The Story of Rick Miller and his Glioblastoma
While waiting for the videoconference next Wednesday at 7:00 pm, in which Ted will tell us his story, I found it interesting to tell the story of Rick, one of the first persons to try phonodynamic therapy.
Rick Miller is a man from Maryland, a craftsman who builds boats. He feels bad, goes to the emergency room and soon the diagnosis arrives: glioblastoma. The social worker suggests hime that “he fix his business because he won’t have long to live”.
This was three years ago. But things are done differently. Rick, 65, is not only alive but there is no sign of cancer and is returning to his boat maintenance business.
His doctors cannot say that he is cured, nor guarantee that the cancer will not return, or even credit the treatment he received during the clinical trial. But Rick and most of the 14 people who participated in the initial study are alive.
The clinical study Rick participated in used focused ultrasound to allow chemotherapy to penetrate the blood brain barrier.
The method used on Miller, focused ultrasound, is one of the promising research paths. Rick was following the STUPP protocol when he entered the Phase 1 clinical trial. Phase 1 clinical trials are intended to evaluate safety and show if a therapy works. Rick had already received surgery to remove the late-stage tumor from the right side of the brain in 2019.
At the Baltimore hospital, neurosurgeon Dr. Graeme F. Woodworth and medical staff secured Miller’s head with a blocking helmet. They gave him an MRI and injected an agent into his arm. Then they used ultrasound, which is high-frequency sound waves, to guide the tiny particles in the agent towards the precise site and shape of the tumor. The vibration of the bubbles stimulated by ultrasound creates a temporary opening of the blood brain barrier. The barrier serves to protect the brain from toxins, but it also blocks therapies.
Opening the barrier takes a few hours, long enough for Rick to go home and follow the oncologists’ instructions for taking the chemotherapy. Rick repeated the therapy monthly.
Dr. Woodworth has not yet presented the results in a scientific journal, but is seeking funding for Phase 2 trials to gain approval from the U.S. Food and Drug Administration for a broad use of the therapy. He is also working on whether there are more effective or targeted drugs for individuals and their specific glioblastomas. In fact, the ideal would be to use phonodynamic therapy in combination with personalized or precision medicine.
Phonodynamic therapy is a growing area of research, with more than a dozen companies having invested nearly $ 400 million last year to improve this technology according to the Focused Ultrasound Foundation.
The absence of Rick’s tumor was confirmed by several MRI scans repeated at regular intervals by Dr. Mark Mishra, director of radiation oncology clinical research at the University of Maryland. Rick hasn’t had any relapses but, he has maintained his quality of life and is returning to go out and do the things he mainly did before glioblastoma.
This is a beautiful story of hope and is also a chance to remember the importance of scientific research and clinical trials. However, the question that arises spontaneously is whether the therapy is also available in our country, and where, or at least if clinical trials are active. So I searched on the clinical trials database and the following studies are active, both at the Besta Neurological Institute in Milan, the following links provide direct references:
- Exablate Blood-Brain Barrier Disruption With Carboplatin for the Treatment of rGBM
- Assessment of Safety and Feasibility of ExAblate Blood-Brain Barrier (BBB) Disruption in GBM Patients
That’s all for today, I recommend and I wait for you at next week’s videoconference.