Only 3 percent of patients with this type of cancer live longer than five years, but new therapies that destroy cancer cells and prolong patients’ lives offer hope
“Terminator” is the name used among doctors for one of the deadliest forms of cancer – glioblastoma multiforme brain tumor (GBM). It is a rare disease, with around 28,000 cases diagnosed each year in the EU and the USA, for which it is known that despite treatment, sufferers cannot survive more than 12 months. Less than 30 percent of adults diagnosed with GBM survive a year after diagnosis, and only 3 percent of patients live longer than five years. Hence the name “terminator”, but the good news is that scientists have discovered how the breakdown of sugar can destroy cancer cells, and their discovery was published in the journal Cancers.
Accurate tumor resection can significantly prolong the life of patients
The current standard treatment for glioblastoma multiforme consists of surgery followed by radio and chemotherapy. GBM surgery is aided by the use of fluorescent photosensitizers, drugs conventionally used for photodynamic therapy. One such is Protoporphyrin IX (PpIX) which can precisely guide GBM resection because its prodrug 5-ALA accumulates very specifically in cancer lesions. This is now standard practice in GBM resection, approved by both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA), as accurate tumor resection can significantly increase patient survival.
Scientists from Institute of Cancer Research on the Oslo University Hospital, together with colleagues from NCSR Democritus from Athens found that, in addition to being photosensitizing, the drug 5-ALA is also a potent inhibitor of the glycolytic enzyme lactate dehydrogenase (LDH). This is a very important finding because most tumor cells derive their energy from glycolysis (the process that breaks down glucose into pyruvic acid), unlike healthy cells that get their energy mainly through respiration. Disruption of glycolysis in cancer cells can cause them to die because they are unable to meet their energy needs from other sources. This has proven to be a well-established approach in cancer therapyand LDH has been identified as a valuable target in many anticancer strategies.
“Terminator” is an incurable and deadly cancer, but new treatment methods have shown surprising results
The advantage of the 5-ALA drug as an inhibitor of LDH, and thus of glycolysis, i.e. the breakdown of glucose, is that it specifically accumulates in glioblastoma multiforme, even tens of times more than in normal cells. Hence, there is a disturbance in the breakdown of “sugar” in tumor cells, which can lead to their decay. The discovery of this process thus opens new avenues for the treatment of the brain tumor glioblastoma multiforme and potentially for other types of cancer.
The leader of the research team, Dr. Theodossis Theodossiou, does not hide the fact that the members of the scientific team are delighted to have discovered this alternative property of the 5-ALA drug.
– The fact that 5-ALA is approved for the detection of malignant gliomas and GBM makes our findings more valuable and easier for clinical application. For detection purposes, the drug 5-ALA is administered to patients for only a few hours, which is not enough to kill cancer cells by disrupting glycolysis. However, prolonged application, lasting one or several days, can lead to surprising results in a disease that is currently incurable and fatal – stressed Dr. Theodossiou.