What a cure looks like
Importantly, knowing more makes it possible to do less. Since doctors have been able to divide medulloblastomas into different groups, they’ve realised that children and young people with wingless (WNT) medulloblastoma are more likely to respond to treatment.
Because these patients already have a good chance of recovering from their cancer, doctors can focus more on minimising side effects. That’s especially important for the growing brain, our most sensitive and complicated organ, and one that’s connected to almost everything else in the body.
“It isn’t just about improving our ability to cure,” explains Peet. “It’s what does ‘cure’ look like.”
“You can’t operate on a developing brain without causing some damage. You can’t give radiotherapy to a developing brain without causing damage. And the same with chemotherapy: the drugs have to get into the brain in order to work, and they’re designed to be toxic.
“So, being able to reduce the intensity of treatment, if you know people with medulloblastoma can still survive, is really important.”
Equally, quickly identifying that a child or young person has a high-risk type of medulloblastoma gives doctors more time to find innovative treatments to meet their specific needs. Today, those treatments might only be available on clinical trials, but they could soon be part of standard care too.
A new way to treat high-risk medulloblastoma
“What I’m sure of is that in the future we will have more targeted drugs to use instead of chemotherapy,” says Peet. “Chemotherapy is a bit of a blunderbuss approach. It works on any cancer cells pretty well, but it’s really quite damaging and not as effective as we’d like it to be. These techniques will allow us to work out which bits of which cancer we need to be attacking and which ways to do it.”
In fact, the study has revealed a new target for treating high-risk medulloblastoma.
While looking closely at the how the four different types of medulloblastoma consumed and used energy, the team started to notice something interesting about a chemical called glutamate.
Some of Peet’s previous work had helped show that glutamate was important in tumour metabolism. Now, though, his team is beginning to understand just how important it might be.
“When tumours had a lot of glutamate, the children did less well,” Peet explains. “So, finding ways of blocking glutamate, or changing it, could be a very important avenue for treating these tumours in the future.”
The team’s new technique means glutamate levels are visible on MRI scans today. And there are already drugs with the potential to interfere with it. This research isn’t just helping doctors match children and young people to the same treatments faster; it’s revealing even better ones.
Tim
