How little smart beads go to a place that can fight your cancer

Imagine treating advanced liver cancer by slipping microscopic beads, called LUMI beads, laden with chemotherapy drugs directly into a tumor. There, the drugs block the blood supply and destroy the tumor without battering nearby healthy tissues. Also imagine penetrating a protective barrier to deliver medication right to the brain to kill tumors and even halt the tremors of Parkinson’s.

The promising field of nanotechnology — creating and using materials at the tiniest atomic level — is advancing. Leading the way are local medical institutions like the University of Miami and Florida International University.

Dr. Govindarajan Narayanan, an interventional oncologist at Sylvester Comprehensive Cancer Center at UHealth, said the LUMI-beads treatment for liver cancer became reality in January.

“It’s a new generation of a procedure we’ve been doing many years,” he said. “It’s called TACE — transarterial chemoembolization — and basically what we do is we treat tumors instead of giving chemotherapy through the veins or mouth. You go through the blood vessels.”

LUMI beads are a part of a growing field of nanotechnology to combat cancer: Devices are being studied to carry medicine directly inside cancer cells, sparing patients from chemotherapy’s nausea and hair loss.

For instance, researchers from Herbert Wertheim College of Medicine at Florida International University and Nicklaus Children’s Hospital in Miami are studying “c-dots” — glowing carbon nanoparticles — to penetrate the blood-brain barrier to treat brain tumors and Parkinson’s.

The LUMI procedure Narayanan describes works as such: The LUMI bead is loaded with the chemo drug and a contrast agent to aid visualization of the beads after they’re administered. The mixture is delivered directly to the tumor through a catheter. Physicians track the beads via X-ray guidance.

“The LUMI beads gives you real-time information while doing the procedure. We will treat the patient, send him home, and in four weeks, repeat the imagery with a CAT scan and decide whether to repeat the procedure. It’s like lighting up a Christmas tree. You can see if you got it completely or if a part was not treated so you can retreat,” he said.

Currently, the procedure is in its infancy and hasn’t been approved by the Food & Drug Administration.

Beads are approved as a way to block the blood supply, Narayanan said. “But when you add a drug to it, which is what we are doing, it is considered ‘off label.’ It’s on label in the rest of the world. In Europe, you can load a drug. It’s not approved in the U.S. The FDA has a different mechanism when you load a drug.”

Meanwhile, a group of scientists at UM and FIU have been studying medicinal and nanotechnological engineering to create targeted therapy to overcome one of the most challenging problems: how to break the blood-brain barrier by attaching a chemotherapy drug to a glowing nano particle to penetrate the protective obstruction.

“The brain is in a Ziploc bag, and that’s called the blood-brain barrier, and it’s like a nemesis that doesn’t allow chemotherapy to penetrate and attack the tumor. This is a way of transport, a method of delivery of chemotherapy, to go through that Ziploc bag and kill the tumor,” said Dr. Guillermo DeAngulo, a pediatric oncologist at Nicklaus who is working alongside UHealth researcher Dr. Regina Graham.

“This is for brain tumors, primarily, but it has other advantages for imaging as well,” DeAngulo said. “A lot of times, you are unable to detect if it’s a tumor or inflammation. If you inject the nano particle, it gives you luminescence and you can tell if it’s a tumor or inflammation.”

Dr. Carolyn Runowicz, executive associate dean for academic affairs and professor of obstetrics and gynecology at FIU’s Wertheim College of Medicine, is excited about nanotechnolgy’s possibilities of breaking the blood-brain barrier for treating other cancers, including her specialty, ovarian cancer.

Working alongside FIU physicist and electrical engineer Sakhrat Khizroev, the pair have been looking at magneto-electric nanoparticles. Because of the magnetic properties, physicians can use a magnet to deliver the medicine-loaded particles to the area of the brain or other organ in the body that needs treatment.

In a study in 2014, the pair administered the chemotherapy drug Taxol into magneto-electric nanoparticles, guided them remotely by a magnetic field to penetrate a tumor in the brain of a mouse, and destroyed the tumor within 24 hours. Normal cells — often collateral damage via chemo — remained intact.

The next step will be to perform the test in larger animals and then in humans, a process than can take several years and requires funding for research.

Runowicz eyes the possibilities of using the technology to beat ovarian cancer.

“I have spent 40 years working with patients with ovarian cancer, and it is a frustrating cancer. You get a good response initially, but the disease always finds little hiding places and comes back,” she said. The idea is to “put this magnetic electrical particle and tag it to any chemotherapeutic drug, and get it into the sanctuary through this magnetic force and release the drug into the cancer cell.”

She also cites the potential to administer shock therapy through the blood-brain barrier to stop the tremors produced by Parkinson’s.

“Nanotechnology is enabling treatment through the blood-brain barrier, the safety mechanism of keeping foreign bodies, toxins, out of the brain. This team figured out how to get through the blood-brain barrier using nanotechnology and because of magnetic properties, could use the magnet to deliver to an area of the brain where they wanted to deliver shock therapy,” Runowicz said.

“I’m a cancer doctor and I thought that was fascinating,” she added. “For me it was an ‘a-ha’ moment, an ‘oh-my-gosh, we could deliver treatment anywhere in the body by this technology.’”

This story was originally published May 20, 2016 at 12:57 PM with the headline "How little smart beads go to a place that can fight your cancer."