Editor's Note: 6/7/00: The following trial is closed now - we are awaiting published results!
BRAIN TUMOR PATIENTS OFFERED NEW HOPE
WITH EXPANDED TRIAL OF PROMISING THERAPY
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 Health Sciences Center and 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 http://www.bnct.bnl.gov 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.
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BNL Media & Communications
pubaf@bnl.gov
516-344-2345 * Fax 516-344-3368
Brookhaven National Laboratory
Bldg. 134 PO Box 5000
Upton NY 11973
www.bnl.gov
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