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Duration of the tests: Vicki Searle and his son Henry, who was diagnosed with an inoperable brain tumor at the age of 19
We tend to combine innovative treatments with new drugs – often unaffordable.
But it seems that a remarkable improvement in the survival time of patients with brain cancer has been achieved by combining four old drugs (a statin, a diabetes pill, an antibiotic tablet and a dewormer ) that cost only £ 400 a year.
The results of an ongoing trial conducted by the Private Care Oncology Clinic in London suggest that the administration of this new combination of drugs has doubled the average survival time.
The survival rates of brain tumors have remained unchanged for at least 20 years, when the brain cancer drug, temozolomide, entered the market. About 15% of adult patients survive more than five years after diagnosis. For glioblastoma, the most aggressive type of brain cancer, this figure is between 6 and 10%.
The new study looked at nearly 100 patients with glioblastoma – the type of fast-growing brain cancer affecting politician Tessa Jowell – treated at the clinic for three years with combination therapy, as well as radiotherapy and chemotherapy.
The average survival time of glioblastoma is estimated between 8 and 14 months – the average survival time of patients receiving the new combination therapy was 27.1 months.
Earlier this year, Tessa Jowell spoke poignantly to the House of Lords to highlight the lack of funding for brain cancer research. She said that survival rates reflected the fact that less than 2% of cancer research funds in the UK were devoted to this area.
Developing a new anti-cancer drug may take ten years, and the cost of treating a patient may be prohibitive – one of the newer anti-cancer drugs, pembrolizumab, used for advanced melanoma and lung cancer, costs nearly 100 £ 000 a year. The cocktail of drugs used at the Care Cancer Clinic is available now and only costs a few hundred pounds.
Henry Searle, who was diagnosed with glioblastoma a little over three years ago at the age of 19, was among those who treated him.
It was discovered too late for surgery. Even with chemotherapy and radiotherapy, he was only supposed to live 14 months.
Alarmed by these difficulties, the parents of Henry – Vicki, who works in the tourism industry and Jonathan, a chiropodist – were determined to give him every opportunity and despite the objections of his oncologist, they l & # 39; 39, initiated the cocktail of drugs that had just been available. at the clinic.
Defiant: his oncology team told him that even with the "standard" treatment (chemotherapy and radiotherapy), he should live only 14 months.
Two years after Henry's diagnosis, his NHS consultant wrote to the family to tell him that even though she had to keep an eye on him, there was "no evidence of active illness" and that Henry had not need additional cancer treatment through the NHS. (His family continues to seek alternative treatment for him outside the NHS to prevent the return of cancer).
Henry is still on the drug cocktail (the last time he had a chemo was in 2015) and today his tests show that the tumor is no longer growing. And the cost of this life-changing treatment? £ 200 to £ 400 a year, plus £ 1,000 for four consultations.
It is four ancient drugs, so inexpensive, used for a long time to treat other diseases and considered safe. Two of the world's best-selling drugs: atorvastatin, a type of statin, and metformin, a diabetes medicine.
The other two are an antibiotic, doxycycline, used for dental infections and acne, and mebendazole, a de-worming pill. So, how could this seemingly random combination of drugs reduce tumors?
What connects them is that in many ways they interfere with a tumor's ability to absorb or use the resources it needs to grow. The way the body controls energy is called metabolism. The metabolism of cancer cells is different from that which feeds healthy cells.
Cancer cells need a lot more glucose, the form of sugar that our body uses to produce energy. So, making it less available, what metformin does in particular, means that the drug combination effectively starves the cancer cells.
Weakened by energy decline, they become more vulnerable to the attacks of chemotherapy and radiation therapy commonly used to treat cancer.
Miracle: Two years after Henry's diagnosis, his NHS consultant wrote to the family saying there was "no evidence of active disease" and that Henry did not need additional treatment for the cancer.
