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Delivering Chemo Directly Into Brain Tumors Shows Promise
Date:5/4/2009

no tumor visible, microscopic glioma cells usually remain that eventually regrow, Fisher said.

Sen. Edward Kennedy (D-Mass.) is currently battling a malignant glioma.

Topotecan is sold by GlaxoSmithKline and is typically used in lung cancer patients, Bruce said.

In the lab, the drug had been shown to be effective in killing malignant glioma cells, but delivering enough of it through the bloodstream to attack brain tumors would cause too many toxic side effects.

So for four days, using a procedure called convection-enhanced delivery, Topotecan was pumped into tumors in 16 patients through two catheters. The pumping was done very slowly, at a rate of several drops an hour, Bruce said.

Side effects included upper extremity weakness and left parietal syndrome, neurological issues caused by damage to the brain.

The patients had two types of tumors: 10 had a glioblastoma multiforme (GBM), an invasive and fast-growing tumor, while six had anaplastic glioma.

"Topotecan by convection-enhanced delivery has significant anti-tumor effects at doses that are not harmful to normal brain tissue," Bruce said. "These promising preliminary results indicate that this treatment provides a survival advantage that is favorable compared to other treatments that are often used for recurrent malignant gliomas."

The next step will be multi-center Phase 2 clinical trial, which will begin in the next two to three months, Bruce said.

Fisher said the results were encouraging, but the study was limited in that it involved only a small number of patients and two different types of tumors.

"The technology is to be applauded," Fisher said. "We need to be trying new approaches and trying to do things in a different way. Just giving chemotherapy by an IV or radiation is not going to advance the field."

A second study that will also be presented at the conference also explored an alternative
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