Neuro-Oncology Nugget: Targeted Radiotherapy Using Rhenium-186 Nanoliposomes for Recurrent Glioma

0:00Welcome to Neurooncology, the podcast, where we bring you cutting-edge science, inspiring career journeys, and real-life stories within the world of brain tumor research and care. Hi and welcome to Neurooncology Nage. My name is Shahed Mohamed and I'm a PhD candidate at UT Health San Antonio. Today, I'm highlighting a recent phase 1 clinical trial, which explores a new targeted radiation strategy for recurrent glioma. We know that recurrence is one of the biggest challenges in gliobostoma. Even after-centered treatment, most tumors can still reoccur near the original site. While radiation is a key part of therapy, the dose delivered is limited because of the risk to the surrounding healthy brain tissue. So researchers are now exploring ways to deliver a more effective treatment directed to the tumor itself. This trial evaluated Brainium 186 Abyss Bimda or 186 R&L, which is a radioactive isotope

1:06packaged inside a nano-liposome. So instead of being given systemically, the therapy is delivered directly into the tumor using convection, enhanced delivery, or CED. CED uses a small catheter, placed into the tumor, and applies gentle pressure to distribute the therapy through brain tissue. This bypasses the blood-brain barrier and allows the drug to spread throughout the tumor region. In this multi-center phase 1 study, 21 patients with recurrent, high-grade glioma received escalating doses of 186 R&L, the delivery through one or more catheters. The treatment was well-treated with no dose limiting toxicities observed, and the maximum tolerated dose was not reached. And although this trial was primarily designed to evaluate the safety, then investigators also looked at early clinical signals. Across all patients, the median overall survival was about 11 months.

2:11But what was particularly interesting is that outcomes appear to depend on how much radiation actually reached a tumor. For example, patients whose tumors absorbed more than 100 gray had a median survival of 17 months, compared with about 6 months in those receiving lower doses. Overall this study highlights an important idea in neuro-oncology. Sometimes the key innovation isn't just the therapy itself, but how it's delivered. But by directly infusing a radiotherapeutic into the tumor and monitoring its distribution, this approach may allow clinicians to deliver higher, more targeted radiation doses than what's possible with conventional external beam radiation. These findings were published in Nature Communications. Thank you for listening to this neuro-oncology nugget. We hope you have enjoyed this episode of Neurooncology, the podcast.

3:11The views and opinions of the participants in this podcast do not necessarily reflect those of the Neurooncology family of journals or their affiliated societies. And finally, until next time, thanks for listening.