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T M C » P U L S E | A U G U S T 2 0 1 8 34 Solutions: TMC Innovations said Frederick Lang, M.D., professor and chair of the department of neurosurgery at MD Anderson and lead author of a report on the clinical trial, published in the May 2018 Journal of Clinical Oncology. Some 15,000 to 20,000 people are diagnosed with glioblastoma each year and it is "universally fatal at this point," Lang said, with patients living an average of 14 months after diagnosis. Glioblastoma is more likely to be diagnosed in people in their mid- to late-50s or early 60s and most likely to be found in men. Symptoms of the tumor can vary and include headaches that don't go away, usually occurring in the morning, as well as seizures and progressive neurological decline, Lang explained. Depending on where the tumor is located in the brain, weakness on one side of the body or a numbness or tingling might occur. Problems with movement, vision or speaking could also arise. "A lot of it can be subtle because as you get older, you have trouble finding the right words anyway," Lang said. Symptoms seem similar to someone having a stroke, but glio- blastoma symptoms are slower in the onset, he added. Using viruses in tumors Research supports using viruses to kill cancer cells. In 2015, the U.S. Food and Drug Administration approved an inject- able drug developed by Amgen Inc. that used the herpes virus to penetrate and kill skin cancer cells in patients with hard-to-treat melanoma. More recently, researchers at Duke University showed positive outcomes while using the poliovirus to treat glioblastoma. They reported a survival rate of three years in about 21 percent of brain cancer patients who received the treatment. Meanwhile, other researchers have experimented with low concen- trations of the Zika virus, which was shown to kill certain types of brain cancer cells. Though these experiments had promising results, Lang and his fellow researchers weighed the safety of each virus with its ability to attack cancer. "Herpes gets into brain cells very well, but it is all about the safety," he said. "You also have to consider if you can make the Zika virus safe enough, and handling it is not easy." Instead, Lang and his team settled on the adenovirus, better known as the common cold. "We thought it was safer and easier for us to engineer," he said. Lang and his team needed to engineer the adenovirus properly, to make sure it would grow in tumor- ous cells but bypass normal cells. The experiment Juan Fueyo, M.D., professor of neuro-oncology at MD Anderson, The Common Cold as Cure? Adenovirus shows promise as brain tumor immunotherapy B y C h r i s t i n e H a l l T he common cold is usually something people try to avoid, but researchers at The University of Texas MD Anderson Cancer Center have discovered that the adenovi- rus is actually useful in attacking certain brain tumors. After turning the cold virus into an injectable "smart bomb," researchers in a Phase 1 clinical trial were able to show that the treatment helped 20 percent of patients with recurrent glioblastoma live for three years or longer. Glioblastoma, which occurs in the brain or spinal cord and forms from cells called astrocytes that sup- port nerve cells, is the most common malignant brain tumor affecting adults and the most aggressive, Credit: Adolfo Chavez III, MD Anderson Cancer Center Frederick Lang, M.D., is a professor of neurosurgery at MD Anderson. Top right: A cell infected with the injectable adenovirus.

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