Queen's University Belfast research suggests brain tumours could be treated with repurposed drugs

Brain tumour cases are projected to increase in Northern Ireland by 36% by 2035.

Some resistant brain tumours may be treated by drugs which have been approved for use against other conditions, according to a new study from Queen's University in Belfast.

Brain tumours are the biggest cancer killer of children and adults under the age of 40 with around 16,000 people diagnosed with a brain tumour each year in the UK.

There is a significantly higher proportion of patients in Northern Ireland and Wales compared to other UK countries, with cases expected to rise by 36% in Northern Ireland in the next 12 years.

Academics said that further testing of the FDA-drugs might show that some could benefit future generations of patients.

The research found how genes in brain tumours changed in their expression patterns as the cancer progressed and the patient relapsed after treatment.

Experts from the Patrick G Johnson Centre for Cancer Research and clinicians from Belfast Health and Social Care Trust compiled the report.

The most common and malignant adult brain tumours, which account for around 70% of all new diagnoses are Glioblastoma (GBM).

It has the worst outcome for patients as it is resistant to therapy, Despite treatments like surgery, radiotherapy and chemotherapy, GMB tumours regrow leading to patients relapse and death.

Developing new drugs to treat resistant cancers such as GBM can take many years and a vast amount of money.

Even then, only a tiny proportion of drugs are approved for safe use in humans.

An alternative approach is to repurpose drugs that have already been approved for treatment in another disease.

The advantage of drug repurposing is that the drug is already FDA-approved for use in humans and therefore is known to be clinically safe, with low toxicity and few side effects. The study focused on patients from Northern Ireland and was initiated by Dr Tom Flannery, a Neurosurgeon from the Royal Victoria Hospital Belfast at the Belfast Health and Social Care Trust.

Over several years, Dr Flannery collected biopsies of the patient's brain tumour at their first surgery and following relapse again at their second surgery to remove the tumour.

The samples were archived at the Northern Ireland Biobank and were processed for their genetics at the Genomics Core Technology Unit at Queen's. Using these samples, the team determined which genes changed in their cell activity and expression during brain tumour disease progression.

The team further tested these genes in a connectivity mapping analysis using software developed at Queen's University (QUADrATiC).

The researchers were able to predict the possibility that some FDA-approved drugs might be effective against GBM.

These drugs are ready for testing in pre-clinical trials to determine their potential to be repurposed for GBM and following this, many years of rigorous trials are still required. Commenting on the importance of these findings, Dr Flannery said: "The standard of care for glioblastoma is maximal safe resection followed by 'Stupp protocol' chemoradiotherapy.

"Unfortunately, current treatment options for inevitable tumour regrowth are limited and ineffective. This paper sheds new insights into potentially effective novel treatments for glioblastoma, not only in the recurrent setting (i.e., relapse) but also as an upfront treatment. Our findings provide the basis for future clinical trials and offer new hope to our patients suffering from this invariably fatal disease." Professor Kevin Prise, Professor of Radiation Biology and the lead scientist at Queen's University Belfast, further added: "There are limited options for the treatment of brain tumours and especially for those patients that experience a relapse.

"By taking a multidisciplinary approach and working collaboratively with our colleagues in the NHS, we were able to highlight potential biologies and target compounds that can be tested in future studies to develop new treatment strategies to help people with brain cancer."

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