London – A new medical breakthrough occurred when U.S. surgeons managed for the first time ever to cure a man with deadly brain cancer that had spread to his spine.
The doctors noticed the tumors shrink and, for a time, completely vanish after a novel treatment to help his immune system attack his disease.
Richard Grady, 50, underwent an immunotherapy which is usually used to help some people with blood cancers such as leukemia.
The way the treatment was administered is new, and may allow its use not just for brain tumors but also other cancers that can spread, such as breast and lung.
Grady, thus, became the first person to get the treatment dripped through a tube into a space in the brain where spinal fluid is made, sending it down the path the cancer traveled to his spine.
Dr. Behnam Badie, neurosurgery chief at City of Hope, a cancer center in Duarte, California, where Grady was treated, said that the patient had “a remarkable response” that opens the door to wider testing.
The case is reported in the New England Journal of Medicine.
Each year, about 20,000 people are diagnosed with a type of brain tumor called glioblastoma in the United States and undergo to radio and chemo therapy, but their tumors don’t vanish.
Grady, who lives in Seattle, had the usual surgery, radiation and chemotherapy, but the cancer came back. He enrolled in a clinical trial at City of Hope and had some of his own blood cells, called T cells, removed and genetically modified in the lab to turn them into specialized soldiers to seek and destroy cancer.
The treatment, called CAR-T cell therapy, has been used for blood cancers, but its value for solid tumors is unknown.
Doctors at City of Hope have been testing injecting the cells directly into the brain.
Initially, Grady had a surgery to remove three of his largest tumors. Then he got six weekly infusions of the cells through a tube into his brain, where the biggest one had been. No cancer recurred there, but the remaining tumors continued to grow, new ones appeared, and cancer spread to his spine.
Doctors then decided on a bold step: placing a second tube in his brain, into a cavity where spinal fluid is made, and putting the cells there.
Badie said: “The idea was to have the flow of the spinal fluid carry the T cells to different locations.”
After three courses of treatments, all tumors had shrunk dramatically. After the 10th treatment, “we saw all the tumors disappear,” and Grady was able to cut back on other medicines and return to work, Badie added.
Another issue occurred when new tumors now emerged in different spots in his brain and spine, and he is getting radiation treatment. His immunotherapy lasted more than seven months, and he lived for more than a year and half after starting the treatment is amazing for a situation where survival often is measured in weeks.
The side effects of the treatment included headaches, fatigue and muscle aches, and some may have been due to other medicines Grady needed, doctors reported.
Associated Press reported Dr. Donald O’Rourke, a neurosurgeon heading a similar study at the University of Pennsylvania saying it’s an early research, but it’s an advance for the field and this is safe for this patient.
O’Rourke treated 10 brain tumor patients with CAR-T cells.
Nine other patients have been treated so far at City of Hope, but only three with infusions into the spinal fluid brain cavity. Two of the nine have not responded to treatment.
The study is supported by the nonprofit Gateway for Cancer Research, the Food and Drug Administration, the California Institute for Regenerative Medicine and the National Institutes of Health.