There is new hope for brain cancer patients with an Australian clinical trial based on Professor Richard Scolyer’s experimental treatment opening for newly diagnosed patients.
Just weeks after the former Australian of the Year’s death, which came three years after he was diagnosed with a highly aggressive glioblastoma, the Peter MacCallum Cancer Centre in Melbourne has confirmed the trial has started in this country.
When it opened in the United States earlier this year, Scolyer said he was “incredibly excited” to see whether it could revolutionise the approach to treating glioblastoma.
“It takes a long time to get trials over the line but to be actually recruiting patients in the United States – and hopefully here soon – means we can test out the drugs to see if they make a difference,” he said.
While he did not live long enough to see the opening of the Australian trial, there are hopes that the country’s pioneering approach to brain cancer will have benefits to patients around the world.
Federal government data shows that more than 2000 Australians are diagnosed with brain cancer every year, accounting for just over 1 per cent of all cancer diagnoses.
The five-year survival rate is just 24 per cent.
The so-called GIANT trial will be for eligible patients with a new diagnosis of glioblastoma, based on an MRI scan, who are suitable for multiple surgical procedures as well as immunotherapy.
About 90 patients are expected to be recruited to the trial from around the world, with about half of them to be Australians from Peter Mac and Austin Health in Melbourne, and the Royal North Shore Hospital and Chris O’Brien Lifehouse in Sydney.
Associate Professor Jim Whittle, an oncologist at Peter Mac and co-director of research strategy for the Brain Cancer Centre, said the study aimed to determine if the treatment was safe before it was expanded further.
“This trial will explore the potential of a novel immunotherapy approach to improve outcomes for people with glioblastoma, a brain cancer for which there is a great need for new treatment options,” he said. “We are pleased to now open this trial to Australian patients.”
Because of the specific eligibility requirements, not all patients with a new diagnosis of glioblastoma would be eligible to participate.
Scolyer was diagnosed with an especially savage form of brain cancer – IDH wild-type glioblastoma – after a seizure on an overseas trip in mid-2023.
Recognising that it was incurable, colleague and medical oncologist Professor Georgina Long proposed trying what she had learnt successfully treating advanced melanoma patients with immunotherapy.
It was a risky plan that recognised that conventional treatment for brain cancer had barely changed in almost two decades.
The treatment for the world-renowned pathologist and skin cancer researcher included receiving three immunotherapy drugs both before and after surgery to remove the bulk of the tumour, as well as radiotherapy and a personalised cancer vaccine.
Scolyer and Long, who were co-medical directors of Melanoma Institute Australia, were jointly named 2024 Australian of the Year.
While he was devastated when an operation revealed the tumour had returned in March last year, Scolyer survived more than twice as long as the median survival of 12 to 14 months.
His death at the age of 59 was widely felt around the country, reflecting the humble and open way he had spoken about having cancer and the courage he had demonstrated in trying an experimental treatment that could have killed him quickly, in the hope of helping future brain cancer patients.
Duke Cancer Institute in the US is the global lead for the GIANT trial.
Australian medical oncologist Professor Mustafa Khasraw, an institute member from Duke University in North Carolina, said in February that he expected to know in about two years whether the treatment would be transformative.
He described the GIANT trial (for Glioblastoma Immunotherapy Advancement with Nivolumab and Relatlimab) as “team science” that was drawing together clinicians and scientists from many institutions around the world “to bring innovation and hope to patients”.
Khasraw thought the trial was “absolutely a step in the right direction” for glioblastoma treatment.
“It’s a stepping stone to generate convincing data that this therapy or a similar therapy is likely to improve patient outcomes at the population level,” he said. “We don’t want one patient to do better. We want all patients to do better.”
A peer-reviewed paper on the treatment developed by Long, published in the international journal Nature Medicine last year, laid the groundwork for the trial.
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