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ASCO 2026 | Promising brain tumor trials at ASCO: MAGMA and ROADS

Nicholas Blondin, MD, Yale University School of Medicine, New Haven, CT, provides an overview of on the recent developments in neuro-oncology. Trials have assessed olaparib, a PARP inhibitor, in glioblastoma and discusses MAGMA study (ACTRN12620000048987) investigated different dosing schedules of temozolomide. The Phase III ROADS trial (NCT04365374) of cesium-131 tile-based radiation therapy (TBRT) with GammaTile additionally showed promising results for brain metastasis treatment. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

Yeah, so in terms of some studies in the neuro-oncology space, unfortunately, it was a pretty disappointing conference, again, on glioblastoma therapies in larger studies. So again, we were excited about our results, but this is a phase one study. There were a few other phase one studies that also had some intriguing results. One study looking at Olaparib, which is a PARP inhibitor...

Yeah, so in terms of some studies in the neuro-oncology space, unfortunately, it was a pretty disappointing conference, again, on glioblastoma therapies in larger studies. So again, we were excited about our results, but this is a phase one study. There were a few other phase one studies that also had some intriguing results. One study looking at Olaparib, which is a PARP inhibitor. I know there’s been some interest over the last few years in PARP inhibition in GBM. But overall, again, no major breakthroughs were reported in GBM treatment. An interesting study was done in Australia, referred to as the MAGMA study, looking at different dosing schedules of temozolomide. And I think that this was a really well-designed study that answers some practical questions about temozolomide. Does earlier treatment with temozolomide improve patient outcome or extended dosing of treatment, temozolomide treatment improved outcomes and the bottom line is it seems like there was not improved outcomes with early or extended treatment um compared to just standard like concurrent temozolomide and then six cycles of temozolomide as maintenance therapy so um i i think that that was practically very helpful again it’s just more data supporting that extended treatment with temozolomide doesn’t really have any actual impacts on patient survival outcomes. With other studies, there was more interest in brain metastasis space. A phase three study was reported using cesium-131 brachytherapy tiles referred to as GammaTile. And GammaTile is placed at the time of resection of a solitary brain metastasis. Patients were randomized to receive GammaTile after surgery or radiation treatment after surgery. The radiation treatment administered was referred to as SRT or stereotactic radiotherapy. And it was delivered on, I think, a median of 27 days post-operative, which is not in the U.S. Really generally, I feel like the standard of care now in 2023. I know at our center, patients get SRS therapy with a gamma knife technology within a few days after surgery. So while the results of the study indicated that patients had improved outcomes on GammaTile compared to SRT, practically speaking, it’s more difficult to kind of like interpret that compared to our current standard of care. So I think that there’ll be further discussion on the role of GammaTile. At least that study indicates that GammaTile has anti-cancer activity and could be a biologically effective drug. But in terms of widespread deployment, I think, again, further conversations will be had. And then a similar study is being done in glioblastoma patients. And abstract was presented just on kind of the study design. And, you know, glioblastoma patients are having GammaTile placed in the context of that study. And we’ll probably know in one to two years, you know, kind of some data on those outcomes.

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