Targeting "The Terminator"

This MRI scan shows the inoperable glioblastoma multiforme.

A Long Island mechanical engineer is pinning his hopes on an experimental treatment for his inoperable brain tumor.

Early this year, Chris Amundsen, 37, started to notice neck pain and a slight vision loss in one eye, though he felt fine otherwise. In April, he had a seizure. Mr. Amundsen received an anti-seizure prescription — then suffered a brain hemorrhage a month later.

Further magnetic resonance imaging (MRI) and computed tomography (CT) scans at a Long Island hospital revealed a glioblastoma multiforme — a brain tumor dubbed “The Terminator” by The Proceedings of the National Academy of Sciences. Mr. Amundsen needed emergency surgery to stop the bleeding and partially resect the malignancy.

Not wanting to waste any time, he and his girlfriend, Laura, got married in the hospital chapel. That evening, her uncle recommended that the couple contact John Boockvar, MD, director of Lenox Hill Hospital’s Brain Tumor Center. They did, and Dr. Boockvar’s office arranged immediate transfer to Lenox Hill Hospital for Mr. Amundsen.

Dr. Boockvar and his Brain Tumor Board colleagues reviewed Mr. Amundsen’s case and determined that the tumor’s location made surgical removal unfeasible because it would cause him to lose the ability to speak. They recommended six weeks of radiation and chemotherapy to manage the tumor instead.

In addition, Dr. Boockvar confirmed Mr. Amundsen as a good candidate for a clinical trial to treat complex, rare brain tumors that require aggressive treatment. Dr. Boockvar is spearheading the trial, called “Super-Selective Intra-Arterial Cerebral Infusion of Temozolomide (Temodar) for Treatment of Newly Diagnosed Glioblastoma Multiforme and Anaplastic Astrocytoma.”

“The purpose of the study is to learn whether temozolomide, at a dose of 250mg/m2, given through the arteries instead of the veins, is safe when combined with chemoradiation in newly diagnosed patients with glioblastoma and anaplastic astrocytoma,” said Dr. Boockvar, principal investigator. “Another goal of the clinical trial is to determine if this treatment will help improve quality of life and extend survival.”

Rafael Ortiz, MD, Lenox Hill’s director of neuro-endovascular surgery and interventional neuroradiology, and David Langer, MD, the hospital’s chief of neurosurgery, performed the procedure. They navigated a catheter from Mr. Amundsen’s femoral artery to the arteries supplying blood to the tumor. Contrast dye helped to map the arteries on a rotational, 3D Xper CT scan. They delivered temozolomide directly into the glioblastoma, which investigators believe may result in better drug penetration with fewer side effects.

Mr. Amundsen was the last of 23 patients to participate in Phase 1 of the clinical trial. Dr. Boockvar and his team have already embarked on Phase 2, which will include a larger cohort.

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