Reprinted with permission,
Courtesy, Asbury Park Press, a Gannett Co. newspaper.
BY BOBBI SEIDEL
ASBURY PARK PRESS STAFF WRITER |
, - An
experimental treatment in use at Monmouth Medical Center — one
of only two sites in the nation that have been studying the
therapy for more than a year — has prolonged the life
of a Manalapan man diagnosed with a deadly brain tumor and
is creating hope for other brain tumor patients.
"The response of malignant brain tumors in the last 50 years
to chemotherapy has been very marginal. We used to say, "Nothing
works for a brain tumor.' Now we can say something works," says
Dr. Sumul N. Raval, study leader. "This research is very, very
exciting."
The treatment combines two drugs normally used only for other
types of cancer. A year of receiving the treatment has tremendously
reduced the brain tumor of Jack Steinberg, 45, of Manalapan,
says Raval, medical director of the David S. Zocchi Brain Tumor
Center at the Leon Hess Cancer Center at Monmouth Medical.
"I feel positive," says Jack Steinberg's wife, Cheryl, 45, who
spoke for the couple while her husband continues recuperating.
"This is not a cure," Raval says. "So far, it is experimental
because both drugs are not FDA-approved for brain tumors. But
this is a major step. This is going to open up the doors to new
treatments.
"All of my patients have responded after the first two cycles
of treatment, although not everyone has responded like Jack Steinberg," Raval
says. "This is not anecdotal reports. We have this response (to
the treatment) continually.
"With more people using it and more literature on it, it will
become a new standard of care," Raval says, adding, "I want people
to know they can get help."
Steinberg is one of 15 patients in Raval's study. The other
study is at Duke University in North Carolina.
"This is a great advance that will help a lot of people," says
Dr. Allan Tunkel, chairman of internal medicine at Monmouth Medical
of Raval's work. "I think in his role as a neuro-oncologist — one
of the few in New Jersey and in the country — what he's
doing is amazing."
Jack Steinberg's treatment began in August 2005, after it was
discovered he had a rapidly growing malignant brain tumor — a
gioblastoma multiforme, or GBM. This is the most common malignant
brain tumor, Raval says.
"The prognosis for him was extremely limited," says Raval, a
board-certified neurologist and neuro-oncologist affiliated with
Monmouth Medical Center for about a year. He previously was at
Jersey Shore University Medical Center, Neptune.
The treatment combines Irinotecan, a chemotherapy, and bevacizumab,
a monoclonal antibody that blocks receptors that allow blood
vessels to grow in the tumor.
"Chemotherapy destroys the rapidly developing cancer cells in
the body," says Raval, 37. "Bevacizumab prevents new blood vessels
from forming.
"When you have a brain tumor, lots of new blood vessels form,
carrying lots of oxygen and nutrition to the tumor cells. The
cells, without nutrition, die," he says.
Until now, Irinotecan was used for lung cancer and bevacizumab
for colon or rectal cancer.
"When I started using this combination, there was only a small
abstract published in The Journal for Neurology in May 2005," Raval
says. "Duke decided to do a small study. We also decided to
do a study. We did not have information about Duke's study at
that time."
Steinberg's case is an example of what the new treatment can
do.
In April 2005, Steinberg had undergone surgery in Manhattan
to remove an initial tumor, which was diagnosed after he experienced
dizziness, blurred vision, headaches and personality changes.
In July 2005, he had a very small tumor remaining, Raval says.
"In August, he grew a massive amount of tumor. That's when we
put him on the combination," Raval says.
Treatments were given that August and September, and an MRI
was done in mid-September.
"I could not believe my eyes," Raval says of what the MRI showed. "I
checked everything 10 times before I broke the news to the family.
There was very little of the tumor left. More than 95 percent
of the tumor had responded, like it had melted away.
"This was an unreal response for a rapidly progressing brain
tumor."
Jack Steinberg remains in remission, Raval says. While recuperating,
Steinberg has taken a leave from the auto-parts business he operates
with his brother.
Raval's data on the study will be published in the Nov. 16-19
issue of The Journal of Neuro-Oncology.
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