Fall 2010

Emerging Brain Tumor Treatments Save Lives, Offer Hope

Rosalie ReibelIn May 2006, when Rosalie Reibel was just 21 months old, she was diagnosed with a brain tumor at the base of her cerebellum. Following surgery, her parents opted to enter her in a clinical trial where radiation oncologists and pediatric oncologists aggressively treated any remaining tumor cells with radiation and chemotherapy. By the end of the treatment, no tumor was visible.

Then, in June 2008, the tumor recurred in Rosalie's spine. Once more, the Reibels chose an aggressive treatment to save Rosalie's life: reirradiation combined with chemotherapy.

Dr. Daphne Hass-Kogan"Reirradiation is a novel therapy that uses sophisticated computer-technology modeling to plan the treatment," says Rosalie's UCSF Radiation Oncologist Daphne Haas-Kogan, M.D. Known as intensity-modulated radiation therapy (IMRT), it's used when the tumor is too diffuse for surgery to be an option.

Two years later, the Reibels were overjoyed to hear that Rosalie's scan has remained completely clean. She began kindergarten this fall.

"I never knew if I would see this day," says Carolyn Reibel, Rosalie's mother.

Novel Treatments Excite Physicians, Patients
and Families

Rosalie's treatment is one example of the ways pediatric cancer treatment is advancing, largely due to ambitious translational research at places like UCSF Benioff Children's Hospital and its associated UCSF Pediatric Brain Tumor Institute.

Dr. Anuradha Banerjee"We are doing a lot of work with biological therapies, new drug delivery strategies, and combining radiation and chemotherapy in unique, new ways," says Pediatric Neuro-Oncologist Anuradha Banerjee, M.D.

Trials seeking to improve treatment outcomes and reduce long-term toxicities are open at UCSF for newly diagnosed patients. Other clinical trials are open for patients who have not responded or progressed after conventional treatment — or for those with brain tumors that have traditionally been resistant to any therapy at all. Some of the new approaches that physicians at UCSF use include:

  • Novel, molecularly targeted therapies for a wide range of pediatric tumors, including low- and high-grade gliomas, ependymomas and embryonal tumors such as medulloblastoma
  • A study of diffuse pontine glioma that uses biological markers observed in tumor tissue and obtained by biopsy at diagnosis to guide treatment decisions
  • Targeting radiation-resistant pathways with traditional and novel chemotherapy agents to clear the way for more effective radiation therapy
  • Gamma Knife and CyberKnife radiosurgery
  • Intraoperative radiation therapy (IORT) for neuroblastomas

Dr. Nallin GuptaNalin Gupta, M.D., Ph.D., directs the Pediatric Neurological Surgery program and is the principal investigator of the study of diffuse pontine glioma. He notes, "We want to move beyond current trial-and-error methodologies of using a drug and seeing if it works. Our hope is that the biology can drive the therapeutics — that we can stratify and, so, choose the best treatment."

For more information, contact Dr. Banerjee at (415) 476–3831, Dr. Gupta at (415) 353–2342 or Dr. Haas-Kogan at (415) 353–7175.

 

Fall 2010 Table of Contents

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