offer glioblastoma patients precious extra months to live and make memories with their loved ones.
“We know there is significant interest among our community about the potential activity of cannabinoids in treating glioblastomas, and we’re really excited that this world-first trial here in the UK could help accelerate these answers.
The recent early-stage findings were really promising and we now look forward to understanding whether adding Sativex to chemotherapy could help offer life-extension and improved quality of life, which would be a major step forward in our ability to treat this devastating disease.
“But we also know that for many, this trial won’t come soon enough. In the meantime, while other cannabis-based products may help alleviate symptoms, there is insufficient evidence to recommend their use to help treat brain tumours.
For anyone considering using cannabis-based products or other complementary therapies, it’s vital that you discuss these with your medical team first, as they could interact with other treatments such as anti-epileptic medicines or steroids”
Anyone affected by a glioblastoma, can get help and support from the Brain Tumour Charity on 0808 800 0004. You can also email: support@thebraintumourcharity.org.
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