Cancer Research Wales puts Wales on the map as brain cancer clinicians and scientists meet in London

Hosted by University College London and the National Hospital for Neurology and Neurosurgery, the theme of this year’s conference was ‘Biotechnology and The Future of Neuro-Oncology’ which allowed some of the world’s leading brain tumour scientists and clinicians to discuss and reflect on some of the exciting developments that are taking place within the connected fields of neuro-oncology, biology and technology.

Repurposing Old Drugs as New Therapies for Brain Tumours

An increased understanding of brain tumour biology opens doors to possible new therapeutic strategies for the disease, some of which are already used for other conditions. 

Several talks at the conference focussed on repurposing commonly prescribed drugs - normally used for the control of high cholesterol, pain and epilepsy - as additional treatments for brain tumours for use with conventional therapies.

Astrocytes ae specialised brain cells that support the structure and function of neurons and are the main cell type that give rise to brain tumours. It has recently become known that cancerous astrocytes form intricate and complex functional relationships with non-cancer brain cells such as neurons.

Keynote speaker Professor Shwan, a neurosurgeon based in San Francisco, US, gave a riveting talk where he described how neuronal networks in the brain are infiltrated with tumour cells, and how these regions become hyperexcitable with increased electrical activity. 

Furthermore, this enhanced electrical activity appears to further drive brain tumour progression and spread. Such a requirement could represent an Archilles heel for brain tumours.

Professor Hervery-Jumper suggested that the enhanced electrical activity is due to a flux of chloride into cells of the brain tumour/neuronal junction. 

Therapies that regulate chloride channels already exist with new ones in development and could represent a new treatment approach. Gabapentin a common and well tolerated drug works by regulating chloride channels and Professor Hervey-Jumper suggested this could be used in combination with other treatments to limit brain tumour growth. Clinical trials are now set up to answer this very question.

Mimosa and Cancer Research Wales

Dr Marco Palombo of the Cardiff University Brain Research Imaging Centre presented the first results from the Cancer Research Wales funded MIMOSA study. Using an advanced MRI brain scanner – of which there are only four in the world – known as the CONNECTOM, forty patients with aggressive brain tumours will receive MRI scans which will give greater detail of the tumour and its environment, before and after treatment, than previously possible. 

This will allow clinicians to better understand and predict how tumours are responding to treatment and identify which therapies are not working much earlier, saving valuable time.

Not only will this study allow scientists to better understand the natural course of brain tumour progression, but it will give clinicians the opportunity to offer patients alternative treatments where needed, and possible access to eligible clinical trials, where they can be offered the very latest new treatments that research has developed. 

As Dr Palombo told a packed room with a global audience, this Welsh led research has just gone where no-one else has gone by mapping the first brain tumour patients with the CONNECTOM MRI system.

Immunotherapy to Treat Neurological Tumours and the Need to Learn More

Immunotherapy, a form of cancer treatment that stimulates the patient’s own immune system to tackle the cancer has become one of the success stories of the last decade. Patients with advanced melanoma, lung and kidney cancers, as well as several others, are living much longer than ever before. Many with metastatic melanoma remain disease free many years after first receiving the treatment.

As a result of these successes, clinicians and scientists have turned their attention to the possibility that immunotherapy may hold promise for neurological cancers. In the case of the most aggressive brain tumours, no new treatments have been introduced into standard care for almost 20 years.

CAR-T is a highly specialised form of immunotherapy where the patient’s own immune cells are removed and engineered to recognise cancer cells. When created these cells are then multiplied and reintroduced into the body where they set out to destroy cancer cells. CAR-T has proven to be a cutting-edge therapy that can give cures for some cancer types - mainly lymphomas - when all other treatments have failed.

While a highly effective treatment CAR-T does come with challenges and can lead to distressing neurological symptoms, especially when the lymphoma is in the brain or other parts of the nervous system, as the heightened immune system activity begins to affect delicate neuronal structures within the brain.

Professors Karin Straathof, Marta Alonso, Claire Roddie, each shared unique perspectives on what causes neurotoxicity in CAR-T and what can be done to predict and limit its effect. It is becoming apparent that the greater tumour burden within the brain, the more likely patients are to suffer neurological side effects when recieving CAR-T or other forms of immunotherapy.

