Hadassah-University Medical Center, in Jerusalem’s Ein Kerem, is performing, for the first time in the world, an innovative treatment for patients with recurrent aggressive brain tumors using alpha radiation, the hospital announced earlier this month.
A 77-year-old man diagnosed with a recurrence of glioblastoma after having undergone surgery, radiation, and drug treatments became the first patient in Israel to be treated with the newly developed Alpha DaRT technology.
Developed in collaboration with the Sharett Institute of Oncology and ALPHA Tau, the technology emits highly bioefficient alpha particles that deliver radiation concentrated in the tumor area with minimal damage to nearby brain tissue.
During the procedure, radiation sources are injected into the brain tumor from two different pathways simultaneously, allowing for optimal coverage of the tumor while maintaining maximum accuracy.
Beyond its local effect, preclinical studies also suggest that the treatment may trigger an immune response to the tumor in other brain regions.
Professor Yigal Shoshan, Director of the Neurosurgery, Oncology, and Stereotactic Radiosurgery Unit at the hospital, led the surgery alongside doctors from the Department of Neurosurgery and a multidisciplinary team that included the operating rooms, the Sharett Institute of Oncology, the Institute of Radiotherapy, and the Neuropathology Unit.
Results have garnered interest in neuro-oncology community
Preliminary results published in the US have garnered interest among the neuro-oncology community and offer a new direction for a disease with extremely limited treatment options.
"One of the great advantages of the technology is that it integrates naturally with the neurosurgical navigation systems we use every day," said Shoshan. "The same system that allows us to perform brain biopsies with millimeter accuracy also allows us to insert the alpha sources into the center of the tumor with similar precision.”
“Adapting the technology to existing navigation systems has been a key part of the development we have carried out in recent years,” he continued. “After taking a sample from the tumor to confirm active disease, we used the same system to precisely insert the alpha sources into the tumor. We thus performed local, precise, minimally invasive treatment, without the need for extensive brain surgery."
"The procedure that was carried out at Hadassah is not only the first treatment in Israel, but the culmination of years of research. As part of our collaboration with Alpha Tau, we have adapted the technology for brain tumor treatment. This included laboratory studies, preclinical studies in a large-animal model, the development of dedicated applicators, their implementation in the neurosurgical navigation system, and many exercises on models in the operating room," Shoshan said.
"Every step was designed to ensure that the transition to clinical research was carried out with the highest level of accuracy and safety. Seeing the technology reach a patient in Israel for the first time today is an exciting moment for everyone who has been part of this journey," he said.
Professor Aron Popovtzer, director of the Sharett Institute of Oncology, noted that glioblastoma is the most common primary malignant brain tumor in adults, and almost always recurs despite surgery for resection, radiation, and chemotherapy.
"Patients with recurrent disease currently have very limited treatment options,” he explained. “Therefore, any innovative technology that can be tested in a controlled clinical study is of great importance. A combination of research, clinical experience, and multidisciplinary collaboration is the only way to advance new treatments for these patients."
About 150-250 new patients are diagnosed with glioblastoma in Israel each year.
Even with usual treatment, which includes surgery, radiation, and chemotherapy, the disease recurs in the vast majority of patients, and the median survival is only about 15-16 months, according to Hadassah. Only about 10% of patients survive for 5 years after diagnosis.
A US study titled REGAIN, conducted in parallel with Hadassah’s study, found full local control of the disease in the three patients studied. Two of the patients showed no evidence of growth after treatment.
Shoshan said that "the current study focuses on recurrent glioblastoma, but we are already preparing to expand the clinical program to patients with targeted brain metastases, especially in cases where stereotactic surgery or radiosurgery has not achieved control of the disease.”
“We believe that the ability to inject alpha sources directly into the tumor focus and provide accurate, bio-efficient local radiation makes the technology particularly suitable for this indication as well,” he continued.
Treatment a 'significant milestone,' says Alpha Tau CEO
Alpha Tau CEO Uzi Sofer said that the first treatment in Israel is a significant milestone for the company.
"We are an Israeli company that currently operates in medical centers around the world, but our hearts remain here. For us, it is especially significant that technology developed in Israel also reaches patients in Israel. This is not just a scientific or business success. It is also a Zionist mission. It is important to us that the innovation that was born here will also be available to patients in Israel,” he said.
The researchers emphasized that the purpose of the study is to examine the feasibility and safety of the treatment, and only after this phase is complete will it be possible to expand the study and continue examining its clinical efficacy.
“For patients with recurrent glioblastoma who have exhausted the usual treatment options, this is a first but significant step. For the research teams at Hadassah, it is also the continuation of a scientific journey that has lasted for years,” the hospital said.
“That journey has moved from the laboratory, through preclinical research, the development of the technology, its adaptation to the neurosurgical operating room, and the first clinical application in humans,” it added.
The research may also open possibilities for treating brain metastases and other brain tumors.