FOR RELEASE JUNE 15, 1998
To learn more about BNL's BNCT trials, visit http://www.bnct.bnl.gov
UPTON, NY - A promising brain tumor therapy now in clinical trials at the U.S. Department of Energy's Brookhaven National Laboratory will have added cancer-treatment potential, thanks to a $1.4 million award to improve the facility used to deliver the therapy.
The upgrade is being funded by DOE's Office of Energy Research.
Once the improvements are made at BNL's Medical Research Reactor, physicians will be able to deliver seven times more intense radiation directly to patients' tumors than can currently be delivered, while sparing the healthy brain tissue surrounding the tumors.
The design, construction and installation of the innovative neutron-shutter system that will make this possible is expected to be completed within 18 months to two years.
"Many cancer patients want to see the Laboratory deliver on the promise of this treatment. This funding will enable continued progress in exploring this important therapy. I'm glad the Department of Energy was able to provide these funds and congratulate the Brookhaven scientists on their achievements so far," said Secretary of Energy Federico Peña.
"Even with the small number of patients treated to date, we see indications that this treatment, boron neutron capture therapy, can give brain tumor patients a comparable or somewhat longer life expectancy, and a better quality of life, than they would have had with conventional treatments," said Dr. Arjun Chanana, leader of the BNL team.
"Now," he continued, "we look forward to exploring the potential benefits of this therapy for deeper and larger brain tumors, and for tumors in other organs."
Boron neutron capture therapy, or BNCT, is a two-part therapy that enhances the effect of radiation on cancer cells while minimizing the effect on nearby healthy cells.
Inadvertant damage to non-cancerous tissue is a major side effect of conventional radiation therapies, especially in the treatment of brain tumors. Conventional radiation therapy also requires several bouts of treatment, an inconvenience for many patients.
BNCT avoids these pitfalls by using radiation from BNL's medical reactor and a drug containing the element boron. Called BPA for boronophenylalanine, the drug is injected into the patient and travels through the bloodstream, concentrating preferentially in tumor tissue.
By itself BPA is harmless, but when exposed to a beam of neutrons from the reactor, the boron atoms "capture" neutrons, creating secondary effects that kill cells in the immediate vicinity.
Clinical trials of BNCT have been under way at BNL since 1994. Other locations in the U.S. are conducting related research. Preliminary research results from the first 10 patients in the BNL study have already been published in peer-reviewed medical journals.
So far, BNL has treated 38 patients diagnosed with a lethal form of brain cancer known as glioblastoma multiforme, which strikes more than 7,000 Americans each year. The disease is usually treated with conventional radiation alone or in combination with chemotherapy, approaches that require multiple treatments and result in many side effects, including hair loss and nausea.
The therapy is now being tested under a Phase I/II dose-escalation protocol approved by the U.S. Food and Drug Administration to determine the best doses of radiation and boron compound to use. The majority of the patients treated with BNCT at BNL to date have received relatively low doses of radiation. In the current trial, the radiation doses are being increased step-by-step as soon as the safety of a given dose is reasonably assured.
To be accepted into this trial, patients must have a confirmed diagnosis of glioblastoma multiforme, must be over 18 and must never have had radiation or chemotherapy. Additional criteria, such as the depth and size of the tumor, are also considered. BNCT is given only after the patient has undergone surgery to remove the bulk of the tumor.
The clinical trials are carried out in conjunction with the State University of New York at Stony Brook's Health Sciences Center and Beth Israel Medical Center in New York.
BNL's Medical Research Reactor was built in 1959 for the first clinical trials of BNCT, which were not successful. But the facility, specifically designed for medical use, was used for several decades in non-clinical research on the therapy as well as other scientific work. It is similar in size and power to reactors found at universities around the world.
When clinical trials of BNCT were ready to began again, the reactor was improved using new technology to produce a better beam of neutron radiation that could penetrate to the tumor without giving a significant radiation dose to healthy tissue.
BNCT requires neutrons of a certain low range of energies which can reach tumors after passing through the skull. The new improvements will go even further toward increasing the amount of neutrons with desirable energies; increasing neutron density sevenfold; and producing fewer unwanted beam contaminants, such as neutrons that are too energetic.