The idea of this approach to cancer is known as metabolic theory – that is, it deals with the use of energy in the body. Because the cocktail of drugs targets how cancer cells get their growth factors and their raw material to produce energy, it has the potential to be effective against various types of cancer.
The drug cocktail was developed by Dr. Robin Bannister, co-founder of the Care Oncology Clinic, researcher, from a list compiled by the clinic's researchers, browsing through thousands of studies of licensed drugs at home. anticancer properties demonstrated.
The normal way to test a new treatment is what is called a randomized controlled trial, where it is compared to another treatment, often a placebo. With the drug patents on the new cocktail being exhausted, drug manufacturers are no longer being encouraged to do these (expensive) trials.
Instead, the results were based on what is known as a "service assessment", in which data is collected from patients in a real context approved by the Medicines and Health Products Regulatory Agency. , the UK Medicines Monitoring Group.
The clinic plans to use this data to provide NICE with the data needed to make the treatment available on the NHS. "Giving these drugs safely to patients as part of a real-life study allows us to gather valuable information about their impact on cancer," says Robin Bannister.
Dr. Padman Vamadevan, one of the doctors at the clinic who previously worked for the NHS, said the results "slowly change the attitudes of the consultants whose patients go to the clinic."
"When we started, few oncologists were used to treating the metabolic characteristics of cancer, so they were skeptical," he says. "But now patients report that their doctors are really interested in this research because they see the apparent benefits."
Combination: Since the cocktail of drugs targets how cancer cells get their growth factors and their raw material into energy, it can potentially be effective in many types of cancer.
Dr. Lucinda Melcher, a clinical oncologist at North Middlesex University Hospital in Edmonton, admits she was not convinced at first.
Her husband, Adam Blain, a 48-year-old lawyer, has glioblastoma and, having had everything the NHS had to offer, began treatment at the clinic more than three years ago.
"I was skeptical at first because their treatment was not supported by any evidence, but the team was obviously professional and committed and the treatment is scientifically plausible," says Dr. Melcher.
Adam, a father of three who still takes the drug cocktail, has had to stop working but has a good quality of life, although his short-term memory is poor, his wife says.
But while Dr. Melcher is delighted that her husband has broken all the obstacles, she is not convinced that this is due to the combination of drugs.
"It could still be a chance," she says. "It is possible that Adam is one of the 10% of these patients who survived standard treatment for five years, especially since his tumor was completely removed, which increases your chances."
Robin Bannister points out that: "Every oncologist has his own list of" miracles "; people who have lived much longer and better than expected.
"That's why we need to conduct studies with enough patients to make sure the element of luck can be taken into account.
"The hundred or so people treated in this trial make it one of the largest studies ever done on glioblastoma." (Compare to one of the trials on temozolomide, which involved more than 500 patients).
The study is continuing. The next step is to compare the results of nearly 100 glioblastoma patients treated in the clinic with a closely related group of NHS patients who received only standard radiotherapy and chemotherapy treatment.
The results will make the test results more reliable and should be published in a journal later this year.
For more information, visit: careoncologyclinic.com
EXPERTS WHO THINK A DIET IN FAT CAN FIGHT BRAIN TUMORS
Raffi Kalamian Walsh was only four years old when a routine eye check revealed a disturbing change and he was diagnosed with brain cancer.
Over the next 14 months, Raffi received weekly chemotherapy followed by 12 weeks of a chemotherapeutic drug followed by two operations to remove part of the tumor. Two months later, an analysis showed that he was back and that he was spreading.
"I can not begin to describe how devastating it is to see our young child part way through," says Miriam, Raffi's mother, who, along with her husband, Peter, had adopted Raffi at the age of 18. two years.
Tragic: Raffi Kalamian Walsh was only four years old when a routine eye check detects a disturbing change and diagnosed him with brain cancer.
Three years after his diagnosis, Raffi began treatment with five anti-cancer drugs. "A few weeks later, my normally cheerful guy was nauseated, tired and unable to concentrate," recalls Miriam.
