Boy, 13, beats deadly brain cancer, but how?

At age six, Lucas faced an ominous diagnosis of a rare brain tumour, leaving little hope. Yet, seven years later, he stands as a beacon of triumph with no remnants of the once-debilitating disease.

Lucas, a Belgian teen, emerges as the world’s first known case of a child to vanquish brainstem glioma – known as an aggressive cancer – as proclaimed by researchers at the Gustave Roussy cancer research centre in Paris, France.

Dr Jacques Grill, a physician-researcher responsible since 2011 for the Brain Tumour Programme in the Department of Child and Teenage Oncology at Gustave Rouss, remembers having to tell Lucas's parents the difficult news that their son was going to die.

Yet, seven years later, he stands as a beacon of triumph with no remnants of the once-debilitating disease.

“Lucas beat all the odds” to survive, Dr Grill told the French news agency AFP.

Lucas's story is a testament to resilience, defying dire odds that shadowed other children afflicted by diffuse intrinsic pontine glioma (DIPG).

Miraculous recovery

While most face a bleak prognosis, Lucas's miraculous recovery stands unparalleled.

His journey began with experimental treatment under the BIOMEDE trial, showcasing a promising response to the drug everolimus.

With each MRI scan, the tumour’s complete disappearance astonished medical experts.

“Over a series of MRI scans, I watched as the tumour completely disappeared," Dr Grill told AFP.

However, he refrained from halting the treatment until a year and a half ago when Lucas disclosed he had ceased medication.

“I don't know of any other case like him in the world,” said Dr Grill, one of the scientists working on a treatment for DIPG.

In November 2019, Dr Grill presented the initial results of a randomised trial in the first 230 patients from Europe and Australia as part of the BIOMEDE 1 study at the Society for Neuro-Oncology conference in Phoenix, USA.

The society is a group of healthcare professionals dedicated to promoting advances in neuro-oncology through research and education.

Potential implications

The reasons behind Lucas's remarkable recovery and its potential implications for similar cases await further investigation.

While seven other children in the trial survived, Lucas stands alone in achieving complete tumour disappearance, according to the AFP report.

While Lucas’s remarkable recovery inspires hope, the mechanism of action surrounding his recovery beckons further medical exploration.

Researchers delve into the genetic intricacies of his tumour, cultivating optimism for potential breakthroughs in combating similar cases.

Though the path to widespread treatment remains lengthy, advancements in research and trials offer renewed optimism for conquering this formidable foe.

The medical community has highlighted advances that mean 85 percent of children now survive more than five years after being diagnosed with cancer.

Cases

Each year, around 300 children in the United States and up to 100 in France are diagnosed with diffuse intrinsic pontine glioma (DIPG), a lethal brain tumour.

While researchers express enthusiasm for this promising discovery, they caution that any potential treatment remains distant. "On average, it takes 10-15 years from the first lead to become a drug – it's a long and drawn-out process," explained Dr. Grill.

Dr. David Ziegler, a paediatric oncologist at Sydney Children's Hospital in Australia, noted significant transformations in the DIPG landscape over the past decade. Breakthroughs in research labs, augmented funding, and trials like BIOMEDE "makes me convinced that we will soon find that we are able to cure some patients", Dr. Ziegler affirmed to AFP.

About BIOMEDE trial

The BIOMEDE trial (which stands for Biological Medicine for Diffuse Intrinsic Pontine Glioma Eradication) looks at targeted cancer therapies to treat a type of brain tumour called DIPG. The trial, supported by various institutions including research centres in Australia, Europe and the UK, is for children and young people up to the age of 25.

The standard treatment item for DIPG is radiotherapy. Unfortunately, for many people, radiotherapy isn’t a cure and the tumour is likely to come back within a year.

The trial team think that giving a targeted cancer drug (a biological therapy) alongside standard radiotherapy might be better. But they aren’t sure.

Some targeted cancer drugs work by blocking pathways in cancer cells that tell them to grow and divide. These are called cancer growth blockers. Certain substances (biomarkers) in the tissue of the tumour show that these pathways are active.

As part of the BIOMEDE trial, researchers take a small sample of the tumour tissue (biopsy) to look for these biomarkers. Depending on which biomarkers are present, patients are given one of the following, in addition to radiotherapy:

The aim of the trial is to investigate how well erlotinib, everolimus and dasatinib with radiotherapy works for children and young people with diffuse intrinsic pontine glioma, according to Cancer Research UK.