SURGICALLY TARGETED RADIATION THERAPY FOR PATIENTS WITH OPERABLE BRAIN TUMORS

Right Treatment. Right Time. Right Place.

GammaTile Therapy is a Surgically Targeted Radiation Therapy 

(STaRT) that provides immediate, dose-intense treatment at the completion of resection. By getting a head STaRT on fighting the tumor, resection plus GammaTile Therapy can extend local

recurrence-free survival with minimal complications, reduced patient burden, and assured compliance.[1]

 

Elevating Outcomes With Optimized Dosimetry

GammaTile Therapy vs Intensity-Modulated Radiation Therapy (IMRT)

GammaTile is designed with uniform radiation-source spacing to ensure an even dose distribution. The favorable depth-dose profile optimizes local tumor control.[2,3]

The colors indicate the radiation location and intensity from the 2 types of treatment. Blue-green indicates lower radiation levels. Red indicates higher levels. The extracranial dose is likely lower than shown, as the planning system did not utilize inhomogeneity corrections.

Advancing Safety

Designed with the brain’s delicate environment in mind to limit radiation changes in healthy tissue[9]

* Defined as common terminology criteria for adverse events (CTCAE), Grade 3–5 possibly or probably related to GammaTile Therapy placement occurring at any time during follow-up.

 
 

How It Works. An Eloquent Solution.

GammaTile Therapy targets tumor cells while preserving brain tissue. Surgically guided treatment of the local radiation dose to the operative bed optimizes the therapeutic margin while minimizing complications.[1]

 

Structural offset of the radiation source from the brain tissue prevents harmful direct seed-to-tissue contact and enables intraoperative adjustment. 

Enhanced local control and proven efficacy[8]

  • 50% of the therapeutic dose is delivered within the first 10 days after surgery, which helps prevent residual tumor cells from replicating.[8]

  • 88% of the therapeutic dose is delivered within 30 days, with more than 95% of the dose delivered by 6 weeks.[8]

  • A favorable depth-dose profile optimizes local tumor control.[2]

Cesium-131 Distribution and Intensity
Bioresorbable, conformable collagen tile preserves healthy tissue 
  • Provides a structural offset of the radiation source from normal brain tissue[8]

  • Enforces uniform radiation-source spacing, both within a single tile and between multiple tiles[8]

  • Minimizes local hot and cold spots[8]

  • Facilitates rapid, accurate placement to deliver a predictable radiation dose[8]

Uniform Radiation Source,

Structurally Offset Design

2-cm height  |  2-cm width  |  4-mm thickness

What I like about GammaTile is that they’re taking a radiation technology that already exists and making it safer and easier to deliver… [It] should be equally effective and faster to implant after tumor surgery…[It’s] better for patients (with less anesthesia time) and safer for the staff (with less exposure in the OR).

  Dr Helen Shih  

Radiation Oncologist at Massachusetts General Hospital

 

GammaTile Therapy Webinars

Clinical presentation  “GammaTile Therapy: Why The Next Big Thing In Brain Tumor Treatment Is Something Small”.
In this webinar, Dr David Brachman and Dr Mehee Choir review clinical data from the prospective GammaTile clinical trial, along with recent clinical publications and trial plans, and examine brain tumor patients’ access to radiation therapy.
Watch here

The clinical presentation “A Neurosurgeon’s Perspective On GammaTile Therapy For Recurrent Meningiomas” is led by

Dr Zabramski. This webinar reviews the meningioma subset of clinical data from the prospective GammaTile clinical trial, clinical case examples of patients with recurrent meningiomas, and surgical GammaTile implant footage. Watch here

This Congress of Neurological Surgeons (CNS) Virtual Visiting Professor webinar, Brachytherapy For Brain Tumors, is led by Dr Clark Chen and Dr Peter Nakaji.  The webinar covers historical brain brachytherapy techniques, as well as Surgically Targeted Radiation Therapy for brain tumors.  Topics include GammaTile Therapy technology overview, clinical data review, and single center experience clinical case examples.  CME credit is available for a fee. Watch here 

Watch an in-depth educational webinar about GammaTile Therapy, presented by world-renowned neurosurgeon Dr Joseph Zabramski and hosted by The Musella Foundation. Content includes background, safety and efficacy, surgical placement, a case study, and clinical trial information. Watch here

