Researchers investigate treatment for tumor cells in spinal fluid

August 6, 2012

In two to five percent of women with breast cancer, tumor cells migrate into the spinal fluid invading the tissue surrounding the brain and spinal cord called the meninges. While a rare complication, the condition is challenging because there is no agreed-upon standard of treatment, leaving little hope for patients affected. Northwestern Medicine® researchers are currently examining a novel approach to delivering an FDA approved drug that they hope will advance research for this type of cancer and lead to discoveries that may improve outcomes in the future.

As part of the clinical trial, the drug Trastuzumab is directly injected into the in hopes of stopping the growth of the cancer cells in patients with HER-2 positive . Jeffrey Raizer, MD, co-director of the Northwestern Tumor Institute (NBTI), is the principal investigator for trial which he developed. NBTI is part of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital.

"When cancer spreads to the spinal fluid and tissues surrounding the brain, called leptomeningeal metastases (LM), there are very limited therapeutic options," said Raizer, who is also medical director of neuro-oncology at Northwestern Memorial and associate professor of neurology at Northwestern University Feinberg School of Medicine. "This rare condition typically occurs in later stages of cancer and often the benefits of treatment are small and may be counteracted by its side effects. For women with HER-2 positive breast cancer, they often have well-controlled disease in their body when this complication occurs."

Raizer explains that drugs cannot easily penetrate from the blood stream into the spinal fluid because of the blood brain barrier, making the condition difficult to treat. In this trial, the antibody will be delivered directly into the spinal fluid using a device that is placed under the scalp called an Ommaya reservoir. A small catheter is inserted into a fluid-filled space allowing fluid to be removed and for the drug to be instilled into it.

Women with HER-2 positive breast cancer that has spread to their spinal fluid are currently being enrolled in the clinical trial. HER-2 is a type of breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 and leads to an excess of HER-2 protein. This type of breast cancer tends to be more aggressive compared to other breast cancers. Trastuzumab is currently approved for intravenous administration for treatment of HER-2 positive breast cancers and has been shown to be effective in slowing growth of these cancer cells while decreasing the risk of recurrence. Researchers hope similar findings will be true for its use in the treatment of LM.

"We want to offer patients the best chance of recovery possible," said Raizer. "By injecting the drug directly into the brain and spinal fluid, we hope to be able to offer a better means of treating the cancer in the spinal fluid."

The trial will enroll up to 30 women at five sites around the country. Participants must be 18 years old and have HER-2 positive breast cancer that has spread to the spinal fluid. Participants will be assigned to one of four groups receiving dosages of the drug to test its safety and effectiveness and then the safe dose level will be expanded.

"Research trials like this are an important means of finding better treatments for conditions that currently have very few options," added Raizer

Explore further: Novel combined therapy extends life, diminishes pain in brain cancer patients

Related Stories

Novel combined therapy extends life, diminishes pain in brain cancer patients

July 14, 2011
Approximately five to ten percent of patients with primary or metastatic cancer suffer from devastating neurological complications such as headaches, seizures, confusion, difficulty swallowing and visual disturbances. These ...

Can topical skin gel shrink some breast cancer tumors?

June 24, 2011
Can a gel applied to the skin of a woman's breast provide the same cancer-fighting benefits as a pill taken by mouth but reduce the side effects of the medicine?

Can gel shrink some cancer tumors?

July 8, 2011
(Medical Xpress) -- Can a gel applied to the skin of a woman's breast provide the same cancer-fighting benefits as a pill taken by mouth but reduce the side effects of the medicine?

Trastuzumab and chemotherapy improved survival in HER2-postive breast and brain cancer patients

July 18, 2011
The use of trastuzumab, chemotherapy and surgery among women with HER2-positive metastatic breast cancer significantly improved survival from the time central nervous system metastases were diagnosed.

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.