The idea: tiny radioactive fat particles, only 100 nanometers across, inserted by the thinnest of catheters directly into a tumor where they remain, radiating only a tiny distance, affecting only the tumor.
The target: glioblastoma, the deadliest of brain tumors.
On March 10, David Williams became the first human ever to have the new radiation treatment implanted in the center of his brain tumor.
The technology, developed by scientists from the UT Health Science Center’s Cancer Therapy & Research Center, uses radioactive liposomes, or fat particles, and inserts them into a tumor. There they remain, radiating a tiny distance and affecting only the tumor, causing less damage to surrounding healthy tissue.
Conventional radiation therapy, considered the best treatment option to date, has not changed much in 40 years. It also has limitations. It must send its beams through healthy tissue to reach the tumor, and so must be limited in the amount of radiation it delivers.
Days after the procedure, Williams reported feeling well and had not experienced adverse side effects.
“This technology is unique,” said Andrew Brenner, M.D., Ph.D., a neuro-oncologist who is leading the clinical trial. “Only we can load the liposomes to these very high radioactivity levels.”
David Williams was the first patient to receive a new radiation treatment implanted into the center of his brain tumor.
Doctors inserted radioactive liposomes, or fat particles, directly into the tumor (tan mass), using a tiny catheter (blue cylinder) inserted through a small hole drilled into the skull. The liposomes retain the radiation and keep it from spreading throughout the rest of the brain or blood stream, causing less damage to surrounding healthy tissue. The mass shown in teal was another tumor surgically removed.
The concept was developed by nuclear medicine physician William T. Phillips, M.D., and biochemist Beth A. Goins, Ph.D., in the Department of Radiology; and Ande Bao, Ph.D., a medical physicist and pharmaceutical chemist formerly in the Department of Otolaryngology.
One of the challenges was getting the highly radioactive nanoliposomes into the brain and directly into the tumor. Past chemotherapy treatments using catheters had limitations because of the catheter design, said neurosurgeon John R. Floyd II, M.D., who worked with Dr. Brenner to apply the first treatment to Williams at University Hospital.
“To effectively deliver this novel therapy and improve our surgical targeting, [we knew] we would need a better catheter. The one we are using is a new design, enabling us to deliver small quantities in precise locations. We are very pleased already with delivery in our first case.”
While not all brain tumors are malignant, the glioblastoma is especially deadly. Moreover, as the tumor advances, it affects the brain in unpredictable ways, often involving radical shifts in personality and behavior.
“It’s a terrible thing for a family to lose a loved one to glioblastoma,” Dr. Brenner said. “It’s tough to lose them to any cancer, but with the brain tumor you see them change right before your eyes.”
The nanotechnology is igniting hope that there will soon be a major step forward in treatment options for brain cancer, and there is potential that it also could be adapted for use in other cancers.