It appears that CAR-T increases the activity of microglia cells in the brain, unique specialised immune cells, chiefly found in the brain and peripheral nervous system. This activity reduces the white matter in the brain which can alter the function of the hippocampus, a key structure in the brain responsible for learning and processing and storing memories.

This is a challenging scenario for clinicians as they want to treat patients with the latest and most effective treatments, especially when the disease is great, yet the burden of disease may be a limiting factor when opting to use immunotherapies.

The presenters called for a greater understanding of response and resistance to CAR-T and other immunotherapies so that new strategies based on the information can be devised to limit side effects. 

Also new ways of engineering CAR-T cells and combining them with other treatments such as virotherapy that identify cancer cells more accurately, may prove beneficial in reducing the distressing cognitive impairment that can occur with these treatments.

Brain Tumour Clinical Trials - Understanding What Matters Most to Patients

Brain tumour clinical trials featured heavily on both Thursday and Friday of the conference. 

Some areas of the UK have better access to clinical trials than others, meaning that a lot of brain tumour patients miss out. 

This is compounded by the fact that most brain tumour trial patients are white, middle aged and have spare expenditure to make multiple hospital visits which further increases cancer inequalities.

Presenters communicated that there is real need to increase the neuro-oncology workforce. Looking after brain tumour patients in clinical trials is a highly specialised job. 

With interpersonal kindness a key skill, it is unworkable to have a research nurse working across multiple tumour sites, as is so often the case with a shortage of staff. 

More neuro-oncology nurses are urgently needed, especially given the ambition to increase the number of brain tumour trials across the UK.

Everything we do has to put patients at the centre, yet concerns were raised that patients do not have timely access to information and guidance when it comes to participation in clinical trials.

NIHR Brain Tumour Novel Therapeutics Consortium

At the conference a ‘world first’ was announced by the National Institute Health Research. 

The NIHR Brain Tumour Novel Therapeutics Consortium will see to drive forward national and international brain tumour research, with the hope that the UK will soon establish itself as a leader for the development and testing of much needed new therapies.

The consortium will aim to develop a portfolio of well-coordinated improved early and late-stage clinical trials for both adult and paediatric brain tumour patients. 

This will help ensure all patients, where eligible, can participate in a clinical trial, no matter where they live in the UK. Essential to the success of this will be access to comprehensive genetic testing for all patients affected by a brain tumour so the right therapy can be matched with the right patient at the right time.

The consortium also plans to extend the repertoire of molecular characterisation of brain tumours where the anonymous information can be linked to other databases and shared for use by researchers and clinicians across the world to help drive forward progress. 

Part of this the project will also set out to map the natural course of development of rarer brain tumour subtypes as well as those that are more commonly encountered in the clinic.

This ambitious project will be supported by the training infrastructure of the Tessa Jowell Brain Cancer Mission, of which Cancer Research Wales is a proud partner. 

This will help to identify future scientific and clinical leaders in the field of brain tumour research. Something that would really place the UK at the forefront of research and treatment of a disease that continues to devastate families worldwide.

To The Future

While brain tumours were once considered a relatively rare cancer compared to others such as bowel, breast, lung, and prostate cancer, rates of incidence are increasing, and it remains the leading cause of death from cancer in people under 40 years of age. 

Historically, brain tumours have only received around 1% of all cancer research funding.

However, by the end of the three-day conference, you couldn’t help but feel a real sense of optimism that the next decade of brain tumour research will see real meaningful breakthroughs in the treatment and care of patients diagnosed with this devastating disease as more investment is pledged.

The research showcased over the three days demonstrated a real momentum in the field as the critical mass of clinicians and scientists involved with brain tumour research continues to grow. 

The introduction of the NIHR Brain Tumour Therapeutics Consortium in the UK should see research and treatment better co-ordinated and more focused around patient’s needs.

To help foster a thriving brain tumour research community across the UK, Cancer Research Wales will be hosting its own one-day brain tumour research symposium at the SWALEC stadium in Cardiff on September 19th, 2025, and will bring together clinicians, scientists, nurses and patients from across Wales to share ideas and forge new collaborations.