Gliomas, a particularly lethal form of brain and spinal cord tumor, pose a formidable challenge for treatment. Developing precise therapies for these tumors is hampered by the difficulty of testing numerous drug combinations in real tumor cells, as patients can only undergo one treatment approach at a time. Now, a groundbreaking solution has emerged in the form of tiny devices, no larger than a grain of rice, capable of conducting multiple experiments concurrently to assess the impact of novel treatments on these hardest-to-treat brain cancers.

Researchers from Brigham and Women's Hospital (Boston, MA, USA) have designed a device for testing glioma treatments in patients suffering from this deadly type of brain cancer. This innovative device, integrated seamlessly into standard surgical procedures, offers unprecedented insights into drug effects on glioma tumors and, importantly, did not cause any adverse reactions in a phase 1 clinical trial. During surgery, these microdevices are implanted directly into the patient's tumor and remain in place for around 2-3 hours. During this time, the device administers minuscule doses of up to 20 drugs into extremely small areas of the brain tumor. Subsequently, the device is removed, and the surrounding tissue is sent to the lab for in-depth analysis. Since the device operates within the patient's body, it provides an unparalleled opportunity to evaluate drug impacts on the tumor microenvironment – the cells immediately adjacent to cancer cells, often composing a significant portion of the tumor mass.

In a recent study, the researchers applied their device to six patients undergoing glioma tumor removal surgery. Remarkably, none of the patients experienced adverse effects from the device. The research team collected invaluable biological data, including how responses change with varying drug concentrations and the molecular changes induced by each drug in the cells. While the study confirmed the device's safety and seamless integration into surgical practice, researchers are now focusing on optimizing glioma therapy using the data collected. They are presently conducting a two-stage procedure in which patients receive the device through minimally invasive surgery 72 hours prior to their main surgery, further advancing the potential of this groundbreaking approach.

“We’re optimistic that this is a new generation approach for personalized medicine,” said co-principal investigator and co-corresponding author Pierpaolo Peruzzi, MD, PhD. “The ability to bring the lab right to the patient unlocks so much potential in terms of the type of information we can gather, which is new and exciting territory for a disease that has very few options at present.”

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