Drug combination trial for low grade tumours

Fast facts

• Official title: Phase I-II study of Vinblastine in combination with Nilotinib in children, adolescents and young adults with refractory or recurrent low grade glioma. An ITCC and SIOPE-Brain tumour protocol (VINILO)
  
• Lead researcher: Dr Susan Picton
• Where: University of Birmingham and Leeds General Infirmary
• When: November 2014 – October 2020
• Cost: £55,050
• Research type: Paediatric, Glioma (Low Grade), Clinical Trial

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Dr Susan Picton from the University of Birmingham is leading the UK arm of an exciting international drug trial. The trial is investigating a combination treatment for low grade glioma (LGG) in children and young adults.

What is it?

This research is part of a clinical trial programme exploring the use of VINILO, a combination therapy for the treatment of LGG. The two drugs in VINILO are:

• Vinblastine: a chemotherapy drug used for many different cancer types, including LGG.

• Nilotinib: a targeted drug therapy. It acts on several protein targets, including platelet-derived growth factor (PDGF) receptors, which are expressed on the blood vessels in paediatric LGGs.

Since the two drugs work through different pathways, it is hoped that combining them will increase the anti-tumour effects. The side-effects of VINILO will also be tested to make sure it’s suitable for children.

Phase I of the trial aims to find the right dose of each drug. Phase II will test whether the drug combination can stop tumour growth (also known as tumour progression). Researchers will also look for biomarkers that might help predict future response to treatment.

The trial is being conducted in children and young adults aged 6 months to 21 years old. All participants will have been diagnosed with LGG that has continued to grow despite treatment with chemotherapy.

Why is it important?

LGG is the most common type of brain tumour in children, and new ways to treat it must be found.

Chemotherapy is usually the first treatment for LGG and, while it can control the tumour for some time, tumours usually become resistant to the initial drugs. Most tumours will eventually begin to grow again (progress) and need treatment with one or more new drugs to halt progression.

This research addresses the need to find more active drugs for those whose tumours don’t stop growing after chemotherapy and/or radiotherapy.

Who will it help?

LGG is the most common type of brain tumour in children, and new ways to treat it must be found.

Chemotherapy is usually the first treatment for LGG and, while it can control the tumour for some time, tumours usually become resistant to the initial drugs. Most tumours will eventually begin to grow again (progress) and need treatment with one or more new drugs to halt progression.

This research addresses the need to find more active drugs for those whose tumours don’t stop growing after chemotherapy and/or radiotherapy.

We hope that this trial will lead to a larger phase III study to determine new standards of treatment for low grade glioma.

Dr Susan Picton

Milestones

The latest news

• Phase I of the trial was completed and Dr Picton’s team identified the recommended doses of vinblastine and nilotinib when used in combination.
• A total of 132 patients were recruited to the trial across the UK, France, Denmark and Spain.
• Interim analyses of phase II highlighted that vinblastine treatment alone was more effective against LGGs compared to when it was used in combination with nilotinib. Recruitment to the trial was therefore halted and all patients on the trial have now switched to vinblastine only treatment.
  

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