Stereotactic Placement of Intratumoral Catheters for Continuous Infusion Delivery of Herpes Simplex Virus -1 G207 in Pediatric Malignant Supratentorial Brain Tumors

Overview

Journal World Neurosurg

Publisher Elsevier

Date 2018 Nov 28

PMID 30481622

Citations 10

Authors

Joshua D Bernstock

Zachary Wright

Asim K Bag

Florian Gessler

George Yancey Gillespie

James M Markert

Gregory K Friedman

James M Johnston

Affiliations

Soon will be listed here.

Abstract

Objective: The engineered herpes simplex virus-1 G207, is a promising therapeutic option for central nervous system tumors. The first-ever pediatric phase 1 trial of continuous-infusion delivery of G207 via intratumoral catheters for recurrent or progressive malignant brain tumors is ongoing. In this article, we describe surgical techniques for the accurate placement of catheters in multiple supratentorial locations and perioperative complications associated with such procedures.

Methods: A prospective study of G207 in children with recurrent malignant supratentorial tumors is ongoing. Preoperative stereotactic protocol magnetic resonance imaging was performed, and catheter trajectories planned using StealthStation planning software. Children underwent placement of 3-4 silastic catheters using a small incision burr hole and the Vertek system. Patients had a preinfusion computed tomography scan to confirm correct placement of catheters.

Results: Six children underwent implantation of 3-4 catheters. Locations of catheter placement included frontal, temporal, parietal, and occipital lobes, and the insula and thalamus. There were no clinically significant perioperative complications. Postoperative computed tomography scans coupled with preoperative MRI scans demonstrated accurate placement of 21 of 22 catheters, with 1 misplaced catheter pulled back to an optimal location at the bedside. One patient had hemorrhage along the catheter tract that was clinically asymptomatic. Another patient had cerebrospinal fluid leak from a biopsy incision 9 days after surgery that was oversewn without complication.

Conclusions: The placement of multiple intratumoral catheters in pediatric patients with supratentorial tumors via frameless stereotactic techniques is feasible and safe. Intratumoral catheters provide a potentially effective route for the delivery of G207 and may be employed in other trials utilizing oncolytic virotherapy for brain tumors.

Citing Articles

The safety and accuracy of intratumoral catheter placement to infuse viral immunotherapies in children with malignant brain tumors: a multi-institutional study.

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Multiple strategies to improve the therapeutic efficacy of oncolytic herpes simplex virus in the treatment of glioblastoma.

Zhou Z, Tian J, Zhang W, Xiang W, Ming Y, Chen L Oncol Lett. 2021; 22(1):510.

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Immunovirotherapy for the Treatment of Glioblastoma and Other Malignant Gliomas.

Estevez-Ordonez D, Chagoya G, Salehani A, Atchley T, Laskay N, Parr M Neurosurg Clin N Am. 2021; 32(2):265-281.

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The Current State of Oncolytic Herpes Simplex Virus for Glioblastoma Treatment.

Nguyen H, Saha D Oncolytic Virother. 2021; 10:1-27.

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