David Munn, MD
Medical College of Georgia at Augusta University
Catapult Award: 2023-2025
Focus: Pediatric Brain Tumors; Immunotherapy; Novel Agent, Combination Therapy
Project title: Combined IDO and BTK Inhibition for Immunotherapy of Pediatric Brain Tumors
This project is supported in part by the Rally Foundation for Childhood Cancer Research.
Project Summary: Brain tumors are the most common solid tumor of childhood. However, for glioblastoma, medulloblastoma, and ependymoma the cure rate remains only 60-70%. Once pediatric brain tumors recur or progress, the disease is usually rapidly fatal. Repeated cycles of chemotherapy can lead to resistance. However, the immune response differs fundamentally from the response to chemotherapy in that repeated cycles of immunotherapy may actually increase the beneficial anti-tumor effects. A suitably activated immune system is capable of allowing otherwise ineffective chemotherapy to now become potent and effective.
David Munn, MD, from Augusta University, is conducting an open-label Phase 1b study to test if adding ibrutinib can restore systemic immune activation and functional anti-tumor activity in patients 12 to 25 years old with brain cancer who are highly resistant, actively progressing, and have already become resistant to chemoimmunotherapy with indoximod alone. The trial comprises a dose-finding cohort to establish safety and dosing of ibrutinib, then an expansion cohort to evaluate the efficacy of the combination.
"We chose brain cancer because it was a completely understudied or underserved field. Until today, there’s just no accepted standard pathway to deal with any relapse brain cancer. So it was a population of patients who seemed best positioned to benefit from new modalities of therapy."