LONG BRANCH 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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Bobbi Seidel: (732) 643-4043 or bobbi@app.com
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