Researchers have identified critical time periods following brain tumor surgery that may allow for the more effective use of chemotherapy against glioblastoma, the most dangerous and fastest-growing type of brain tumor.
The new study, published in the journal Science Translational Medicine, suggests that chemotherapy may be more effective if administered in the minutes and days immediately following surgery, rather than waiting several weeks as is currently the practice.
This is because surgery causes a temporary disruption of the blood-brain barrier, the protective layer that normally prevents drugs from reaching the brain, during two specific time periods: the first 15 minutes after surgery, and the second between 48 and 72 hours later.
Currently, doctors refrain from starting chemotherapy or radiation therapy for four to six weeks after surgery to allow the patient time to recover. However, researchers believe that utilizing these two time windows could allow for a powerful and direct attack on any remaining cancer cells before they can regrow.
The research team from the University of Manchester conducted their experiments on mice, where they simulated the surgical procedure to remove the tumor, and used a drug formulation that does not cross the blood-brain barrier except in cases of disorder.
The results showed that exploiting these time windows effectively suppressed tumor recurrence.
Dr. Thomas Kisby, who co-led the study, said: "For the first time, we demonstrate that glioblastoma surgery briefly exposes a vulnerable point that can be exploited. If treatment is timed within the windows we identified, it is able to significantly halt the disease before it regrows. The hours and days immediately following surgery may hold the key to stopping the return of this deadly tumor."
Professor Costas Kostarellos, who co-led the study, added that this discovery could open new horizons in the care of cancer patients after surgery, noting the possibility of using advanced treatments such as nanomedicines, immunotherapy, and gene therapy to target the high-risk area around the site of the removed tumor.
Dr. Gerben Burst, a consultant oncologist at Christie NHS Foundation Trust, praised the findings but urged caution, noting that the research is still in its early stages and that clinical trials are needed to confirm its effectiveness in humans. He added that a better understanding of the body's response to surgery could help improve drug delivery, rather than relying solely on developing new and expensive drugs.
