Columbia University Medical Center Phase I NIH-Funded Study of Chemotherapy Drug Topotecan; Drug Delivered Directly to Brain Tumor, Bypassing Blood-Brain Barrier
Feb 25, 2005
As part of an ongoing Phase I NIH-funded study, brain tumor patients at NewYork-Presbyterian Hospital/Columbia are being treated with a novel chemotherapy treatment, in which the drug topotecan is administered directly into the brain tumor through catheters. Traditional intravenous chemotherapy cannot treat brain tumors due to limitations caused by the blood-brain barrier, which prevents drugs from entering the brain. NewYork-Presbyterian Hospital and Columbia University Medical Center is the only medical center worldwide where this topotecan treatment is available.
The study hopes to show that the treatment called convection-enhanced delivery is safe and effective, slows tumor growth, improves quality of life, and lengthens survival for patients with malignant and recurrent gliomas the most common type of tumor that originates in the brain.
Seven patients so far have received topotecan, some have experienced side effects, which have been expected and very manageable, says Dr. Jeffrey Bruce, professor of neurological surgery at Columbia University College of Physicians and Surgeons and attending neurosurgeon at NewYork-Presbyterian/Columbia. The drug has previously been shown to reduce tumor size in animal and other laboratory studies.
With convection-enhanced delivery, developed in the mid-1990s by NIH researchers, a slow steady flow of chemotherapy builds up pressure in the brain, pushing the drug into the tumor and surrounding brain tissue. This allows for higher drug concentrations and better distribution of the drug into the brain.
Brain tumors that develop from brain tissue are rare, arising in 15,000 to 20,000 people in the U.S. every year, but they are extremely aggressive. According to Dr. Bruce, radiation and surgery may control the initial mass, but the cancer comes back in nearly 100 percent of cases. Patients typically survive one to three years after diagnosis.
Other NewYork-Presbyterian/Columbia and Columbia University Medical Center physicians involved in the study include Drs. Guy McKhann, Michael Sisti, Casilda Balmaceda, Robert Fine, Joanne Loughlin, Charles Hesdorffer, Peter Canoll, Stephen Sands, Robert DeLaPaz, and Truman Brown.
Topotecan is manufactured by GlaxoSmithKline, of Conshohocken, Pennsylvania, and is sold under the trade name Hycamtin®.
Study participants must have a single, recurrent malignant glioma tumor under 100 cc in size located in the cerebral cortex and have already undergone standard surgical or radiological treatment. For more information, patients may contact Joanne Loughlin at 212-305-1282.
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