Brain Tumor Patients Offered New Hope With Expanded Trial Of Promising Therapy

November 09, 1998

UPTON, NY - Brain tumor patients, including those whose cancer is inoperable or has regrown, may find new hope in an expanded clinical trial of a promising experimental therapy offered by the U.S. Department of Energy's Brookhaven National Laboratory.

BNL and its collaborating institutions are seeking 56 patients with the lethal type of brain cancer known as glioblastoma multiforme to participate in the new clinical trial begun recently.

Already, clinical trials at BNL have yielded preliminary results indicating that the enhanced-radiation treatment, called boron neutron capture therapy or BNCT, may give patients a better quality of life than conventional treatments do, while offering similar life expectancy and causing few side effects. And, BNCT's treatment time is much shorter than that of other therapies.

Since the start of its clinical trials in 1994, BNL has been the one of only three institutions in the world offering BNCT for brain tumors. The new trial will increase the radiation dose aimed at the tumor, and expand eligibility requirements for patients diagnosed with glioblastoma multiforme.

Among those now able to participate in the trial are patients whose tumor has begun to grow again, despite previous treatment with radiation or chemotherapy. Such patients often cannot tolerate other therapies aimed at killing the tumor, and most die within three months.

Patients whose tumors cannot be removed by surgery will also be eligible.

"With this trial, we're offering a new option to those who need it most, while continuing to improve BNCT and include more patients," said Jeffrey Coderre, leader of the BNL team.

BNL's partners in the trial are the State University of New York at Stony Brook's University Hospital and Medical Center, Beth Israel Medical Center in Manhattan, and the University of Tennessee at Knoxville. "Together, this network of physicians and researchers will give patients from New York and around the nation the choice of being treated with BNCT," said Coderre.

Prospective patients, their family members or their physicians should call 516-344-3684, or visit on the World Wide Web, for more information.

Enhanced Radiation To Kill Cancer Cells

BNCT is a two-part therapy that enhances the effect of radiation on cancer cells while minimizing the effect on nearby healthy cells.

So far, BNL has treated 41 patients diagnosed with glioblastoma multiforme, which strikes more than 7,000 Americans each year. The disease is usually treated with surgery, followed by conventional radiation alone or in combination with chemotherapy.

For glioblastoma patients, as well as other cancer victims, damage to non-cancerous tissue is a major side effect of conventional radiation therapies.

Conventional radiation therapy also requires as many as 30 sessions of treatment, an inconvenience for many patients - especially those with a fatal diagnosis. And both radiation and chemotherapy result in many side effects, including hair loss and crippling nausea.

Even after conventional treatment, spidery extensions of the main tumor can evade destruction, surviving and growing again, and eventually killing the patient.

BNCT is designed to avoid many of these pitfalls. It uses radiation from the Brookhaven Medical Research Reactor and a drug containing the element boron called BPA for borono-phenylalanine. The drug is injected into the patient intravenously and travels through the bloodstream, concentrating preferentially in tumor tissue.

By itself BPA is harmless, but when exposed to a beam of neutrons from the reactor, the boron atoms "capture" neutrons, creating secondary effects that kill cells in the immediate vicinity. The surrounding healthy brain tissue is left relatively unharmed. The treatment can be delivered in a single session and causes virtually no side effects.

While BNL's clinical trial has focused on brain tumors, BNCT may eventually work for many other kinds of cancer. Research is now under way at Brookhaven and elsewhere to expand the range of diagnoses on which BNCT could be used.

Expanded Entry Requirements

BNCT's unique strategy has shown promise in destroying tumor tissue from within. But the experimental nature of the therapy has required carefully selected conditions for the trial.

Until now, all BNCT patients have first had to undergo surgery to remove the bulk of their tumors, and the strict requirements for tumor size, depth and placement have limited the number of patients participating. Relatively low doses of radiation have been used.

The new trial will allow more patients to participate and will increase the radiation dose. One group of patients will receive a one-time escalated dose, while another will receive a lesser dose in two "fractions" spread over two days.

A third group will be able to receive BNCT without having had surgery. This will allow BNL to treat patients whose tumors are too close to crucial brain centers to be removed. This group may include more patients over the age of 65, who often elect to forego surgery. BNL's BNCT trials have already shown that patients over 65 experience a somewhat increased life expectancy than with conventional treatments.

The fourth group will include those who have already had BNCT or conventional therapy once, but whose tumor has begun to regrow from tumor cells left behind by the previous treatment. The time since last treatment must be at least six months.

To be accepted into the BNL trial, patients must have a confirmed diagnosis of glioblastoma multiforme and must be over 18.
The U.S. Department of Energy's Brookhaven National Laboratory creates and operates major facilities available to university, industrial and government personnel for basic and applied research in the physical, biomedical and environmental sciences, and in selected energy technologies. The Laboratory is operated by Brookhaven Science Associates, a not-for -profit research management company, under contract with the U.S. Department of Energy.

DOE/Brookhaven National Laboratory

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to