This American Brain Tumor Association patient webinar provides a detailed overview of surgically implanted brain tumor therapies, including GammaTile Surgically Targeted Radiation Therapy (STaRT). Dr John A. Boockvar, the director of the Brain Tumor and Pituitary/Neuroendocrine Center at Lenox Hill, discusses various treatment options, highlights their differences, and provides guidance on how patients can talk with their heath team about their care plan. Watch here

Watch a clinical abstract presentation webinar and Q&A session led by Dr Vincent DiNapoli, Neurosurgeon at Mayfield Brain & Spine in Cincinnati, Ohio. In the webinar, Dr. DiNapoli presents the abstract that was accepted and scheduled to be presented at the 2020 American Association of Neurological Surgeons annual meeting. Watch here

 

Notable Clinical Publications & Awards

CNS Virtual Conference 2020

Resection and surgically targeted radiation therapy for initial or salvage treatment of aggressive meningioma: results from a prospective trial

L. Rogers, P. Nakaji, E. Youssef, K. Smith, J. Zabramski, T. Thomas, C. Dardis, D. Pinnaduwage and D. Brachman; St Joseph’s Hospital, Phoenix, AZ, Barrow Neurological Institute, Phoenix, AZ, GT Medical Technologies, Tempe, AZ. Presented at CNS Virtual Conference; September 30, 2020.

Cureus 2020

Re-irradiation using brachytherapy for recurrent intracranial tumors: a systematic review and meta-analysis of the literature

Mehee Choi, MD, Joseph Zabramski, MD in Cureus 12(8): e9666. Published August 11, 2020. Doi: 10.7759/cureus.9666. Read here

Future Oncology 2020
GammaTile: Surgically targeted radiation therapy for glioblastomas

Dominic J. Gessler, MD, Clara Ferreira, PhD, Kathryn Dusenbery, MD, and Clark C. Chen, MD in Future Oncology. 2020; Published ahead of print. Doi: https://doi.org/10.2217/fon-2020-0558. Read here

SNO Conference on Brain Metastases 2020
A prospective trial of resection plus surgically targeted radiation therapy for brain metastasis

David Brachman, MD, Peter Nakaji, MD, Kris Smith, MD, Emad Youssef, MD, Theresa Thomas, MS,  Dilini Pinnaduwage, PhD, C. Leland Rogers, MD. Poster presented at: SNO 2020 Virtual Conference on Brain Metastases; August 14, 2020. Read here

 

A randomized, multicenter phase III trial of surgery plus stereotactic radiosurgery (SRS) compared with surgery plus permanently implanted collagen tile brachytherapy (CTBT) for resectable metastatic brain tumors-protocol in progress

Jeffrey Weinberg, MD, FAANS, FACS, Hussein Tawbi, MD, PhD, Frederick Lang, MD, Jeffrey Scott Wefel, PhD, ABPP, Jason Michael Johnson, MD, Heather Lin, PhD, Ying Yuan, PhD, Mary Frances McAleer, MD, PhD. Poster presented at: SNO 2020 Virtual Conference on Brain Metastases; August 14, 2020. Read here

Permanent intracavitary Cs131 brachytherapy for previously-irradiated recurrent brain metastases: initial clinical and radiation safety experience

Nelson S. Moss, MD, Brandon Imber, MD, Kavya Prasad, MS , Bae Chu, MPH , Arun Goel, MD , David Aramburu-Nunez, PhD , Michael Bellamy, PhD , T. Jonathan Yang, MD, Atif Khan, MD, Laurence Dauer, PhD , Gilad Cohen, MS , Kathryn Beal, MD, Viviane Tabar, MD. Poster presented at: SNO 2020 Virtual Conference on Brain Metastases; August 14, 2020. Read here

Current Oncology Reports 2020
Evolving strategies to potentially further optimize surgical interventions in brain cancer 

Bindi B. Parikh, MD and Elizabeth C. Neil, MD, in Current Oncology Reports. 2020; 22, 32.

Journal of Neurosurgery Publication 2019

Resection and permanent intracranial brachytherapy using modular, biocompatible cesium-131 implants: results in 20 recurrent, previously irradiated meningiomas 

David G. Brachman, MD, Emad Youssef, MD, Christopher J. Dardis, MD, Nader Sanai, MD, Joseph M. Zabramski, MD, Kris A. Smith, MD, Andrew S. Little, MD, Andrew G. Shetter, MD, Theresa Thomas, MS, Heyoung L. McBride, MD, MS, Stephen Sorensen, PhD, Robert F. Spetzler, MD, and Peter Nakaji, MDl, in the Journal of Neurosurgery. 2018;131:1683-1994. doi:10.3171/2018.7.jns18656

AANS Annual Scientific Meeting Abstracts 2019 – 2020
Rosenblum-Mahaley Clinical Award winner for the best abstract in the field of neuro-oncology 

Surgically targeted radiation therapy: a prospective trial in 79 recurrent, previously irradiated intracranial neoplasms on a prospective clinical trial

Peter Nakaji, MD, FAANS; Emad Youssef, MD; Christopher Dardis, MD; Kris Smith, MD; Dilini Pinnaduwage, PhD; David Brachman, MD, at the 2019 AANS Meeting.

