Henry Friedman Discusses the Quagmire of Glioblastoma
Special Topic of Glioblastoma Interview, Janaury 2012
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How small is that minority?
Maybe 10% of patients appear to be beating the disease. That would be my guess. I may be optimistic. The bottom line, though, is that we do have an ever-increasing cohort of patients, a small minority, who appear to be winning and we can learn from those patients.
What do you consider the most promising lines
of research at the moment?
There are three or four promising areas of research. One is vaccines. They offer the potential of exploitable weapons for beating this disease. A second category is monoclonal antibodies targeting these tumors and carrying whatever warheads you want them to carry.
A third is the so-called personalized approach, doing genomic analysis of the tumor and trying to discover a potential Achilles heel in the tumor's genetic makeup. You discover what genes are up- or down-regulated or amplified, and then try to do something meaningful for the patients by targeting those specific pathways. That may be problem here, though, because so many pathways are aberrant. It may not be a very doable proposition.
That's three. Are there any more?
That's a lot. I think that's pretty good.
If you had unlimited funds for
research—if you lived in an ideal research environment—what
experiment or project would you do that you can't afford to do
now?
Probably genomic analysis of the individual tumors. We would sequence entire tumor genomes to see if there are things we can exploit. I have wealthy patients for whom that's being done now, patients for whom resources are not an issue.
Has it helped them?
I'm not sure it's helped anyone yet.
What message would you convey to the general
public about this work?
That there will come a day when this kind of genomic analysis is done for every tumor and it will lead to more personalized and effective therapies.
Henry S. Friedman, M.D.
Preston Robert Tisch Brain Tumor Center
Duke University Medical Center
Durham, NC, USA
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HENRY S. FRIEDMAN'S MOST CURRENT MOST-CITED PAPER IN ESSENTIAL SCIENCE INDICATORS:
Vredenburgh JJ, et al., “Bevacizumab plus irinotecan in recurrent glioblastoma multiforme,” J. Clin. Oncol. 25(30): 4722-9, 20 October 2007. 331 cites. Source: Essential Science Indicators from Clarivate.
KEYWORDS: GLIOBLASTOMA, GBM, GRADE FOUR GLIOMA, PEDIATRIC TUMORS, ADULT TUMORS, BEVACIZUMAB/AVASTIN, IRINOTECAN, RECURRENT GLIOBLASTOMA, CLINICAL TRIAL, IDH1, IDH2, MUTATIONS, POTENTIAL TARGETS, TEMOZOLOMIDE, SURGERY, RADIOTHERAPY, NOVOCURE, ELECTRIC CURRENT, PATHWAYS, VACCINES, MONOCLONAL ANTIBODIES, INDIVIDUAL GENOMIC ANALYSIS.
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