The inability to achieve sufficient intratumoral concentrations of chemotherapeutic drugs in is one of the primary causes of treatment failure in patients with glioblastoma. We have shown in a Phase 1 clinical trial that a topoisomerase inhibitor, topotecan, can be safely and effectively delivered by convection enhanced delivery into patients with recurrent malignant gliomas as a means of overcoming systemic delivery limitations. In this proposal, we will improve this treatment strategy by validating an innovative method for non-invasive monitoring of drug distribution and expanding the duration of infusion by innovating the use of an implantable microinfusion pump. At the conclusion of these studies, the expected outcome will be a novel, measureable strategy to treat patients with recurrent glioblastoma via an implantable pump that can chronically deliver high doses of topotecan into the tumor and surrounding brain to avoid the limitations imposed by conventional systemic delivery. On a broader level, we will have demonstrated, for the first time in humans, the ability to chronically achieve a local-regional distribution of a drug directly into the brain parenchyma.

Public Health Relevance

Chemotherapy for brain tumors is ineffective because excessive side effects limit how much drug can be delivered into the brain. In our proposal we describe and critically test an innovative implantable catheter and pump system for delivering chemotherapy directly into the tumor for over extended time periods to avoid the side effects associated with standard oral or intravenous delivery.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA161404-03
Application #
8727272
Study Section
Developmental Therapeutics Study Section (DT)
Program Officer
Timmer, William C
Project Start
2012-07-01
Project End
2018-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
3
Fiscal Year
2014
Total Cost
$576,100
Indirect Cost
$207,916
Name
Columbia University
Department
Neurosurgery
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Mehta, A M; Sonabend, A M; Bruce, J N (2017) Convection-Enhanced Delivery. Neurotherapeutics 14:358-371
Sims, Jennifer S; Ung, Timothy H; Neira, Justin A et al. (2015) Biomarkers for glioma immunotherapy: the next generation. J Neurooncol 123:359-72
Chow, Daniel S; Ha, Richard; Filippi, Christopher G (2015) Increased rates of authorship in radiology publications: a bibliometric analysis of 142,576 articles published worldwide by radiologists between 1991 and 2012. AJR Am J Roentgenol 204:W52-7
Surapaneni, Krishna; Kennedy, Benjamin C; Yanagihara, Ted K et al. (2015) Early Cerebral Blood Volume Changes Predict Progression After Convection-Enhanced Delivery of Topotecan for Recurrent Malignant Glioma. World Neurosurg 84:163-72
Miloushev, V Z; Chow, D S; Filippi, C G (2015) Meta-analysis of diffusion metrics for the prediction of tumor grade in gliomas. AJNR Am J Neuroradiol 36:302-8
Sonabend, Adam M; Carminucci, Arthur S; Amendolara, Benjamin et al. (2014) Convection-enhanced delivery of etoposide is effective against murine proneural glioblastoma. Neuro Oncol 16:1210-9
Chow, D S; Qi, J; Guo, X et al. (2014) Semiautomated volumetric measurement on postcontrast MR imaging for analysis of recurrent and residual disease in glioblastoma multiforme. AJNR Am J Neuroradiol 35:498-503
Oberg, Jennifer A; Dave, Amie N; Bruce, Jeffrey N et al. (2014) Neurocognitive functioning and quality of life in patients with recurrent malignant gliomas treated on a phase Ib trial evaluating topotecan by convection-enhanced delivery. Neurooncol Pract 1:94-100
Bruce, Jeffrey N; Fine, Robert L; Canoll, Peter et al. (2011) Regression of recurrent malignant gliomas with convection-enhanced delivery of topotecan. Neurosurgery 69:1272-9; discussion 1279-80