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Impact of cannabis-based drug on aggressive brain tumours to be studied in UK trial

A British trial hopes to establish whether a cannabis-based drug could help extend the lives of those diagnosed with aggressive brain tumours.

Brain tumours are the biggest cancer killer of people under the age of 40, and around 2,200 people are told they have a glioblastoma – the most aggressive form – every year in England alone. The typical prognosis is 12 to 18 months from the date of first diagnosis.

The new trial hopes to look at whether using Sativex – an oral spray containing cannabinoids – in conjunction with chemotherapy could extend the overall length of glioblastoma patients’ lives, delay the progression of their disease, or improve their quality of life.

Some 232 patients at 15 hospitals across the UK are due to be recruited early next year if the trial goes ahead.

However, with the Brain Tumour Charity’s income having dropped by 25 per cent due to the pandemic, it has launched an appeal to help raise £450,000 needed to fund the three-year trial.

Sativex can currently only be prescribed on the NHS for people with multiple sclerosis-related spasticity. If the trial were to prove successful, researchers say it would represent one of the first new treatments for glioblastoma added to the NHS since temozolomide chemotherapy in 2007.

Almost all glioblastomas recur even after intensive treatment including surgery, radiotherapy and chemotherapy, with an average life expectancy of 10 months after the tumour first recurs following initial surgery or treatment.

Over the last decade, there has been significant global interest within both patient and scientific communities about the activity of cannabinoids in brain tumours, with patients sometimes seeking various forms of medical cannabis products illicitly.

While several pre-clinical laboratory studies have suggested that cannabinoids THC and CBD may reduce brain tumour cell growth and could disrupt the blood supply to tumours – there has so far been limited clinical evidence that they could treat brain tumours.

In phase one trials earlier this year, the drug was found to be tolerable in recurrent glioblastoma patients already receiving temozolomide.

While more patients who received Sativex were still alive after one year compared to those given placebos, that phase of the trial was not sufficiently geared towards establishing survival rates to draw firm conclusions. Ten out of 12 patients receiving Sativex survived the year, compared to 4 out of 9 patients in the placebo arm.

If phase two trials are able to go ahead, two-thirds of participants will be given Sativex, and a third given a placebo, up to 12 times per day, with regular check-ups. They will receive monthly clinical assessments, blood tests and MRI scans every eight weeks, and will also complete quality of life questionnaires.

Stephen Lee, 62 from Leyland in Lancashire, was first diagnosed with glioblastoma in 2010, just a few months after losing his older brother to the same disease. In 2015, he took part in the phase one trial after his cancer returned following initial treatment.

“My diagnosis was very sudden and was one of those days you never forget,” Mr Lee said. “Having had to leave work early with a severe headache and a stabbing pain in my right eye, my wife insisted that we go straight to hospital after what my brother had experienced.

“I was admitted that same day, had a scan and that’s when they identified it was a brain tumour. I had the operation the following week, and beforehand my wife and I agreed that we wanted to stay positive, to keep living our lives and to enjoy however much time we had together.”

Mr Lee joined the early trial of Sativex in the hope it could improve his quality of life, but said he “thought it only right and proper” that he followed in the footsteps of those who had taken part in the trials of the chemotherapy and radiotherapy he himself was receiving.

“I took the oral spray 10 times a day, and it was easy as I could take it wherever we were going, even while out for dinner. While I don’t know whether I had Sativex or the placebo, since the trial finished in 2016, all my MRI scans have been clear,” Mr Lee said.

"This new trial is so important as it will give people hope that there could be life beyond a glioblastoma diagnosis and that there are other treatments being trialled to support them to live their lives.”

The study will be led by an expert at the University of Leeds and coordinated by the Cancer Research UK Clinical Trials Unit at the University of Birmingham.

Dr David Jenkinson, interim chief executive at The Brain Tumour Charity, said: “We hope this trial could pave the way for a long-awaited new lifeline that could help offer glioblastoma patients precious extra months to live and make memories with their loved ones.

“We know there is significant interest among our community about the potential activity of cannabinoids in treating glioblastomas, and we’re really excited that this world-first trial here in the UK could help accelerate these answers.”

Pointing to the “really promising” early-stage findings, Dr Jenkinson added: “But we also know that for many, this trial won’t come soon enough.

“In the meantime, while other cannabis-based products may help alleviate symptoms, there is insufficient evidence to recommend their use to help treat brain tumours. For anyone considering using cannabis-based products or other complementary therapies, it’s vital that you discuss these with your medical team first, as they could interact with other treatments such as anti-epileptic medicines or steroids.” 

Reference: Independent: Andy Gregory

Drug poisoning deaths in England and Wales reach record high

Deaths due to drug poisoning in England and Wales have reached a record high, with a growing number of people dying after using cocaine and opiates, new data shows.

