BRAIN CANCER ADVANCE
Each year, about 170,000 people will have a tumor in the brain that has spread from another part of the body, and about 15,000 Americans are diagnosed with a primary brain tumor. The deadliest type -- a grade-four glioma -- has a life expectancy of less than a year. Now, one doctor's lifelong pursuit of finding a better treatment could extend life expectancy and offer hope to patients who need it most.
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Richard and June share more than lunch these days. They're also sharing one of life's toughest tests.
Richard Belding
Has brain cancer
"After 51 years, it's just, I cannot imagine her not being there, so that's why this trial is so hard on her."
That trial is brain cancer. Richard was recently diagnosed with the most aggressive type there is.
Richard Belding
"That was a real shock and took some getting used to it."
They sought help and found it in a man who's been called a hero of medicine -- Doctor Keith Black.
Keith L. Black, M.D.
Neurosurgeon
Cedars-Sinai Medical Center
Los Angeles, CA
"I've been trying to search for an effective treatment for brain tumors my entire medical career."
His latest research focuses on special immune cells -- dendritic cells. They're used to stimulate powerful t-cells using tissue from the patient's own tumor.
Keith L. Black, M.D.
"These T-cells will then divide into millions and millions of T-cells that will then invade back into the brain tumor to try to destroy it."
The vaccine is now delivered directly into the tumor to make it more effective. Richard was the first patient to receive it.
Keith L. Black, M.D.
"He's really a patient where we would expect a tumor to behave very, very aggressively, and it looks to be stabilizing."
The vaccine is even more effective when used with chemotherapy. Early research suggests that combination boosts 5-year survival from 5 to 40 percent. Richard doesn't know if he'll make it five years, but he's hopeful.
Richard Belding
"I'd like to live a few more years, but being 73, I know it's inevitable. Who wants to live forever, anyway? But, I just don't want to go now."
Researchers need part of the tumor tissue to make the vaccine, so the tissue needs to be saved when the tumor is surgically removed. If a person has already had their tumor removed, the vaccine may still be used, but not until the cancer recurs. Most high-grade gliomas do recur after the first surgery.
BACKGROUND: Each year, about 170,000 people will have a tumor in the brain that has spread from another part of the body and about 15,000 Americans are diagnosed with a primary brain tumor. The deadliest type -- a grade-four glioma -- has a life expectancy of less than a year. According to the National Brain Tumor Foundation, some of the most common symptoms of a brain tumor are headaches (headaches that wake you up in the morning), seizures in a person who does not have a history of seizures, cognitive or personality changes, eye weakness, nausea or vomiting, speech disturbances, or memory loss.
TREATING TUMORS: Surgery is the chief form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. Because a tumor will recur if any tumor cells are left behind, the surgeon's goal is to remove the entire tumor whenever possible. Radiation therapy and chemotherapy, in general, are used as secondary or adjuvant treatment for tumors that cannot be cured by surgery alone.
A VACCINE FOR THE BRAIN: Keith Black, M.D., of Cedars-Sinai Medical Center has been studying brain tumors for about 18 years. Dr. Black says brain tumors try to hide proteins on the tumor cell surface that the immune system could use to recognize the tumor. By hiding these cells, brain tumors become difficult to eradicate. The first step of Dr. Black's research strips these "hidden" proteins from tumor cells and then cultures them from a piece of a patient's tumor that's removed with surgery. Next, come special immune cells called dendritic cells. Dendritic cells make up a very small percentage of the white blood cells, but they are the most efficient cells for presenting foreign proteins to the immune system. After isolating the dendritic cells, Dr. Black says, "We essentially have developed a technique to put these proteins [that the tumor tries to 'hide'] directly on these [dendritic cells] and allow these cells to present these back to the proteins to the immune system by giving these cells back under the skin just as a shot, like a vaccine." The killer immune cells then recognize them and divide into millions of powerful T-cells. He says, "Now, when they see the tumor with this protein on the surface, they will try to attack it and kill the tumor cell."
MOVING FORWARD: Dr. Black's newest endeavor is to inject the vaccine directly into the tumor of patients whose cancer has recurred. In the first patient vaccinated this way, the tumor appears to be at least stabilizing. Dr. Black says, "Certainly, it's a much more efficient way of using the vaccine. Ultimately, we hope that we will be able to eliminate the need for surgery altogether by combining this strategy with non-invasive strategies of destroying the tumor ... and just putting these cells right into the tumor to allow the tumor to be eradicated."
Cedars-Sinai Physician Referral Line
(800) CEDARS-1
www.cedars-sinai.edu
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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