Laser Ablation Makes Headway in Brain Cancer

Laser Ablation in Brain Cancer

Clark C. Chen, PhD

Neurosurgeons at UC San Diego Health are making headway in a study of minimally invasive laser treatment of brain tumors focused on improving quality of life for patients who have been diagnosed with glioblastoma.

“Oncology studies have a tendency to focus on survival benefits alone. This study, however, focuses on quality of life,” said lead investigator, Clark C. Chen, PhD, vice-chair research and academic development in the Division of Neurosurgery at UC San Diego School of Medicine.²“This national study will measure the long-term effects of laser treatment in patients with brain tumors.”

The study, called Laser Ablation of Abnormal Neurological Tissue using Robotic NeuroBlate System (LAANTERN), is shedding light on long-term outcomes for patients with glioblastoma undergoing laser interstitial thermal therapy. LAATERN has enrolled approximately 1000 patients and is expected to be completed by September 2020, with an estimated primary completion date of June 2020.³

The FDA-approved laser device used in the study, The NeuroBlate System, is a multifaceted system composed of hardware, software, and disposable surgical devices used within an already existing MRI scanner.

The system provides a real-time image of a patient’s brain, in order to better assist surgeons. The NeuroBlate System is produced and funded by Monteris Medical¹and was approved by the FDA in April 2013.

The procedure, according to Chen, requires an incision as small as 5 mm. A laser probe is then inserted through the skull, directly into the tumor.

“Patients with brain tumors located at the surface or deep in the brain are typically not considered candidates for surgery because of the extensive amount of healthy brain tissue that can be damaged during an operation. As a result, the overall survival and quality of life for these patients is suboptimal,” said Chen.²

The technique employed by Chen uses a pinpointed laser to attack and minimalize brain tumor tissue while leaving healthy tissue intact. This method is an up-and-coming breakthrough for patients previously deemed inoperable because of the location of their tumor.

In order to deliver the best results, UC San Diego Health has a specifically designed operating room equipped with an MRI machine and a dedicated intra-operative MRI team. The role of the team is to help guide neurosurgeons in placing the laser in a specific location of a brain tumor with real-time MRI monitoring. With this advanced imaging technology, the operating team can make better clinical decisions faster with more visual information minimizing loss of healthy tissue and maximizing efficiency of tumor destruction.

“We are proud to be the only neurosurgery facility in the region with the capacity to support this advanced form of minimally invasive neurosurgery,” said Bob S. Carter, MD, PhD, chairman of the Department of Neurosurgery at UC San Diego Health.

Along with minimal incision and targeted ablation of tumor tissue, patient recovery was also faster. Patients enrolled in LAANTERN were discharged the following day after their procedure and were able to resume their normal, day-to-day activities.

“As a truly minimally invasive surgery, I anticipate that the quality of life of the laser-treated patients to be significantly improved relative to conventional surgeries where large incisions are made and significant portions of skull are removed,” said Chen.

Chen added that although the preliminary results of the study are promising, it is important to carefully monitor all new technologies and discoveries until the completion of the study, should they become vital to the study or treatment paradigm.

“Through the integration of next-generation imaging technologies, we can help patients who would otherwise be untreatable,” he said.

Chen said he is actively seeking industry leaders and others to help develop advanced technologies that may aid in the treatment of brain cancer.

References

1. Monteris.com. The NeuroBlate® System |Monteris Medical. 2016. http://www.monteris.com/our-technology/neuroblate-system/. Accessed January 16, 2016.
2. Carr J. Neurosurgeons evaluate precision laser treatment of brain tumors at UC San Diego Health.UC Health - UC San Diego. 2016. http://health.ucsd.edu/news/releases/Pages/2016-01-13-precision-laser-treatment-for-brain-tumors.aspx. Accessed January 16, 2016.
3. Clinicaltrials.gov. Laser ablation of abnormal neurological tissue using robotic NeuroBlate System. 2016. https://clinicaltrials.gov/ct2/show/NCT02392078. Accessed January 16, 2016.