 |
 |
Dr. Theodore Schwartz (view slideshow of the surgery) |
|
| |
|
 |
|
Dr. John Boockvar |
|
|
Patients with a GBM tumor survive, on average, only nine to 12 months after diagnosis, and those with an AA tumor fare only slightly better, with a life expectancy of three to four years.
What makes these tumors particularly difficult to treat is that surgeons cannot remove every tiny cancerous cell in the brain, and chemotherapy, typically the post-surgery treatment to kill remaining cancer cells, is only partially effective since the brain is separated from the bloodstream by the blood-brain barrier*.
In their clinical trials, Drs. Schwartz and Boockvar both surgically remove the tumor, but after this, their approach differs. Dr. Boockvar uses Tarceva, a drug in pill form designed to slip through the blood-brain barrier, while Dr. Schwartz uses TP-38, a drug in liquid form that he infuses into the brain through catheters.
Tarceva is a "small molecule" drug. Its structure is diminutive enough to slip between endothelial cells and clever enough to stick to the surface of cancer cells. Tarceva prevents proteins on the cells’ surface known as epidermal growth factor from binding with growth factors or proteins in the blood and setting off a chemical process that allows the cells to multiply. The cancer cells are first kept from multiplying and then eventually destroyed by the drug.
 |
|
A tablet of Tarceva, the medication used in Dr. Boockvar's study. |
|
|
|
Several days after the tumor is removed, Dr. Schwartz performs a second surgery. He drills tiny holes in the skull for access and, using a computer-imaging system for guidance, gently slides catheters into the brain, positioning them so their outflow encircles the tumor site. Pumps attached to the catheters then infuse medication continuously over a period of several days. During that time, the patient needs to stay in the hospital but can walk around or engage in other light activity.
*What is the blood-brain barrier?
In most parts of the body, capillaries are lined with a loose collection of endothelial cells that allow substances to pass in and out of the bloodstream. However, in the brain, endothelial cells are packed so closely together that most substances cannot pass through. This protects the brain from infection, but it also prevents medication, such as chemotherapy, from reaching its target.Patients interested in the trials, please contact (866) NYP-NEWS.
About the doctors:
Dr. Theodore Schwartz is director of the Center for Epilepsy Surgery, Brain Tumors, Minimally-Invasive Skull Base and Pituitary Surgery, and an associate professor of neurological surgery at Weill Cornell Medcial College. He is also an associate attending neurological surgeon at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.Dr. John Boockvar is director of the Neurosurgical Laboratory for Translational Stem Cell Research, and the Alvina and Willis Murphy Assistant Professor of Neurological Surgery at Weill Cornell Medical College. He is also an assistant neurological surgeon at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
