Fighting brain cancer with electricity
Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)
Posted on: 02/23/2007
Fighting brain cancer with electricity
Wednesday, February 14, 2007
By Joe Fahy, Pittsburgh Post-Gazette
Two days a week, Dennis Gibbons has his head shaved and four electrodes pasted to his scalp, part of an experimental treatment aimed at destroying the cancer cells in his brain.
||Tony Tye, Post-Gazette
Dennis Gibbons, 56, of Chartiers Township, Washington County, is being tested for whether a battery-operated device can slow the progression of glioblastoma multiforme, an aggressive form of brain cancer. Rachel Molinaro, a head clinician for NovoCure, attaches electrodes to his head at the company's office in Green Tree. The privately held company produces the device.
Click photo for larger image.
Mr. Gibbons, 56, of Chartiers Township in Washington County, has glioblastoma multiforme, an aggressive form of brain cancer that is often fatal within a few years of diagnosis. He is the nation's second person to use the battery-operated device as part of a large clinical trial.
The trial will test whether the device, the Novo-TTF, can slow the progression of the disease. The device delivers low-intensity, alternating electric fields to the tumor site through the scalp. The fields interfere with the alignment of certain electrically charged structures within cancer cells during the cell division process, according to NovoCure, the privately held company that produces the device.
While preliminary data suggest that tumor growth may be slowed by the electrical treatment, healthy cells are unaffected because they multiply at a much slower rate, if at all, company officials said.
Patients typically notice only a slight warming of the scalp during the treatment, said Mike Ambrogi, NovoCure's U.S. general manager.
"Cancer cells don't sleep. They're dividing all the time," Mr. Ambrogi said, noting patients are encouraged to wear the device as much as possible. Because good contact with the scalp is required, patients must have their heads shaved every few days and have a new set of electrodes applied.
The device was invented by Dr. Yoram Palti, an Israeli researcher who founded NovoCure.
Company officials believe the technology might eventually be used to treat other types of cancer.
"But we're starting with glioblastoma multiforme because it's a deadly disease that does not have a lot of options," Mr. Ambrogi said.
Glioblastoma multiforme "is the most aggressive primary brain tumor," said Dr. Lara Kunschner, Mr. Gibbons' physician and principal investigator for the local study at Allegheny General Hospital's Allegheny Singer Research Institute.
It is one of the most common malignant brain tumors in adults, though less common than cancers that have metastasized to the brain from elsewhere in the body.
Patients with glioblastoma multiforme usually have surgery to remove as much of the tumor as possible, followed by radiation, chemotherapy or a combination of both, Dr. Kunschner said. Overall, the median survival rate is about one year after diagnosis, she said, though younger people, those with few neurological impairments and those who have virtually all of the tumor surgically removed tend to live longer.
While a few patients survive for long periods, a majority die or have a recurrence of the cancer within two years, she said.
Dr. Kunschner said the device's effect on brain cancer cells appears similar to the effect caused in the laboratory by certain chemotherapy drugs such as Taxol. That drug, however, has not been very effective in brain cancer patients because of the blood-brain barrier, she said.
NovoCure officials note that two glioblastoma multiforme patients with recurrent disease had significant recoveries after participating in a 10-patient pilot study of the Novo-TTF in Europe. One has no tumor visible on an MRI scan and the other shows no progression of the cancer.
Overall, patients treated with the device in that study tended to have longer median survival rates than those treated with standard chemotherapy, company officials said. But they cautioned that the pilot study was too small to determine the device's effectiveness in treating the cancer.
The current study, a Phase III trial approved by the Food and Drug Administration, is being conducted at centers in the U.S. and in Europe. Plans call for enrolling more than 200 patients by late next year.
Adults whose cancers have progressed despite therapy and who meet other criteria are randomly assigned to receive treatment with the device or the best standard of care available. If assigned to the device group, they will be treated as long as their disease is stable or regressing.
Besides Allegheny General, other U.S. centers currently recruiting patients include the University of Illinois at Chicago, which treated the first U.S. patient with the device in the current study; Northwestern University; the New Jersey Neuroscience Institute; Memorial Sloan-Kettering Cancer Center; Columbia University Medical Center; the Cleveland Clinic; the University of Virginia Health System and the Medical College of Wisconsin.
The University of Pittsburgh Medical Center also plans to join the study soon along with a number of other centers.
Institutional review board approvals are being obtained and UPMC will likely begin enrolling patients in the next three to five weeks, said Dr. Frank Lieberman, director of adult neuro-oncology at UPMC Hillman Cancer Center.
Dr. Lieberman, a member of the medical team that treated the late Mayor Bob O'Connor for brain cancer, said the device probably wouldn't be effective in treating the primary central nervous system lymphoma that struck the mayor because that cancer tends to occur in more than one location.
"But for glioblastoma and other unifocal cancers, this could potentially be a very interesting new biotechnology," he said.
So far, Mr. Gibbons is the only study patient at Allegheny General using the device. Dr. Kunschner said it is too early to tell if it has had a positive effect.
Mr. Gibbons learned that he had brain cancer in 2004. He had been experiencing weakness on his right side and eventually had problems with memory and coordination.
An MRI indicated that he had a tumor about the size of a hen's egg in the left frontal lobe of his brain. He had surgery to remove it that July, followed by radiation and chemotherapy.
But he had been told that the cancer would likely recur, and a biopsy last August indicated that it had come back. Dr. Kunschner mentioned the NovoCure trial, and it seemed like a good alternative to Mr. Gibbons and his family.
"When you get to this point, you don't know what's going to work," said his wife, Leona. "And we knew chemotherapy had not been real productive."
She noted that only a small percentage of patients with the disease survive long after diagnosis.
"But maybe this new treatment will change things," she said. "We don't know, but we hope it does."
More information on the NovoCure trial is available at www.novocuretrial.com.
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