Six-year-old Isabella knows she had a “boo boo” in her head when she was a baby.
But she does not know about the three surgeries and multiple rounds of chemotherapy she underwent at Miami Children’s Hospital to help treat her brain tumor.
“It’s just too much information for her to take right now,” said Isabella’s mother, Lisette Diaz, of Pembroke Pines.
On the eve of July 4, 2007, Isabella was diagnosed with choroid plexus carcinoma, a rare tumor that develops in young children’s brain ventricles. She was 6 months old.
“I thought she was going to die,” said Diaz, 43. “When they told me she would have to go through intensive care, I thought, ‘Oh my God, she is gone.’ ”
Isabella is one of about 2,500 children diagnosed with a brain tumor every year in the U.S. Brain tumors are the second most common tumors in children after leukemia, said Dr. Antonello Podda, assistant professor of pediatrics and director of the Pediatric Neuro-Oncology Program at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.
“Brain tumors in children are difficult because they impact the whole neurological well-being,” said Dr. Ziad Khatib, director of neuro-Oncology at Miami Children’s Hospital.
The good news? Within a month, doctors at UM will treat their first patients with a vaccine designed to boost the immune system and help fight stubborn brain cancers. Doctors will give the vaccine to children with chemo-resistant tumors and to adults and teenagers diagnosed with glioblastoma multiforme, the most common and deadliest of malignant brain tumors in adults. Initially, the vaccine will only be administered at UM, but if it proves successful, doctors hope to make it available throughout South Florida.
At Joe DiMaggio Children’s Hospital in Hollywood, neurosurgeons use ultrasonic aspirators that remove tumors intertwined in the brain. The device vibrates the tumor at an ultrasonic frequency and then suctions it out.
Many South Florida hospitals also administer radiation that targets only the brain tumor and avoids healthy tissue. Proton beam radiation significantly minimizes the risk of neurological damage. Generally, doctors avoid using radiation on children younger than 3, Podda said.
“The rule is the later, the better,” he added.
That is why the soon-to-be-implemented dendritic cell vaccine is critical, doctors say. It not only avoids radiation for children, but may help those whose brain tumors who do not respond to chemotherapy. Based on science developed by Professor of Microbiology and Immunology Eli Gilboa, as well as on studies in Belgium of a similar vaccine administered to mice, this new treatment significantly boosts a patient’s immune system, said Dr. John Goldberg, assistant professor of clinical pediatrics at UM and director of Sylvester’s Pediatric Oncology Early Phase Clinical Trials Program.
In laboratories, dendritic cells, or immune cells drawn from the blood of a brain cancer patient, are taught how to fight cancerous cells and are returned to the patient through the vaccine.
“The problem with cancer is that it figures out a way to trick the immune system that it is OK to be there,” Goldberg said. “Cancer cells derive from normal cells so they look alike, and cancer cells figure out a way to hide from the immune system. One thing we are trying to do with this vaccine is to overcome those ways that cancer invades the immune system.”