World first trial of cannabis-based drug to treat aggressive brain cancer gets the go ahead at 15 NHS hospitals
Hundreds of cancer patients in the UK will be given a cannabis-based drug to treat their aggressive brain tumours as part of a world first trial, it was announced today.
The Brain Tumour Charity raised £400,000 to back the three-year study, which will supplement glioblastoma patients’ chemotherapy treatment with Sativex — an oral spray containing cannabinoids.
Experts at the University of Leeds will look at whether the addition of the drug extends life for people diagnosed with the cancer.
The trial will begin recruiting 230 patients at 15 hospitals across the UK early next year.
If the drug works, it could become the first addition to NHS treatment for glioblastoma in more than a decade.
Professor Susan Short, chief trial investigator and an expert in clinical oncology and neuro-oncology at Leeds University, said cannabinoids have ‘well-described effects’ in the brain and the trial will determine whether they help treat the most common and aggressive form of brain cancer.
Around 2,200 people are diagnosed with glioblastoma every year in England. Even after intensive treatment, almost all glioblastomas recur and the average survival is just 12 to 18 months after diagnosis.
The trial — dubbed ARISTOCRAT — will determine whether adding Sativex to chemotherapy extends the patients’ lives, slows the progression of their disease or improves their quality of life. Sativex is sprayed into the mouth and contains cannabinoids THC and CBD. Pictured: medicinal cannabis
WHICH HOSPITALS WILL OFFER THE TREATMENT?
A trial offering 230 glioblastoma patients cannabis-based drug Sativex to treat their tumour is set to launch early next year.
The trial will recruit patients at 15 hospitals across the UK early next year.
These 15 sites are:
- Leeds General Infirmary
- Guy’s and St Thomas’ in London
- Queen Elizabeth Hospital in Birmingham
- Addenbrooke’s Hospital in Cambridge
- Western General Hospital in Edinburgh
- The Beatson in Glasgow
- The Clatterbridge Cancer Centre in Liverpool
- The Christie in Manchester
- Queen’s Medical Centre in Nottingham
- John Radcliffe Hospital in Oxford
- Southampton General Hospital
- Southmead Hospital in Bristol
- Charing Cross Hospital in London
- Velindre Cancer Centre inCardiff
- The Royal Victoria Hospital in Belfast
The trial — dubbed ARISTOCRAT — will determine whether adding Sativex to chemotherapy extends the patients’ lives, slows the progression of their disease or improves their quality of life.
It will be the first major trial in the world to use the drug to treat glioblastoma.
Sativex, made by Cambridge-based GW Pharma, is sprayed into the mouth and contains cannabinoids THC and CBD.
Laboratory studies have suggested that these cannabinoids may reduce brain tumour cell growth and could disrupt the blood supply to tumours. But clinical evidence of their effect has so far been limited.
A phase one trial earlier this year found more patients were alive after one year compared to the group who received a placebo treatment.
But the study — which involved 27 patients — was too small to confirm the treatment increased survival rates.
The most common side-effects reported during the phase one study were fatigue, headache, vomiting and nausea, which most volunteers said were mild or moderate.
Hospitals including Leeds General Infirmary, Guy’s and St Thomas’ in London and Queen Elizabeth Hospital in Birmingham will recruit participants for the trial’s second phase.
Two-thirds of the patients will receive the current standard chemotherapy treatment, called temozolomide, plus Sativex, while one third will be given temozolomide with a placebo spray.
Participants will be asked to administer up to 12 sprays per day of Sativex or placebo oral sprays.
Participants will have a follow-up appointment every four weeks, blood tests and MRI scans every eight weeks and complete regular quality of life questionnaires.
If the study is successful, Sativex could be one of the first additions to NHS treatment for glioblastoma patients since temozolomide chemotherapy in 2007.
Sativex is currently licensed in the UK for people suffering from multiple sclerosis-related muscle spasticity, which hasn’t got better with other treatments.
But its availability on the NHS is limited. The National Institute for Health and Care Excellence (NICE) does not recommend that NHS doctors prescribe Sativex, because it is not cost effective.
WHAT IS GLIOBLASTOMA?
Glioblastomas are fast-growing brain tumours.
They are likely to spread to other parts of the brain and can come back, even if they are intensively treated.
Symptoms of glioblastomas can include personality changes, memory and communication difficulties, tiredness, depression and vision problems.
Once the tumour is spotted, surgery to remove it is performed if the patient is well enough.
Patients may then receive chemotherapy or radiotherapy.
Experts don’t know why glioblastomas start growing, but factors that increase the risk of developing the cancer include a family history of the tumour, being overweight and over-75.
Source: Brain Tumour Charity
Professor Short said: ‘The treatment of glioblastomas remains extremely challenging.
‘Even with surgery, radiotherapy and chemotherapy, nearly all of these brain tumours regrow within a year, and unfortunately there are very few options for patients once this occurs.
‘Cannabinoids have well-described effects in the brain and there has been a lot of interest in their use across different cancers for a long time now.
‘Glioblastoma brain tumours have been shown to have receptors to cannabinoids on their cell surface, and laboratory studies on glioblastoma cells have shown these drugs may slow tumour growth and work particularly well when used with temozolomide.
‘It’s really exciting that we’re now at the point where we can run a definitive, well-designed study that will tell us the answer to whether these agents could help treat the most aggressive form of brain tumour.
‘Having recently shown that a specific cannabinoid combination given by oral spray could be safely added to temozolomide chemotherapy, we’re really excited to build on these findings to assess whether this drug could help glioblastoma patients live longer in a major randomised trial.’
Dr David Jenkinson, interim chief executive at the Brain Tumour Charity, said: ‘We know there has been significant interest among patients and researchers alike for some time about the potential activity of cannabinoids in treating glioblastomas.
‘We’re really excited that this world-first trial here in the UK could help accelerate these answers and are so grateful to Leeds Hospitals Charity and so many others across the world who are helping us make this study possible.’
The funding campaign was backed by Olympian Tom Daley, whose father died in 2011 aged 40 from a brain tumour.
It was also bolstered by a £45,000 donation from Leeds Hospitals Charity.