Toronto firefighter back to work after new drug slows ‘incurable brain cancer’ uptrends.live

In December 2020, Steven Stefanidis, a 36-year-old Toronto firefighter, was responding to a medical call when he lost consciousness and had a seizure.

After being examined by first responders, he was taken to hospital, where an MRI revealed a tumor. He was diagnosed as IDH grade 2 mutant glioma, an incurable form of brain cancer.

It was a complete shock, Stefanidis told Global News.

“I was in my early 30s, living my best life with a dream job when I suddenly had a seizure. I can’t describe what it was like to learn I had incurable brain cancer,” he said.

“At first, I was in shock and I couldn’t digest the information because it was heavy. But overall the neurosurgeon I met was very relaxed and confident, I trusted him and he put me in a good situation. I didn’t panic or anything. I knew I was in good hands right now.

He then underwent surgery to relieve his symptoms, a week after his diagnosis.

Stefanidis is one of thousands of Canadians diagnosed with brain and spinal cord cancer each year, according to the Canadian Cancer Society. The type he has, gliomas, is the second most common cancer among Canadians under 40 and the second leading cause of cancer-related deaths in this age group.

And IDH-mutant glioma typically occurs in people in their 30s and 40s, when they are in the prime of life — working and raising a family, explained Dr. Mary Jane Lim-Fat, a neurologist and neuro-oncologist. at Sunnybrook Health Sciences Centre.

“There is currently no cure for diffuse gliomas in adults,” Lim-Fat told Global News. “So our best treatments, which until now have consisted of radiotherapy and chemotherapy, only delay the regrowth of the tumor. It has been very difficult to find better treatments for our patients.

But there is hope. A new oral drug called Voranigo has been shown to target brain tumors and, in phase 3 clinical trials, “significantly” slow their growth. Stefanidis participated in these clinical trials at Sunnybrook Health Sciences Center in Toronto and said the treatment was effective for his cancer.

“Since I received the treatment during the clinical trials… there have been no side effects from the drug, and on the positive side, we have noticed some stabilization and some shrinkage of the remaining (tumor),” he declared.

And now it has been officially approved in Canada.

On Tuesday, Health Canada announced the approval of Voranigo, the first targeted therapy for the treatment of Grade 2 isocitrate dehydrogenase (IDH) mutant glioma in adults and pediatric patients aged 12 years and older, following an intervention surgical. This is the first targeted oral treatment for brain cancer in Canada.

Voranigo was studied in a large-scale, randomized, placebo-controlled clinical trial in patients around the world, including Canada, from January 2020 to February 2022.

The results of the Phase 3 clinical trials were published in June 2023 in the New England Journal of Medicineand show promising results, Lim-Fat said.

“This new drug is essentially a brain-penetrating oral drug that patients can take orally that changes the function of this mutant protein. So by doing that, it slows the growth of the tumor, stabilizes it in some cases and even decreases the growth or shrinks the tumors in some cases,” she said.

So what exactly does this mean?

Gliomas are difficult to treat and often progress to more aggressive forms of brain cancer, in part because of the blood-brain barrier. This protective layer protects the brain from damage, but also makes it difficult for therapies to penetrate and target them effectively, Lim-Fat explained.

Due to the blood-brain barrier, current treatment for gilomas involves a combination of surgery, followed by radiation and chemotherapy. Although these treatments can temporarily stop the tumor from growing, Lim-Fat noted that it eventually returns.

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But Voranigo is specifically designed to cross the blood-brain barrier and reach the brain to target mutated enzymes that cause cancer.

Results from phase 3 clinical trials show the drug more than doubled the time it took for the tumor to return in patients. It has also delayed the need for interventions such as chemotherapy and radiotherapy, which carry serious side effects.

“The median progression-free survival of patients on placebo – therefore having received nothing – was approximately 11.1 months. But when they looked at the group that got (Voranigo), that progression-free survival, that time frame was more than double that time, or 27.7 months,” Lim-Fat said.

“These results in themselves are very encouraging and show that this drug was actually quite effective in delaying this progression in these patients. »

Now that Voranigo is approved in Canada, Stefanidis said he hopes the drug can help others who find themselves in the same situation.

After taking time off work, he returned to his job as a firefighter and even began traveling, exercising, and hiking again.

“I feel like an ordinary, normal, healthy adult. I am gradually returning to my usual daily routine. I’m back to work now, fully back on the responding fire trucks. And it’s great to have the same crew again,” he said.

“I recently took my first vacation in July this year. And it was amazing to go out there. And that’s another thing about this drug. It’s not something where I had to stay in my area because I could only get the treatment there. I can take it with me wherever I go and use it as a mobile treatment,” he added.

Stefanidis said he takes it once a morning, like a multivitamin, and keeps track of it in his diary for the dosage and time.

Lim-Fat expressed that the oncology community is really excited about the approval of this drug in Canada, stating: “We haven’t had a breakthrough like this in terms of a new drug in about 20 years. »

However, she noted that some questions remain. Doctors still don’t know the long-term survival outcomes of patients taking this drug, or whether certain groups of patients might respond better or longer to treatment.

“But nonetheless, we think this is a major breakthrough and a major step forward in terms of providing more options for patients,” she said.