"When he opened his mouth to speak, all that came out was gibberish." While seeking information on Raffi's medicines, Miriam came across a radically different approach to cancer, based on the idea that a diet very rich in fats and carbohydrates could slow down tumor growth. Professor Thomas Seyfried, a biochemistry researcher at Boston University, was in the study.
Miriam explains, "Professor Seyfried has shown that it is possible to slow the growth of brain tumors in mice.
"I knew it had not been tested on patients yet, but Raffi desperately needed something different." His son's doctors were surprised.
The five anticancer drugs were stopped and within three months the Raffi tumor had decreased by almost 15%. He became a talkative and energetic little boy.
The ketogenic diet is to avoid sugary foods: sweets, cookies, puddings, cereals, pasta and bread, even whole grain types, as well as starchy vegetables such as potatoes or cooked carrots, as well as all legumes, beans and legumes.
Instead, the diet is built around fat such as butter, cream, coconut oil, avocado oil and omega 3 oil, small portions of protein like meat, fish or eggs, as well as salad and non-starchy vegetables and green beans).
Intensity: Over the next 14 months, Raffi received weekly chemotherapy followed by 12 weeks of different chemotherapy, followed by operations to remove some of the tumor.
Fruits are limited to berries because they are low in sugar. The goal is to starve cancerous glucose cells, their favorite fuel. In the absence of carbohydrates, the body instead burns fat and your liver starts to pump substances called ketones that can replace glucose as a fuel for the brain and muscles.
Most importantly, tumors can not use ketones as fuel.
Miriam admits that Raffi had trouble organizing social events: "Because there were cakes and sweets everywhere," she says. "But it was a walk in the park compared to what he had endured in terms of grueling treatments." During his first nine months of regimen, Raffi also received a low dose of chemotherapy before relying on the diet.
The chances against Raffi were daunting – at his diagnosis, the doctors said he had a one in three chance of reacting to treatment.
"The first three years of diet have been phenomenal," says Miriam. "He seemed again almost completely well."
Miriam was so impressed by the immediate and beneficial effect of the diet that she enrolled in a master's degree in nutrition. His book – Keto for Cancer – just published in the UK – tells the story of Raffi's remarkable success and is also a textbook for anyone wishing to follow the diet.
Raffi stayed on the diet for six years. "Most of the time, he lived normally," says Miriam. "In contrast, children with brain tumors following the standard protocol often undergo treatment after treatment." Dr. Nelofer Syed, senior scientist and lecturer in cancer biology at Imperial College London, acknowledges that the ketogenic diet has great potential.
"Early research shows that it can improve the effectiveness of chemotherapy and radiation therapy and that cancers have difficulty using ketones as a source of energy," she says.
Loss: He died nine years after being diagnosed, at the age of 13 in April 2013.
She is co-author of a review article on diet research, published last year in the journal Frontiers In Molecular Neuroscience.
He reported laboratory studies showing that diet could, among other things, reduce the ability of tumors to connect to a blood supply and make it more difficult to spread cancer. However, until now, no major studies have compared diet to other treatments, and Cancer Research UK does not recommend it as an alternative to the standard balanced and balanced diet.
"We all would like to have better evidence," says Dr. Syed, "but I think it's worth trying, provided that patients do so under the supervision of a trained dietician.
The ketogenic diet is already approved by NICE for children with epilepsy; a large randomized trial on infantile epilepsy showed that it could reduce or even stop seizures.
In the end, however, the scheme could not save Raffi. He died nine years after being diagnosed at the age of 13 in April 2013.
Not all patients will benefit as dramatically as Raffi, and his success does not "prove" that the diet works. "Its value is to complement what you already do with your oncology team," says Miriam. She adds, "The food has propelled the can for six years.
"During a period when most people with cancer attended clinics or hospitals, Raffi was on his tricycle."
Keto For Cancer by Miriam Kalamian (Chelsea Green, (£ 18.99).