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Mayfield Neurosurgeon Is First in Eastern U.S. to Offer Targeted GammaTile™ Therapy for Recurrent Brain Tumors

August 22nd, 2019 Cindy Starr, MSJ
Mayfield Neurosurgeon Is First in Eastern U.S. to Offer Targeted GammaTile™ Therapy for Recurrent Brain Tumors
Image of GammaTile Credit: GT Medical Technologies, Inc.

Vincent DiNapoli, MD, Ph.D., a neurosurgeon with Mayfield Brain & Spine and Director of the Brain Tumor Center at The Jewish Hospital-Mercy Health, is the first surgeon in the eastern United States to offer GammaTile Therapy for the treatment of recurrent glioblastoma multiforme (GBM) brain cancer. Dr. DiNapoli performed the first case with GammaTile on August 13.

GammaTile Therapy is a surgically targeted radiation therapy designed to delay brain tumor recurrence. It consists of a 3-D-collagen tile embedded with a cesium radiation source. GammaTile is placed in the tumor cavity at the time of surgery so that it immediately begins to target residual tumor cells with radiation while limiting the impact on healthy brain tissue.

Dr. DiNapoli is using the therapy in place of implantable radioactive seeds the size of grains of rice.

"Previously, we embedded individual seeds into the brain and glued them in place," Dr. DiNapoli said. "Despite our best efforts, they had the potential to migrate to another part of the brain. With GammaTile, the radiation is embedded into a wafer that is similar to a surgical sponge. This eliminates the worry that individual seeds will migrate from their original placement, and helps protect healthy brain tissue from radiation."

Implanting tiles that contain four seeds rather than placing seeds one by one also cuts down on the length of the surgery and, consequently, the length of time the patient is under anesthesia. "The process is very quick," Dr. DiNapoli said. "It can be done in less than 5 minutes."

Placement of GammaTile into tumor cavity Credit: Jake Andreadis, Surgical One

The Brain Tumor Center at The Jewish Hospital—Mercy Health is anchored by Mayfield neurosurgeons and the oncology specialists of OHC (Oncology Hematology Care).

"The Brain Tumor Center offers hope to patients and their families who are facing the diagnosis of a brain tumor," said Pat Davis-Hagens, President of The Jewish Hospital. "The center provides comprehensive and compassionate state-of-the-art care for residents of the Greater Cincinnati-Northern Kentucky region and beyond, attracting patients from across the country and serving as an important referral destination for Bon Secours Mercy Health patients."

GammaTile, manufactured by Tempe, Arizona-based GT MedTech, has been cleared by the FDA for treatment of recurrent brain tumors, including glioblastomas, gliomas, meningiomas, and brain metastases. Glioblastoma, the most aggressive type of glioma tumor, tends to be resistant to current treatments and has a high likelihood of recurrence. Outcomes for patients with glioblastoma, including the late Senator Ted Kennedy and Senator John McCain, have improved very little over the past 30 years.

"For years, doctors have sought better treatment options for patients with recurrent brain tumors," said Elizabeth Levick, MD, radiation oncologist with OHC (Oncology Hematology Care). Even after successful surgery and standards treatments, many brain tumors can return, and patients often feel as though they are starting over from square one. Now, we have a strong opportunity with GammaTile to treat recurrent brain tumors. It's another advancement in OHC's fight against cancer, and it's an honor and a privilege to be a member of the team introducing this technology to our region."

Patients who undergo surgery for newly diagnosed glioblastoma are also treated with 1) external beam radiation delivered over a period of weeks via a linear accelerator machine and 2) temozolomide (Temodar) chemotherapy.

Mayfield Neurosurgeon Is First in Eastern U.S. to Offer Targeted GammaTile™ Therapy for Recurrent Brain Tumors
Mayfield neurosurgeons Vincent DiNapoli, MD, PhD, left, and Yair Gozal, MD, PhD, during surgery for recurrent glioblastoma. Credit: Jake Andreadis, Surgical One

If the cancer recurs and patients undergo surgery a second time, they may benefit from GammaTile Therapy, which requires no additional trips to the hospital or clinic. Patients may also benefit from GammaTile if they are not candidates for radiosurgery at the time of tumor recurrence because the risk of additional radiation outweighs the potential benefits.

GammaTile therapy, like newer radiation seed implants, uses cesium-131 radiation, which has a half-life of 10 days. Previous iterations of radiation seeds utilized iodine-125, which had a half-life of 60 days. Cesium's shorter half-life means that patients and families are exposed to radiation for a much shorter period of time.