Charities warned the figures showed there was a public health emergency, with the pandemic negatively affecting those with addiction problems. In 2020, 4,561 died – the equivalent of 79.5 deaths per million people. This is 3.8% higher than figures for 2019, and the highest number since records began in 1993.

Men accounted for more than two-thirds of deaths in 2020, a disparity that is consistent with previous years. The highest rate of drug misuse deaths was found in those aged 45 to 49 years, closely followed by those aged 40 to 44 years.

Approximately half of all the deaths in 2020 involved an opiate – pain relief medication such as Codeine and Fentanyl – and 777 deaths involved cocaine, which is 9.7% more than 2019, and more than five times the amount recorded a decade ago.

Rates of drug-related poisoning were 60.9% higher in 2020 than they were in 2010. The rate has increased every year since 2012; the increase from 2019 was not statistically significant.

Dr Emily Finch, vice-chair of the addictions faculty at the Royal College of Psychiatrists, said that years of cuts had left addiction services “ill-equipped”. She added that more funding was needed “and people living with a drug addiction must have access to the mental health support they desperately need.”

Clare Taylor, national director of operations at Turning Point, said the figures showed “a public health emergency” that needed an immediate response.

“Covid-19 has impacted on the nation’s mental health, but the effect of isolation, financial insecurity, and fear has hit many of those who were already vulnerable including people with a history of drug or alcohol problems and some people have not received the support that they needed,” she added, saying that austerity and cuts had also prompted a rise in drug-related deaths.

“Every drug or alcohol-related death is preventable, and our thoughts are with anyone who has lost someone this way.”

There have been increasing numbers of deaths involving benzodiazepines in 2020 (a rise of 19.3% compared with 2019; from 399 to 476 deaths), pregabalin (a rise of 41.0%; from 244 to 344 deaths), gabapentin (a rise of 32.6%; from 89 to 118 deaths) and zopiclone (a rise of 4.3%; from 140 to 146 deaths).

The age cohort born between 1970 and 1979, often referred to as generation X, has consistently had the highest rates of drug misuse deaths for the past 25 years.

In 2020, the highest rate of drug misuse deaths was observed in the north-east, while the lowest rate was in London. The north-east has had the highest rate of drug misuse for the past eight years and has a statistically significantly higher rate than all other regions of England. 

Reference: The Guardian: Sarah Marsh

Over 50s and clinically vulnerable will be offered Pfizer booster shot

Tens of millions of Britons will be offered a Pfizer booster jab this autumn as the vaccine has proved to be the most effective against the Delta variant.

The booster scheme, which was announced earlier this year, is set to start in September and should see 23million over-50s, vulnerable Britons and NHS and care home staff offered a third dose. 

Extra vaccines would be rolled out in two stages — prioritising those most at risk of Covid, before the programme is extended.

While patients were initially expected to be offered the jab they were originally inoculated with, it is understood all patients will be offered the Pfizer jab as it has proven to be the most effective against the Delta variant.

The Department of Health has yet to confirm the official details of the booster scheme, plans of which were first shared by the Joint Committee on Vaccination and Immunisation (JCVI) in June.

The JCVI is expected to issue its final advice in regards to the booster scheme in the coming months. 

A senior government source also told the Times that those who received the AstraZeneca vaccine would 'be getting an mRNA booster'.

MRNA is a type of vaccine and applies to the Pfizer and Oxford jabs while AstraZeneca is not an mRNA jab. 

A UK Government-backed study published earlier this year found that mixing and matching Covid vaccines may result in higher protection against the virus.

People who had been vaccinated with AstraZeneca's jab initially and then received a top-up with Pfizer's had nine times more antibodies than those who stuck to the UK vaccine.

Although antibodies are just one part of the immune response, the Oxford University researchers said the findings strongly suggested the approach could enhance immunity.

But it is understood the mix and match approach is not going to be used in the short term more broadly because there is a 'strong supply' of each vaccine type.

A senior HSE source told the Times: 'Currently there's no need for it. Currently we have plenty of vaccines. The amount of vaccine isn't an issue at all. There's no plan to do it. It's not under immediate consideration, but I wouldn't rule it out.'

The Government said analysis has shown that the Pfizer vaccine is 96 per cent effective against the Delta variant while the Oxford/AstraZeneca vaccine is 92 per cent effective against hospitalisation after 2 doses.

A study published this week also showed that a third dose of the Pfizer vaccine could offer strong protection against the Delta variant.

Research showed that antibody levels increased five-fold among people ages 18 to 55 who were given the booster shot.

The third dose was especially effecting for the elderly, with antibody levels spiking 11-fold among people aged 65 to 85 who had already received the standard two doses.

