Innovative treatments and multidisciplinary team work to help glioblastoma patients

Flint Greer, 24, of Pollock, Louisiana, and Alberto De Solo, 70, of Miami, Florida, don’t know each other, but they have something critical in common: Both traveled to Houston for innovative brain cancer treatment from a team of brain care physicians with The University of Texas Health Science Center at Houston (UTHealth).

Greer and De Solo were diagnosed with glioblastoma (GBM), the most malignant and common type of primary brain tumor. The average life expectancy for patients with glioblastoma is 11 months in all glioblastoma populations and between 14-20 months for those participating in clinical trials, but both men have been able to enjoy their lives for over two years from diagnosis, thanks in part to the work of a team of brain tumor-treating physicians and neurosurgeons.

De Solo was diagnosed in July 2018 with a butterfly glioblastoma, meaning the tumor crossed the midline of the brain and affected both the left and right hemispheres.

Meanwhile, Greer was referred to UTHealth in October 2018, and was in surgery just 48 hours after receiving the diagnosis from his primary care doctor.

“While these cases are different, they both show the power of having a positive attitude in addition to a robust treatment regimen. Both Flint and Alberto, along with their families, maintain a positive outlook and face their diagnoses head on,” said Jay-Jiguang Zhu, MD, PhD, professor and director of neuro-oncology at McGovern Medical School at UTHealth.

The treatment team from the Vivian L. Smith Department of Neurosurgery at McGovern Medical School also includes Nitin Tandon, MD, professor and vice chair; Dong Kim, MD, professor of neurosurgery;  Yoshua Esquenazi, MD, assistant professor of neurosurgery; Angel Blanco, MD, associate professor of neurosurgery; and others including neuroradiologists and neuropathologists with UTHealth Neurosciences.

After surgery, both men underwent several rounds of radiation and temozolomide chemotherapy. Zhu and his team then talked to them about trying an innovative treatment: a device called Optune, a wearable electrical device that creates low-intensity electric fields, or tumor treating fields (TTF), that disrupt tumor cell mitosis – the ability of tumor cells to divide and enable tumor growth.

“The TTF device can be worn on a shaved scalp 24/7, and the U.S. Food and Drug Administration (FDA) recommends patients wear it for at least 18 out of 24 hours a day for at least four weeks, or longer if tolerated. I recommend that my patients wear it for as much and as long as possible to get the maximum benefit of the device,” Zhu said.

Zhu led a clinical trial at UTHealth that studied the device’s ability with radiation and temozolomide to prolong the survival of newly diagnosed GBM patients as opposed to treating those patients with standard radiation and temozolomide chemotherapy. Based on the trial data of significant improvements in survival of the TTF treatment group, the FDA approved the device for newly diagnosed GBMs in October 2015. The device had previously been approved for patients with progressive or recurrent GBMs in April 2011.

Greer wore the device for as long as he could while continuing his temozolomide chemotherapy treatments. By August 2020, after wearing the Optune device for 18 months, his tests showed stable disease without evidence of progression and he made the decision, along with his doctors, to stop chemotherapy treatments as well as wearing the Optune cap. His condition has improved enough that he is now living a normal life with his GBM under control. He visits his team at UTHealth Neurosciences every six months for a follow-up MRI.

“God, my family, and my wife are definitely what got me through it,” Greer said.

De Solo wore the device until December 2019. Zhu explained that while De Solo hasn’t been cured of his brain tumor, the Optune device has allowed a quality of life not usually seen in other patients.

“He still has the disease and it is still growing, but not as fast,” Zhu said. “His was an especially challenging case. People with a butterfly GBM usually live between six and eight months, so for him to still be here more than two years after his diagnosis is inspiring.”

“In Alberto’s case, every little bit helped, so having the Optune device as a treatment option was a relief,” De Solo’s wife Ana said. “Cancer like this is like a war and you have to attack it with any means.”

“All of the brain-treating physicians and neurosurgeons at UTHealth work together as a team to provide the best care for each patient. We talk to one another frequently, see the patient together, and discuss tumor cases at our weekly tumor board meetings. I think people like our teamwork, especially when they come to us from long distances,” Zhu said.

Ana De Solo described finding Zhu and UTHealth Neurosciences, as “a miracle in and of itself” because initially they were told the tumor was untreatable.

 “I’m extremely grateful for the care all of my husband’s doctors have shown him. We have been able to meet the most wonderful people through this experience,” Ana said.

Greer’s mother, Becky, echoes Ana’s sentiments. “He got the best doctors we could have ever found!” she said.