GammaTile is also FDA-cleared as a therapy for recurrent meningioma. Data supporting the efficacy and safety profile of the therapy for patients with recurrent, previously treated meningiomas was published in the Journal of Neurosurgery, the official journal of the American Association of Neurological Surgeons. Clinical data from other types of tumors was presented at the AANS Annual Scientific Meeting in April 2019.

"We are honored to be working with the brain tumor specialists at Mayfield Brain & Spine to deploy GammaTile Therapy for the purpose of improving the lives of patients with brain tumors," said Matt Likens, President and CEO of GT MedTech. "We are excited to begin expanding the availability of GammaTile Therapy to other leading brain tumor treatment centers across the United States."

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Mayfield Neurosurgeon Is First in Eastern U.S. to Offer Targeted GammaTile™ Therapy for Recurrent Brain Tumors
Vincent DiNapoli, MD, PhD Credit: The Jewish Hospital - Mercy Health

Mayfield Brain & Spine is the full-service patient care provider of the Mayfield Clinic, one of the nation's leading physician organizations for neurosurgical treatment, education, and research. With more than 20 specialists in neurosurgery, interventional neuroradiology, physical medicine and rehabilitation, pain management, and physical therapy, Mayfield Brain & Spine treats 25,000 patients from 30 states in a typical year. Mayfield physicians specialize in the treatment of back and neck pain, sciatica, Parkinson's disease, essential tremor, NPH, epilepsy, brain and spinal tumors, stroke, moyamoya, brain aneurysms, Chiari malformation, scoliosis, kyphosis, facial pain, facial twitch, trauma, concussion, spinal cord injury, and carpal tunnel syndrome. As leading innovators in their field, Mayfield physicians have pioneered surgical procedures and instrumentation that have revolutionized the medical art of neurosurgery for spinal diseases and disorders, brain tumors, and neurovascular diseases and disorders.

Mercy Health—Cincinnati is part of Bon Secours Mercy Health (BSMHealth.org), one of the top 20 health systems in the United States, one of the largest employers in Ohio and part of the top performing quartile of Catholic health systems for lowest cost per case for patient care. Mercy Health—Cincinnati makes advanced, compassionate, quality health care easy to help you be well in mind, body and spirit. Mercy Health—Cincinnati has been serving Greater Cincinnati for more than 160 years and provides an integrated network of leading physicians, compassionate caregivers, comprehensive services and exceptional care at more than 180 locations across the region. The Mercy Health—Cincinnati network of care includes five award-winning hospitals, senior living communities, primary care and specialty physician practices, outpatient centers, fitness centers and a variety of outreach programs. Mercy Health Cincinnati hospitals have earned national Truven Health Analytics' 100 Top Hospitals honors more times than all other Cincinnati hospitals combined, placing them among the best hospitals in the nation. Truven has also named Mercy Health Cincinnati as one of the nation's Top 15 health systems five times, more than any other health system in Cincinnati. To learn more visit, mercy.com and engage in the conversation via Mercy Health Cincinnati's social media channels (@mercy_health on Twitter and Mercy Health Cincinnati on Facebook).

OHC (Oncology Hematology Care) has been fighting cancer on the front lines for more than three decades. We are the region's leading experts in the treatment of nearly every form of adult cancer and complex blood disorder. OHC offers the latest medical, gynecologic and radiation therapy, and is always seeking better treatment options through participation in clinical trials. OHC is certified by the American Society for Clinical Oncology in the Quality Oncology Practice Initiative Certification Program, is an accredited Oncology Medical Home, and is one of only 176 practices nationally to be accepted into the Medicare Oncology Initiative. At its heart, our approach to cancer care is simple—to surround you with everything you need so you can focus on what matters most: beating cancer. For more information about services and careers at OHC, call 1-888-649-4800 or visit ohcare.com.

GT Medical Technologies, Inc.: Driven to overcome the limitations of current treatments for recurrent brain tumors and raise the standard of care, a team of brain tumor specialists joined forces and formed GT Medical Technologies with a purpose to prevent disease progression and improve quality of life for patients with recurrent brain tumors. GammaTile Therapy received FDA 510(k) regulatory clearance for the treatment of all types of recurrent brain tumors in July 2018 and has an established CMS code for Medicare reimbursement. Extensive clinical expertise informed the design of GammaTile Therapy, and deep medical device experience guides the company. The company is headquartered in Tempe, Arizona. For more information, visit www.gtmedtech.com/.

More information:
Surgically targeted radiation therapy: A prospective trial in 79 recurrent, previously irradiated intracranial neoplasms, Peter Nakaji, MD, et al; 2019 AANS Annual Scientific Meeting, www.aans.org/Annual-Scientific … mid=SSI&propid=46135


Provided by Mayfield Clinic

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