Novel permanently implanted 3D-collagen tile for intraoperative brachytherapy in a patient with recurrent glioblastoma 

Vincent Anthony DiNapoli, MD, Yair Gozal, MD, PhD, at the 2020 AANS Meeting.

American Brachytherapy Society Annual Meeting 2019
Judith Stitt Best Abstract Award winner 

Surgically targeted radiation therapy: safety profile of collagen tile brachytherapy in 79 recurrent, previously irradiated intracranial neoplasms on a prospective clinical trial 

David Brachman, MD, Emad Youssef, MD, Christopher Dardis, MD, Kris Smith, MD, Dilini Pinnaduwage, PhD, Peter Nakaji, MD, in Brachytherapy. 2019;18(3):S35-S36. doi: 10.1016/j.brachy.2019.04.076.

SNO Annual Meeting Abstract 2019

RTHP-32. First experience with gamma tile permanent implants for recurrent brain tumors 
Clara Ferreira, Parham Alaei, Clark Chen, Margaret Reynolds, David Sterling, Kathryn Dusenbery, in Neuro-Oncology. 2019;21(Supplement_6):vi216. doi:10.1093/neuonc/noz175.903.

REFERENCES

  1. Nakaji P, Youssef E, Dardis C, Smith K, Pinnaduwage D, Brachman D. Surgically targeted radiation therapy: a prospective trial in 79 recurrent, previously irradiated intracranial neoplasms. Poster presented at: 2019 AANS Annual Scientific Meeting; April 2019; San Diego, CA.

  2. Armpilia CI, Dale RG, Coles IP, Jones B, Antipas V. The determination of radiobiologically optimized half-lives for radionuclides used in permanent brachytherapy implants.Int J Radiat Oncol Biol Phys. 2003;55(2):378-385.

  3. Pinnaduwage D, Youssef E, Sorensen S, Srivastava S, Yan X, Brachman D. Dosimetric impact of radioisotope type on permanent brain seed implants. Medical Physics. 2017;44(6):3146.

  4. Combs SE, Debus J, Schulz-Ertner D. Radiotheraputic alternatives for previously irradiated recurrent gliomas. BMC Cancer. 2007;7:167. 

  5. Wernicke AG, Smith AW, Taube S, et al. Cesium-131 brachytherapy for recurrent brain metastases: durable salvage treatment for previously irradiated metastatic disease. J Neurosurg. 2017;126(4):1212-1219. 

  6. Magill ST, Lau D, Raleigh DR, Sneed PK, Fogh SE, McDermott MW. Surgical resection and interstitial iodine-125 brachytherapy for high-grade meningiomas: a 25-year series. Neurosurgery. 2017;80(3):409-416. 

  7. Chiu-Tsao ST, Napoli JJ, Davis SD, et al. Dosimetry for 131Cs and 125I seeds in solid water phantom using radiochromic EBT film. Appl Radiat Isot. 2014;92:102-114. 

  8. Brachman D, Youssef E, Dardis C et al. Resection and permanent intracranial brachytherapy using modular, biocompatible cesium-131 implants: results in 20 recurrent, previously irradiated meningiomas. J Neurosurg. 2019;131(6):1819-1828. doi:10.3171/2018.7.jns18656

  9. Brachman D, Youssef E, Dardis C, Smith K, Pinnaduwage D, Nakaji P. Surgically Targeted Radiation Therapy: Safety Profile of Collagen Tile Brachytherapy in 79 Recurrent, Previously Irradiated Intracranial Neoplasms on a Prospective Clinical Trial. Brachytherapy. 2019;18(3):S35-S36. doi:10.1016/j.brachy.2019.04.076

GammaTile Therapy is indicated to deliver radiation therapy for patients with newly diagnosed malignant intracranial neoplasms and recurrent intracranial neoplasms.

 

For full safety information, refer to the GammaTile Instructions for Use.

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IMPROVING THE LIVES OF PATIENTS WITH BRAIN TUMORS