Focused Ultrasound to Open the Blood-Brain Barrier in Recurrent Glioblastoma (Podcast)

Glioblastoma is notorious for being therapeutically elusive. One key challenge is getting chemotherapies past the blood-brain barrier to target glioblastoma’s highly infiltrative tumors.

“Some of the drugs that work very well against cancers outside the brain just can’t get into the brain,” says Glen Stevens, DO, PhD, Section Head of Adult Neuro-Oncology at Cleveland Clinic. “We realized we needed to look at ways to allow us to deliver chemotherapies into the brain.”

A leading candidate is the use of low-intensity focused ultrasound (LIFU) to open the blood-brain barrier for this purpose. That application of LIFU is the focus of a newly completed phase 1 study that Dr. Stevens is helping to lead — and also the focus of the latest episode of Cleveland Clinic’s Cancer Advances podcast, which features Dr. Stevens as its guest expert.

In the podcast, Dr. Stevens explores the following:

• The essentials of glioblastoma and why it is so difficult to treat
• How LIFU works and the rationale for its use to disrupt the blood-brain barrier
• The phase 1 trial studying LIFU to enable delivery of carboplatin to the brains of adults with recurrent glioblastoma
• Next steps in the research of LIFU for glioblastoma therapy

Click the podcast player above to listen to the 29-minute episode now, or read on for a short edited excerpt.

Excerpt from the episode

Dr. Stevens: We are going to be starting a new trial in glioblastoma patients where we will be using something called 5-ALA, or 5-aminolevulinic acid. It’s a drug that’s used in neurosurgery to light up glioblastoma — it’s taken into the tumor and you can fluoresce it so you can see where it is. You can use photodynamic therapy to affect the oxygenation and kill cells; it’s used in dermatology.

There is some preliminary data looking at using it with sonication, taking this 5-ALA and then, through sonication, using it to kill glioblastoma cells. We have just gotten IRB approval and hope to put our first patient in the trial very soon.