Sunday, November 19, 2017
Health

Cells dripped into the brain help man fight a deadly cancer

RECOMMENDED READING


A man with deadly brain cancer that had spread to his spine saw his tumors shrink and, for a time, completely vanish after a novel treatment to help his immune system attack his disease — another first in this promising field.

The type of immunotherapy that 50-year-old Richard Grady received already has helped some people with blood cancers such as leukemia. But the way he was given it 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 was 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.

He had "a remarkable response" that opens the door to wider testing, said Dr. Behnam Badie, neurosurgery chief at City of Hope, a cancer center in Duarte, Calif., where Grady was treated.

The case is reported in this week's New England Journal of Medicine.

Each year in the United States, about 20,000 people are diagnosed with a type of brain tumor called glioblastoma. 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. City of Hope has been testing injecting the cells directly into the brain.

First, Grady had more 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 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.

"The idea was to have the flow of the spinal fluid carry the T cells to different locations," along the route the cancer had taken, Badie said.

After three 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 said.

New tumors, though, have now emerged in different spots in his brain and spine, and he is getting radiation treatment. But his response to immunotherapy lasted more than seven months, and "for him to live more than a year and half" after starting it is amazing for a situation where survival often is measured in weeks, Badie said.

Side effects of the treatment were manageable, including headaches, fatigue and muscle aches, and some may have been due to other medicines Grady needed, doctors reported.

It's early research, but it's an advance for the field "that they showed this is safe, at least in this patient," said Dr. Donald O'Rourke, a neurosurgeon heading a similar study at the University of Pennsylvania.

O'Rourke treated 10 brain tumor patients with CAR-T cells but used a single IV dose. A paper detailing results is in the works, but "it's pretty striking what we've found," he said.

At City of Hope, nine patients have been treated so far, but only three with infusions into the spinal fluid brain cavity. Two of the nine have not responded to treatment, Badie said.

His 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. Some authors get royalties from pending patents or money from Mustang Bio, which has licensed some of the technology.

Comments
New shingles vaccine touted as a breakthrough for older adults

New shingles vaccine touted as a breakthrough for older adults

Medical researchers and government health policymakers, a cautious lot, normally take pains to keep expectations modest when they’re discussing some new finding or treatment.They warn about studies’ limitations. They point out what isn’t known. They ...
Published: 11/17/17
In Tampa Bay and elsewhere, early numbers show record sign-ups for Obamacare

In Tampa Bay and elsewhere, early numbers show record sign-ups for Obamacare

Despite the budget cuts, the attempts to repeal and replace, and reports of sharp rises in premiums, Floridians and other Americans are signing up for health insurance under the Affordable Care Act at record rates this year.Enrollment has surged 47 p...
Published: 11/16/17
Updated: 11/17/17
Study: Mental quickness exercises can lower risk of dementia

Study: Mental quickness exercises can lower risk of dementia

Where did I leave my keys?As we age, it can take longer to answer a question like that.Humans begin to lose cognitive ability at age 25. Dementia, or the decline of memory most commonly seen in aging adults, takes hold early on and is gradual, but ac...
Published: 11/16/17
Blood pressure of 130 is the new ‘high,’ according to update of guidelines

Blood pressure of 130 is the new ‘high,’ according to update of guidelines

The nation’s heart experts tightened the guidelines for high blood pressure Monday, a change that will sharply increase the number of U.S. adults considered hypertensive in the hope that they, and their doctors, will address the deadly condition earl...
Published: 11/13/17
Are Honey Nut Cheerios healthy? A look inside the box

Are Honey Nut Cheerios healthy? A look inside the box

I had a bowl of Honey Nut Cheerios recently. It had been awhile. Regular Cheerios are more my thing. But sometimes I finish my box faster than my kids do and find myself straying to their side of the cupboard.Honey Nut is America’s best-selling break...
Published: 11/11/17
Owner of Bayfront Health St. Petersburg faces federal inquiry over funds for low-income patients

Owner of Bayfront Health St. Petersburg faces federal inquiry over funds for low-income patients

The corporate owner of Bayfront Health St. Petersburg could be facing a serious federal investigation related to its commitment to take care of St. Petersburg’s poorest residents.In its most recent filing with the U.S. Securities and Exchange Commiss...
Published: 11/09/17
Updated: 11/14/17
Learn to practice gratitude year-round, not just on Thanksgiving

Learn to practice gratitude year-round, not just on Thanksgiving

Is it part of your Thanksgiving tradition to go around the dinner table and have everyone share one thing they are thankful for? The exercise reminds us that the day is about more than just turkey and pie. And, for those who take it seriously, it for...
Published: 11/07/17
Updated: 11/10/17
When the goal is getting to the ER fast and cheap, some choose Uber over 911

When the goal is getting to the ER fast and cheap, some choose Uber over 911

Matt Lavin had just arrived in Charlottesville, Va., for a business trip when he started feeling sick. By the time he got to his hotel around 11 p.m., he felt excruciating pain. "I didn’t know what was happening, but I knew something wasnR...
Published: 11/06/17

Stunning study: Heart stents fail to ease chest pain

A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them, researchers reported Wednesday.Their study focused on the insertion of stents, tiny wire cages, to open blocked arteries. The dev...
Updated one month ago
Vigil calls attention to overdose victims, and brings hope

Vigil calls attention to overdose victims, and brings hope

NEW PORT RICHEY — The room was filling up fast. For Monica Rousseau, the sight of so many people searching for a seat at the annual Narcotics Overdose Prevention and Education candlelight vigil was both heartbreaking and uplifting. "I can’t even gues...
Updated one month ago