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Researchers See Potential in Rapid Gene Sequencing, Direct Treatment During Brain Surgery

September 6, 2018

The passing of U.S. Sen. John McCain underscores brain cancer’s formidable medical challenges, one of which is the blood-brain barrier: Many medicines that enter the bloodstream can’t reach the brain.

Brain surgery, however, provides direct access to a tumor site, and craniotomy could someday become an occasion for drug-based treatment, according to a news release from Brigham & Women’s Hospital. Researchers say they are designing a new, rapid molecular diagnostic and sustained release therapeutic that could be deployed during brain surgery to treat gliomas and prevent their return. The approach could also reduce toxic side effects of treatments delivered by traditional routes.

Surgery presents a treatment opportunity

“When a patient is in the operating room, there’s an ideal opportunity to deliver therapy,” co-senior author Giovanni Traverso, MB, BChir, PhD, principal investigator and a physician-scientist at BWH, said in the news release. “But to provide the best possible therapy, we need to understand what genetic mutations we can target in that person’s tumor. We’re trying to develop a molecular diagnostic that can work fast enough to give us that information while the patient is on the operating table.”

The work – by a team consisting of researchers from Brigham and Women’s Hospital (BWH) and neurosurgeons from Massachusetts General Hospital (MGH), along with colleagues at MIT – is described in the Proceedings of the National Academy of the Sciences.

Beyond tumor removal

“The first and perhaps most important step in treatment of brain tumors is the initial operation, or craniotomy, which obtains tissue to make the diagnosis, and, for lower grade lesions, provides a therapeutic benefit from removal of the tumor mass,” said co-senior author Daniel Cahill, MD, PhD, associate professor of neurosurgery at MGH. “Prior studies from our group, and others, have shown that aggressive surgery provides a substantial survival benefit for patients with lower-grade gliomas. We sought to build upon this surgical scenario, attempting to further prolong survival for these patients.”

New test and treatment

Specifically, the team has developed a rapid genetic test that on previously collected tumor samples identified key mutations in less than a half an hour. The team has also developed a “sustained release microparticle drug delivery system that can provide localized treatment and sustained protection.” The team tested the system in a mouse model and reported significant improvements in survival time.

As is often the case, banked tissue samples provided a foundation for an important discovery that could someday add precious time to a patient’s life. To make this work possible, it’s critical that patients consent to sharing samples, clinicians gather them as they work, and biorepositories share them with researchers like the team in this case.

Brain tumor tissue is one of the many types of biospecimens available through the iSpecimen Marketplace, dedicated to better specimen sharing – and longer, healthier lives. Access to the Marketplace is free. Sign in, and immediately see how it works.

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