'Tumour monorail' on the fast track for human trials © Alamy'Tumour monorail' on the fast track for human trials © Alamy

‘Tumour monorail’ on the fast track for human trials

Pioneering device for treating cancers lures tumour cells out of the brain Pied Piper-style.

A biomedical device designed to lure tumour cells out of the brain Pied Piper-style has been awarded specialist breakthrough status by the US Food and Drug Administration (FDA). Following successful trials in rats, the device, dubbed a ‘tumour monorail’, has been put on the fast track for human trials by the FDA.

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A team at Georgia Institute of Technology have created a biomedical device to trick brain tumour cells into moving in a certain direction by luring them, Pied-Piper-style, out of the brain and away from harm. For the past five years they developing a device they call a ‘Tumour Monorail’ and after successful trials in rats have just been awarded breakthrough status by the US Food and Drug Administration.

Light micrograph of a section through a lymph node showing a malignant (cancerous) tumour (purple) that originated in the breast. Magnification: x200 when printed at 10 centimetres wide. Credit: PHOTO QUEST LTD

Light micrograph of a section through a lymph node showing a malignant (cancerous) tumour (purple) that originated in the breast. © PHOTO QUEST LTD/Getty

The device is essentially a long, thin tube made of fine, flexible fibres that is fed through a narrow opening connecting the brain’s left and right hemispheres. It takes advantage of the fact that tumour cells spread through the brain along fibres of white matter – bundles of brain tissue that connect areas of grey matter together and carry messages between neurons. By providing them with an alternative pathway, it is able to lure cancerous cells out of the brain, preventing their spread into areas of healthy brain tissue.

“This was the first demonstration that you can engineer migration inside the body and move a tumour from point A to point B by design,” said Ravi Bellamkonda, the Vinik Dean of the Pratt School of Engineering at Duke University, who began the research while at Georgia Tech. “It was also the first demonstration of bringing the tumour to your drug rather than your drug going into the brain and killing valuable cells.”

“The idea is to provide by artificial means – in this case, polymer fibres – structures that mimic the structure of the white matter or the nerves that are coursing through the brain, and then to see if the tumour will migrate along the path that we specify, rather than willy-nilly.”

The tumour cells are guided into a tiny reservoir that sits on top of the skull, beneath the scalp. Although not all of the tumour cells will end up being sucked into the reservoir, siphoning some of the cells out of it after they are collected could prevent the spread of the tumour or even shrink it significantly. Preliminary trials on rats showed that the device is capable of reducing the size of tumours by more than 90 per cent. Alternatively, the monorail could be used alongside other treatments to boost their overall effectiveness, since smaller tumours are more easily treated.

While the monorail has been specifically designed to mimic white matter to treat brain tumours, the team says many other types of tumour respond to the same cue. It could be particularly useful for tumours in parts of the body which are hard to access, by moving them to a more accessible location where they can be removed surgically. The reservoir could be used to sample the tumour cells for testing.

“Many tumours, from breast cancer, to prostate, to pancreatic tumours, actually respond to this structural cue. It’s not specific to brain tumours, meaning that if you give them the fibre-like structures, these tumour cells love to grow along them,” said Bellamkonda.

So far the device has only been tested on rats but its designation as a Breakthrough Device should fast-track approval for use in human trails by putting the team in direct contact with the FDA. The team hopes to start human trials by the end of the year.


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