Brain cancer affects an estimated 30 out of every 100,000 Americans. The debilitating disease currently has no cure but can often be managed by treatments such as radiation therapy, chemotherapy and surgery. However, these treatments aren’t always as effective as they could be due to one major obstacle: the blood-brain barrier.
This is a system of specialized brain microvascular endothelial cells (BMVEC) that provides brain tissues with nutrients, filters out harmful substances from the brain to one’s bloodstream, and prevents toxic substances from entering the brain. While the blood-brain barrier undoubtedly serves a critical role, it often makes cancer treatments less effective by preventing medicine in the blood from reaching brain tumors.
As it stands, finding ways to get past the blood-brain barrier and the blood-tumor barrier could make brain cancer treatments a lot more effective.
Neurosurgeons from New York Presbyterian and Columbia University are now working to develop an implantable pump through which chemotherapy drugs can be delivered directly into a patient’s brain via an inserted tube. In a recent study that put the implanted pump to the test, neurosurgeons found that the implantable approach has the potential to kill brain tumor cells effectively with little risk to the patient.
The phase 1 clinical trial involved five patients who had been diagnosed with recurrent glioblastoma. Jeffery Bruce, senior author, neurosurgeon and Edgar M. Housepian Professor of Neurological Surgery Research at Columbia University Vagelos College of Physicians and Surgeons, said the new treatment approach could potentially improve outcomes for patients having brain cancer.
Such patients often have poor health outcomes as brain tumors are heavily protected from chemo drugs by the blood-brain barrier. Once doctors have surgically removed as much of the tumor as possible, the patient will usually undergo radiation as well as chemotherapy. But since the brain only allows little doses of the medicine to actually reach the tumors, chemo is rarely effective at completely eradicating brain tumors.
Higher doses of chemotherapy usually result in side effects that are too serious to bear, and consequently, patients are often given a minimal dose that is essentially ineffective. The surgically reduced tumors will grow back inevitably, Bruce said, and treating them once they have regrown is almost impossible.
Conditions such as glioblastoma have such poor outcomes that the median survival time for patients that go through treatment is approximately a year.
With this new treatment approach, however, physicians will be able to bypass one’s blood-brain barrier in order to reach the brain directly, significantly increasing the level of chemotherapy drugs that reach the tumor. Bruce noted that more research on patients with early-stage tumors and different kinds of chemotherapy is needed before the new implantable pump for cancer treatment can be deployed to the public.
As more treatment options come from for-profit entities such as CNS Pharmaceuticals Inc. (NASDAQ: CNSP) and knowledge about how to bypass the roadblocks that have made brain cancers hard to treat, patients may have better prospects of surviving and even thriving after a cancer diagnosis.
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