Avastin ®, a drug that starves cancer cells, is usually administered intravenously when a GBM tumor recurs. However, the Westchester Brain Tumor Program expects it can increase the drug’s effectiveness by applying it directly to the tumor site right after the recurrent tumor is removed. This is the first time this protocol has been used anywhere.
“With intravenous drug delivery, there’s no certainty that the drug actually penetrates remnant pieces of tumor that cannot be surgically removed because they are intertwined with the patient’s brain tissue,” explains John M. Abrahams, M.D., a neurosurgeon and principal of the Westchester Brain Tumor Program and Brain & Spine Surgeons of New York , as well as the founder of the Westchester Neuroscience Research Foundation . “Applying Avastin directly on the tumor site is a logical step, and if we can successfully treat the tumor with a targeted topical application, we may reduce the time to recurrence and improve outcome in patients with this disease.”
Starving the tumor
Here’s how Avastin works. GBM tumors depend on numerous abnormal blood vessels to fuel their rapid growth. Avastin halts production of new blood vessels, thereby starving the tumor. “We think that with Avastin, new blood vessels cannot grow and therefore the tumor will be less likely to recur,” Dr. Abrahams notes, adding that patients also receive routine chemotherapy after surgery.
If this new protocol works, it will be welcomed news to the 17,000 Americans diagnosed with GBM every year. The disease claims the lives of 90 percent of patients within the first year after diagnosis. Only 5 percent of patients survive beyond two years.
At this time, Avastin – whether it is administrated intravenously or topically -- is used to treat only patients whose GBM tumors have returned. However, Dr. Abrahams explains that if topical Avastin is proven to safely slow the progression of recurrent tumors, the Westchester Brain Tumor Program will use this protocol to treat tumors when they first appear.
Other new treatments
The Westchester Brain Tumor Program is at the forefront in the fight against glioblastoma and is the first program in the Hudson Valley to be conducting the two important clinical trials described below:
1. HSPPC-96 Vaccine
The HSPPC-96 brain tumor-specific vaccine is individually prepared from a patient’s own tumor. The vaccine, containing autologous tumor-derived peptides in complex with the heat shock protein gp96, is injected under the skin with the aim of stimulating the body’s immune system to attack cancer cells.
Data from the Phase 2 trial in recurrent GBM demonstrated a median overall survival of 47.6 weeks as compared to the historical control of 26 weeks.) Importantly, Agenus Inc reports that HSPPC-96 appears to be very tolerated.
The current is being conducted in patients with newly diagnosed GBM whereby HSPPC-96 is being used in combination with temozolomide following standard treatment with radiation therapy and chemotherapy. The formal name and title of the study is Protocol C-100-37: PHASE 2, multi-center, single arm investigation of HSPPC-96 vaccine with temolozomide in patients with newly diagnosed GBM. The Westchester Brain Tumor Program clinical trial is sponsored by Andrew T. Parsa, M.D., Ph.D., from the University of California, San Francisco. The vaccine, HSPPC-96, is provided by the developer, Agenus Inc.
2. DCVax®-L vaccine
The patient-specific DCVax®-L vaccine is manufactured from a patient’s own white blood cells, which are exposed to cells from the patient’s tumor so they “learn” to recognize brain cancer cells. When re-injected under the patient’s skin, the vaccine’s white blood cells “teach” the immune system to recognize brain cancer cells. A supply of up to three years of the vaccine is manufactured, and it is used in conjunction with radiation therapy and chemotherapy. In early trials, the vaccine has extended the median survival time by two-and-a-half times (14.6 months to 35-36 months).
The study is officially called a Phase II Clinical Trial Evaluating DCVax®-L, Autologous Dendritic Cells Pulsed With Tumor Lysate Antigen For The Treatment Of Glioblastoma Multiforme (GBM) . Northwest Biotherapeutics is the trial sponsor.
The Westchester Brain Tumor Program also conducts basic research. At present, Dr. Abrahams is researching the use of hydrogel materials as a topical agent to be used after surgical resection to assist in destroying residual tumor cells, which can lead to a reoccurrence of the tumor. This project involves a biocompatible hydrogel that targets the tumor-brain interface and works on destroying the malignant tumor cells after the wound is closed. The hydrogel delivers a chemotherapy agent to do the work; the hydrogel keeps the chemotherapy in the proper location.
The public is invited to find out more about The Westchester Brain Tumor Program by contacting Jan Strack, R.N., the Westchester Brain Tumor Program Coordinator, by calling (914) 948-3008 or by emailing her at email@example.com . Further information is available at www.bssny.com/
About Brain & Spine Surgeons of New York.
Brain & Spine Surgeons of New York is the oldest and largest neurosurgery private practice group in Westchester County and one of the largest in the New York metropolitan area. With seven board-certified neurosurgeons and one orthopedic spine surgeon, BSSNY is a leader in brain and spinal surgery in the New York metropolitan area. For more information, the public is invited to visit www.bssny.com or call 914-948-6688.
About the Westchester Brain Tumor Program
The Westchester Brain Tumor Program is a professional collaboration between the Westchester Neuroscience Foundation and the Cancer Center at Northern Westchester Hospital. It encompasses leading professionals in the areas of neurosurgery, neuro-oncology, and radiation oncology, combining their expertise to devise an individual treatment program for each patient.
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