The prognosis for most patients with primary anaplastic CNS tumor, the
glioblastoma, is 8-12 months after diagnosis. The outlook is somewhat
better for less common tumors, such as anaplastic astrocytoma with a 38-50%
2-year survival, but most anaplastic CNS tumors are highly resistant to
currently available therapy. Occasional responses to chemotherapy are seen
in recurrent tumors, but these responses are generally of short duration,
and cures are rare. Median survival of patients with cancer metastatic to
the brain, when untreated, is approximately four weeks from the time of
diagnosis. Surgical and radiotherapeutic intervention increase survival,
although the outcome is still grim with median survival less than one year.
First recognized in 1870 neoplastic meningitis is now being seen with
increasing frequency, no doubt reflecting more effective therapy of
systemic cancer as well as heightened awareness nd improvement in
diagnosis. Current therapy of leptomeningeal disease is particularly
ineffective with external beam radiotherapy and intrathecal chemotherapy,
specifically methotrexate, thiotepa, or cytosine arabinoside only providing
modest benefits, with mean survival following leptomeningeal tumor spread
measured in months. Newer therapies are needed for treatment of patients
with neoplastic meningitis. The hypothesis of this proposal is that
regional therapy combined with systemic therapy of primary brain tumors,
metastatic brain tumors and neoplastic meningitis with radiolabeled
monoclonal antibodies (MAbs) or bifunctional alkylating agents can
substantially enhance therapy of these fulminant malignancies. The
specific aims of this proposal are 1) to define the toxicity and activity
of intrathecal radiolabelled MAb (murine and chimeric) 81C6, MAb fragment
Mel-14 (murine and chimeric), and new MAbs, in the treatment of patients
with neoplastic meningitis; 2) to define the toxicity and activity of
intracystic radiolabelled MAb (murine and chimeric) 81C6, and new MAbs, in
the treatment of patients with newly diagnosed or recurrent cystic gliomas;
3) to define the toxicity an activity of radiolabelled mAb (murine and
chimeric) 81C6, MAb fragment (murine and chimeric) Mel-14, and new MAbs
administered via a surgically created cystic resection cavity in the
treatment of patients with newly diagnosed or recurrent primary or
metastatic malignant brain tumors; 4) to define toxicity and activity of
intrathecal melphalan and other alkylating agents in the treatment of
patients with neoplastic meningitis; 5) to define the toxicity and activity
of arterial 4-hydroperoxycyclophosphamide, melphalan, and other alkylating
agents in the treatment of patients with newly diagnosied or recurrent
anaplastic gliomas; 6) to define the toxicity and activity of intrathecal
monoclonal antibody pseudomonas toxin conjugate B3-Lys PE38 in the
treatment of patients with neoplastic meningitis; and 7) to conduct in
years 3-5, Phase 2 and 3 studies combining systemic therapy reaching the
entire neuraxis with the most promising regional MAb/alkylator therapy
evaluated in Specific Aims 1-6.230
National Institute of Neurological Disorders and Stroke
CFDA Code
DUNS Number
044387793
UEI
TP7EK8DZV6N5
Project Start Date
01-March-1998
Project End Date
28-February-1999
Budget Start Date
01-October-1997
Budget End Date
30-September-1998
Project Funding Information for 1998
Total Funding
$192,500
Direct Costs
Indirect Costs
Year
Funding IC
FY Total Cost by IC
1998
National Institute of Neurological Disorders and Stroke
$192,500
Year
Funding IC
FY Total Cost by IC
Sub Projects
No Sub Projects information available for 2P50NS020023-15 0010
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