Evidence map›Paper›PMID 32642705›Full record

ArticleNeuro-oncology advances

Evaluation of neurapheresis therapy in vitro: a novel approach for the treatment of leptomeningeal metastases.

Tiffany Ejikeme, George C de Castro, Katelyn Ripple, Yutong Chen, Charles Giamberardino, Andrew Bartuska, Gordon Smilnak, Choiselle Marius, Jane-Valeriane Boua, Pakawat Chongsathidkiet and 5 more

Open access · goldAbstract read
In one paragraph

Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Tiffany EjikemeDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
George C de CastroDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Katelyn RippleDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Yutong ChenDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Charles GiamberardinoDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Andrew BartuskaDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Gordon SmilnakDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Choiselle MariusDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Jane-Valeriane BouaDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Pakawat ChongsathidkietDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Sarah HodgesDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Promila PagadalaDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Laura Zitella VerbickMinnetronix Neuro, Inc., St. Paul, Minnesota, USA.
Aaron R McCabeMinnetronix Neuro, Inc., St. Paul, Minnesota, USA.
Shivanand P LadDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
Duke Medical Center · USDuke University Hospital · USMinnetronix (United States) · US

Funding

Directed Chemotherapy Delivery for Leptomeningeal MetastasesR41CA206744 · NCI · MINNETRONIX, INC. · PI LAD, SHIVANAND P, MCCABE, AARON RICHARD · 2016 to 2016
$225k
NCI NIH HHS R41 CA206744
6 · The paper itself

Abstract

backgroundLeptomeningeal metastases (LM), late-stage cancer when malignant cells migrate to the subarachnoid space (SAS), have an extremely poor prognosis. Current treatment regimens fall short in effectively reducing SAS tumor burden. Neurapheresis therapy is a novel approach employing filtration and enhanced circulation of the cerebrospinal fluid (CSF). Here, we examine the in vitro use of neurapheresis therapy as a novel, adjunctive treatment option for LM by filtering cells and augmenting the distribution of drugs that may have the potential to enhance the current clinical approach.

methodsClinically relevant concentrations of VX2 carcinoma cells were suspended in artificial CSF. The neurapheresis system's ability to clear VX2 carcinoma cells was tested with and without the chemotherapeutic presence (methotrexate [MTX]). The VX2 cell concentration following each filtration cycle and the number of cycles required to reach the limit of detection were calculated. The ability of neurapheresis therapy to circulate, distribute, and maintain therapeutic levels of MTX was assessed using a cranial-spinal model of the SAS. The distribution of a 6 mg dose was monitored for 48 h. An MTX-specific ELISA measured drug concentration at ventricular, cervical, and lumbar sites in the model over time.

resultsIn vitro filtration of VX2 cancer cells with neurapheresis therapy alone resulted in a 2.3-log reduction in cancer cell concentration in 7.5 h and a 2.4-log reduction in live-cancer cell concentration in 7.5 h when used with MTX. Cranial-spinal model experiments demonstrated the ability of neurapheresis therapy to enhance the circulation of MTX in CSF along the neuraxis.

conclusionNeurapheresis has the potential to act as an adjunct therapy for LM patients and significantly improve the standard of care.

Indexed as

leptomeningeal metastasesmethotrexateNeurapheresissubarachnoid spaceVX2

Identifiers

PMID32642705
PMCPMC7236387
OpenAlexW3016267899

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.