BTW 2016

Dr Slavc talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview she discusses the use of intrathecal cytarabine to treat children with brain tumours such as medulloblastoma. Intrathecal cytarabine has been used for decades to treat patients with acute myeloid leukaemia who have occult or overt central nervous system (CNS) involvement. A liposomal formulation was developed in the 1980s with the aim of providing sustained release and which makes it particularly suitable for use as an intrathecal therapy.

Dr Pearl talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview she discusses her work on intra-arterial chemotherapy for central nervous system tumours. Dr Pearl explains that her research largely focuses on diffuse intrinsic pontine gliomas (DIPG), which is not amenable to surgical resection. Getting drugs across the blood-brain barrier to treat this paediatric brain tumour remains a challenge and one approach Dr Pearl and colleagues are investigating is intra-arterial administration. They have started a pilot study in children with recurrent DIPG and so far two of a planned five children have been recruited. So far they have seen that intra-arterial administration is technically feasible and appears well tolerated.

Prof Gill talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview he discusses early clinical experience of intermittently delivering carboplatin directly to paediatric brainstem tumours using a novel implantable neurosurgical device. The device consists of four very fine catheters that are implanted deep within the brain using a dedicated robotic technique. Chemotherapeutic drugs can then be injected directly into the site the tumour via a technique called convection enhanced delivery (CED). The device was originally developed for delivering a protein therapy to adults with Parkinson’s disease and is now being tested in children with diffuse intrinsic pontine glioma (DIPG), a tumour that is not amenable to surgical resection.

Dr Slavc talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview she discusses the use of metronomic anti-angiogenic therapy in patients with relapsed brain tumours. Together with colleagues in Boston and several other European centres, Dr Slav is conducting a trial in children and young adolescents who have relapsed medulloblastoma. These patients have a very poor prognosis even when treated with conventional chemotherapy, high-dose chemotherapy with stem cell rescue, irradiation or combinations of all these approaches. The novel treatment regimen being tested in the trial consists of biweekly intravenous bevacizumab in combination with five oral drugs (thalidomide, celecoxib, fenofibrate, and alternating cycles of daily low-dose oral etoposide and cyclophosphamide). This is augmented with alternating courses of intrathecal etoposide and liposomal cytarabine.

Dr Green talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. He discusses the research being conducted in his lab at The Johns Hopkins University School of Medicine that is using bioengineering approaches to develop novel nanotherapeutics.

Dr Rahman talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. He discusses the development of a biodegradable polymer paste after surgical removal of high-grade gliomas to deliver therapeutic nanoparticles directly around the site of excision. Preliminary data are promising and show that several standard and investigational therapeutic agents can be delivered using the novel technology.

Dr Brem talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. He discusses how improved drug delivery systems have started to improve the therapeutic options for patients with brain tumours. Dr Brem discusses preclinical data on novel technologies including microchips and nanoparticles and how these relate to the clinical situation and how they could play an important role in the treatment of paediatric brain tumours.

Dr Warren talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview she discusses her research at the National Cancer Institute. This includes using improved drug delivery methods to find an effective local treatment for diffuse intrinsic pontine glioma (DIPG) and improved models of preclinical testing.

Prof Greenwood talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. He talks about the role of the blood-brain barrier (BBB) in protecting the brain and how it can be affected by disease such as brain tumours. Prof Greenwood notes that the BBB is now increasingly considered to be part of a larger structure called the neurovascular unit, which incorporates other brain cells.

Dr Brem talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. He discusses the use of interstitial drug delivery systems to target brain tumours. Dr Brem highlights how the combination of chemotherapy wafer implants, radiation therapy and oral temozolomide have already helped increase the survival of patients with glioma substantially from 9 to 21 months. The use of immunotherapies such as checkpoint inhibitors with local delivery of chemotherapy is potentially very promising.

Dr Beccaria talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview he discusses how local delivery of pulsed ultrasound could help optimise drug delivery across the blood-brain barrier (BBB). Dr Beccaria notes there have been many preclinical studies showing that the technology works and that the first clinical trial assessing BBB disruption with an implantable ultrasound device is now underway in adults with glioblastoma.

Mr Macarthur talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. He discusses his experience of intrathecal administration of chemotherapy to target brain tumours in children. Getting treatment across the blood-brain barrier is one of the challenges when treating childhood brain cancers, he observes, and injecting chemotherapy into the cerebral spinal fluid is one possible way around this. Although not a first-line approach, it is potentially suitable for brain tumours that have metastasised, with medulloblastomas and ependymoma the most common tumour types treated so far in Nottingham.

Prof Walker talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview he discusses the use of intrathecal therapy in children with medulloblastoma. In particular he discusses the findings of a literature review looking at the range of drugs that may be suitable for intrathecal administration. The analysis found 126 candidate drugs of which only 12 were selected as eligible for further clinical investigation at this point. A further 15 were thought probably for further pre-clinical investigation.

Dr Van Vuurden talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview he discusses convection-enhanced delivery (CED) of drugs to brain tumours in children. CED is a relatively new technology that requires very fine and small catheters to be implanted in the brain that can then be used to delivery chemo- or other therapeutic agents. This method of drug delivery is particularly of interest for treating children with diffuse intrinstic pointine glioma (DIPG) who currently have few treatment options and could potentially benefit from local chemotherapy in the brainstem.

Dr Van Vuurden talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview he discusses how nanotechnologies may be used to help deliver therapeutic drugs directly into the brainstem of children suffering from diffuse intrinsic pontine glioma (DIPG). Due to its location DIPG is a particularly difficult paediatric tumour to treat and there are few options available. Several approaches are being investigated that could have a big impact on the disease in the future. One of these is delivering very small gas microbubbles that vibrate when focal ultrasound is applied to open up the blood-brain barrier enough so that a therapeutic agent could enter the brain.

Dr Van Vuurden talks to ecancertv at Children with Cancer UK’s workshop on Drug Delivery in Paediatric Brain Tumours in London, UK. In the interview he discusses how molecular drug imaging can be used to guide drug therapy for childhood brain cancers. Specifically, he talks about the use of molecular drug imaging to help deliver drugs to the brainstem of children with diffuse intrinsic pontine glioma (DIPG) and paediatric high-grade glioma (pHGG).