In the slides published online, the researchers wrote there there is 'estimated potential for up to 100-fold increase in Delta neutralization post-dose three compared to pre-dose three.' 

The booster roll-out will coincide with the annual influenza inoculation programme, which health officials said will be vital this winter amid warnings of a difficult flu season.

Immunity gained from Covid jabs last for at least six months in the 'majority' of cases, but there are fears this could fade later in the year which could trigger a spike in hospitalisations and deaths.

An Oxford University trial looking at booster doses suggested a third shot six months after the second could restore peak immunity against Covid.

It comes as the week-on-week rate of Covid cases fell yesterday for the tenth day in a row with 26,144 infections marking a 17.8 per cent fall while deaths also fell to 71.

The latest data from Public Health England and Cambridge University suggests that about 60,000 deaths, 22 million infections and 52,600 hospitalisations have been prevented by vaccines.

The Government plans to lure young people in for their vaccinations with the promise of cut-price taxis and takeaways, as Boris Johnson tries to tackle the relatively low take-up among the under-30s.

Uber, Deliveroo and Pizza Pilgrims are among the companies in discussion with the Government about offering incentives as part of the 'Jab 18-30' drive.

So far, only two-thirds of people in that age bracket in England have received a first dose since they became eligible in June, compared with 88.4 per cent across all age groups, meaning more than three million 18-to-30-year-olds remain unjabbed.         

 Reference: Katie Feehan For Mailonline and Glen Owen For The Daily Mail

Autism: What is it and what are the signs that someone might have it?

Actor Wentworth Miller has revealed that he has been diagnosed with autism in a post to his Instagram.

Sharing the news with his two million followers, the Prison Break actor, 49, described the process of getting diagnosed as “long” and “flawed”, adding that he was treated like a five-year-old boy and not a middle-aged man.

He stressed that although he was sharing his diagnosis and his experience, he did not want to speak for the autism community as a whole.

“I don’t know enough about autism. (There’s a lot to know.) Right now my work looks like evolving my understanding,” he said.

“Meanwhile, I don’t want to run the risk of suddenly being a loud, ill-informed voice in the room. The #autistic community (this I do know) has historically been talked over. Spoken for. I don’t wish to do additional harm,” he said.

In the UK, one in 100 people are on the autism spectrum, while approximately 700,000 adults and children are autistic, according to the National Autistic Society.

Awareness of autism is growing, with Hollywood films like Rain Main and What’s Eating Gilbert Grape introducing mainstream audiences to the complexity of the condition.

Here are some of the key things to know about autism.

What is autism?

Known as autism spectrum disorder (ASD), it is a developmental disability.

An autistic person experiences their surroundings differently to the average person. This impacts their communication skills, and their ability to relate to others.

The cause of autism is unknown, and genetic and environmental factors are believed to play a part.

What are the symptoms?

Two people will not experience the condition in the same way as it has a variety of effects. This is why it is described as a spectrum condition. However, there are some uniting factors.

Babies with the condition are less likely to babble and struggle to express themselves.

As children grow they learn to socialise. However, children with ASD find this difficult, and may avoid eye contact, and misunderstand facial expressions, gestures, and find it hard to read body language.

Due to such symptoms, children with ASD can prefer playing by themselves. Others feel more comfortable in the company of children of an age different to their own.

Because of this, those with ASD struggle can find it difficult to develop language skills and can instead copy what others say.

ASD can also influence how a child expresses themselves physically, as they can move their hands when they are distressed or excited.

Other children need the order of routine, and become upset when confronted with change.

Autistic people may be over or under sensitive to stimulation such as sound, touch, taste and smell, making everyday activities upsetting.

Autism also affects a person’s cognitive abilities, with around 70 per cent of children having a non-verbal IQ of 70 or below, with 100 considered the average.

However, Asperger Syndrome is a form of autism linked with average or above average levels of intelligence. Those with this condition have less problems with speech, but may have issues reading language cues.

Autistic people often also have other conditions such as attention deficit hyperactivity disorder (ADHD), anxiety, or depression.

How common is autism?

Around 1 in every 100 people in the UK have ASD, according to the NHS.

It is more common for men than women to have ASD.

Those with ASD are generally diagnosed when they are toddlers, or between the ages of 6 and 12-years-old.

How is it treated?

Autism is a life-long condition and many people see it is an important part of their identity.

Some behavioural programmes can help children with ASD to communicate, and learn about social cues.

The family and loved ones of a person with autism can help them by understanding what they find hard day-to-day and accommodate for this. For example addressing a person by their name; minimising the stimulation in an environment, and patience can be important.

Treatments are available for the illnesses related to ASD, such as depression and insomnia.

Reference: Independent: Kashmira Gander