by Harlan Spector
Wednesday September 24, 2008, 8:22 PM
Two Cleveland hospitals are embarking on an experimental procedure using laser heat to "cook" brain tumors, offering hope of improved survival from one of the most difficult to treat cancers.
Cleveland Clinic on Wednesday was expected to perform a first-ever brain tumor operation using the MRI-guided laser.
The Clinic and University Hospitals Case Medical Center are collaborating on the first human trials of the device, made by Monteris Medical Inc. of Winnipeg, Manitoba. The technology uses a thin probe inserted through a small hole in the skull to deliver heat to tumors, without harming healthy tissue.
The study is designed for patients with glioblastoma multiforme, the type of fast-growing, incurable cancer that Sen. Edward Kennedy has. Most patients diagnosed with glioblastomas die within two years.
The Clinic on Wednesday declined to release information about the procedure, but said in an earlier e-mail that it was to be performed in the afternoon. University Hospitals is expected to follow with a second patient within two weeks. UH also declined to release more information.
Dr. Gene Barnett of the Clinic and Dr. Andrew Sloan of UH are leading the clinical trial of the laser device. Both also are paid consultants of Monteris and members of its scientific advisory board, the hospitals said Wednesday.
About 40,000 people a year in the United States are diagnosed with malignant primary brain tumors, says the National Brain Tumor Society, a nonprofit advocacy and research group. An even greater number of patients develop metastatic brain cancer, meaning the cancer has spread from another site to the brain.
Glioblastomas are difficult to remove entirely through surgery because the cancer cells aren't contained in a solid mass, but are spread throughout the brain. Even when doctors remove the bulk of it, the small cell clusters set off new tumor growth.
"This is an awful cancer," said Dr. E. Antonio Chiocca, co-director of neuro-oncology at the Ohio State University Medical Center. "It's one of those cancers, along with pancreatic cancer, where we don't have a handle on providing long-term survival."
Treatments for glioblastomas typically include surgery and radiation. Chemotherapy is also used for some patients, but it has not been very effective.
New drugs to improve survival are under study in Cleveland and elsewhere. Local researchers are experimenting with a vaccine and targeted drug therapies based on tumors' genetic makeup.
Chiocca said new therapies are promising, but "there's been so many treatments that seem successful and they fail.
"I think we have to be hopeful but also realistic," he said.
Vaccine Boosts Survival Rate With Brain Cancer
A cancer vaccine more than doubled the survival time of people with the most common and deadly type of brain tumor, U.S. researchers said. The vaccine, made by Avant Immunotherapeutics and licensed by drug giant Pfizer enlists the help of the immune system to attack the tumor.
Researchers treated 23 patients with a type of brain tumor called glioblastoma multiforme. They have lived, on average, 33 months, said Dr. John Sampson of Duke University, who presented the study at a meeting of the American Society of Clinical Oncology in Chicago.
"That is almost unheard of," Sampson said in an interview. "We have one woman who has gone on to have two babies now," Sampson said.
Patients given standard therapy alone lived on average 14 months. It also took far longer for tumors to grow back after surgery. In people treated with the vaccine, this so-called time to progression was 16.6 months, more than double the usual six months.
Glioblastoma multiforme, a serious form of brain tumor of a type known as a glioma, kills half its victims within a year and patients rarely survive more than three years. The vaccine targets a mutation of a very common structure known as a receptor on the tumor cells, the epidermal growth factor receptor. This mutation is only found in cancer, not in normal tissues.
Read the entire article on CNBC.com
