Microcatheters, mannitol break through BBB

The New York Times has a fascinating feature on a patient's last-ditch attempt to rid himself of glioblastoma, the same kind of brain tumor that killed Sen. Edward Kennedy. The report tells the story of Dennis Sugrue, but it is also about some innovative drug delivery technology that manages to make it past that difficult, frustrating blood-brain barrier.

Dr. John Boockvar, a brain surgeon at New York-Presbyterian/Weill Cornell is performing the study in which Sugrue took part. Doctors first inject mannitol, which temporarily opens the blood-brain barrier, and then flood the tumor area with Avastin, which blocks the growth of new blood vessels.

Instead of dripping Avastin into a vein, as is the normal practice, Boockvar slammed the cancer with a higher dose using microcatheters threaded through blood vessels to the tumor site. A report on the first 30 patients was released last month in the Journal of Neurosurgery. "We've lost about 15, or half the patients. The rest are alive and kicking," Boockvar tells the NYT.

- read the NYT feature
- and the abstract from the Journal of Neurosurgery