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A Promising Approach for Pontine Gilomas

New York (Oct 20, 2010)

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Mark M. Souweidane, MD

Diffuse pontine gliomas make up just 10 to 15 percent of pediatric brain tumors. But their progress is swift, and they are uniformly fatal. NewYork-Presbyterian Hospital/Weill Cornell Medical Center investigators are now assessing an innovative means of delivering radioimmunotherapy to these difficult-to-treat inoperable brain-stem tumors, which most commonly strike children between the ages of 6 and 10.

"Among parents and physicians, there is a lot of desperation, a lot of anticipation, and a lot of hope with regard to these tumors," said Mark M. Souweidane, MD, who is leading the research. Dr. Souweidane is Professor of Neurological Surgery at Weill Cornell Medical College, Vice Chairman of the Department of Neurological Surgery, and Director of Pediatric Neurosurgery.

Children with diffuse pontine gliomas may appear otherwise quite healthy except for the symptoms associated with the tumor - including altered eye movements and facial expressions, headaches, vomiting, and fatigue. "Their hearts are healthy, their kidneys are healthy. There's nothing short of this one-and-a-half to two-inch tumor in the brain stem that we need to cure, which is very frustrating," noted Dr. Souweidane.

The tumor remains localized in the brain stem, eventually interfering with such vital functions as heart rate, respiration, swallowing, and clearing of the throat. Surgery and chemotherapy are ineffective. The standard of care is temporizing external beam radiation therapy. But even with this approach, all patients recur, and the median survival time is only 9 to 12 months.

Children with diffuse pontine gliomas may appear otherwise quite healthy except for the symptoms associated with the tumor - including altered eye movements and facial expressions, headaches, vomiting, and fatigue.

"Their hearts are healthy, their kidneys are healthy. There's nothing short of this one-and-a-half to two-inch tumor in the brain stem that we need to cure, which is very frustrating," noted Dr. Souweidane. The tumor remains localized in the brain stem, eventually interfering with such vital functions as heart rate, respiration, swallowing, and clearing of the throat.

Surgery and chemotherapy are ineffective. The standard of care is temporizing external beam radiation therapy. But even with this approach, all patients recur, and the median survival time is only 9 to 12 months.

In collaboration with investigators at other institutions, Dr. Souweidane and his colleagues sampled pontine glioma tissue from patients to identify receptors for a monoclonal antibody called 8H9, which is very adept at distinguishing between tumor cells and normal brain cells. The researchers attached the antibody to radioactive iodine (124I) and validated its safety and tissue perfusion in animal studies.

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