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The Role of the Ommaya Reservoir in Innovative Approaches to Treating Brain Tumors

July 4, 2024
Shimon Slavin
Ommaya Reservoir for brain cancer

For brain tumor patients, innovative treatments offer new hope. The Ommaya reservoir, a device designed for delivering medications directly into the brain or cerebrospinal fluid, has become a useful tool in the fight against brain tumors. At Biotherapy International, we use the Ommaya reservoir to deliver oncolytic viruses or mismatched donor lymphocytes as part of our treatment protocol to enhance the attack on cancer cells.

What is an Ommaya Reservoir?

An Ommaya reservoir is a small, dome-shaped device surgically implanted under the scalp. It’s connected to a catheter that leads directly into the drainage system for cerebrospinal fluid, allowing it to deliver chemotherapy drugs. This targeted approach ensures treatments reach the tumor site more effectively than traditional methods, especially since the blood-brain barrier (BBB) prevents several agents from entering the cerebrospinal fluid and brain cells.

What is the Ommaya reservoir used for?

The brain’s blood-brain barrier (BBB) often prevents medication from effectively reaching the tumor. The Ommaya reservoir overcomes this barrier by enabling direct intratumoral administration of therapeutic agents. This method ensures the entire dose bypasses the BBB and penetrates the tumor, maximizing the treatment’s efficacy and enhancing its anti-cancer effects.

Implantation and Safety

The implantation of an Ommaya reservoir is a surgical procedure performed under general anesthesia. Here’s how it typically works:

1. Preparation: The patient is given general anesthesia to ensure there is no pain during the procedure.

2. Incision: A small incision is made in the scalp, and a hole is drilled into the skull.

3. Placement: The reservoir, a dome-shaped device with a membrane that can be punctured, is positioned under the scalp, and the catheter is carefully threaded through the hole into the brain’s ventricular system or even directly into the tumor site, depending on the disease.

4. Securing: The reservoir is secured, and the incision is closed with sutures.

The procedure is considered safe, but as with any surgery, there are risks, including infection, bleeding, or damage to surrounding brain tissue. After the operation, the patient can return to their normal lifestyle with standard hospital discharge on the following day, but contact sports should be avoided for the first six weeks after surgery.

How Does It Work with Oncolytic Viruses and ATACK?

Oncolytic viruses are viruses that can infect and kill cancer cells while sparing normal cells. By injecting these viruses directly into the brain tumor via the Ommaya reservoir, we can transform the tumor into an in-situ anti-cancer vaccine. Thus, the immune system cells can once again recognize tumor antigens, a function that is lost in the development and progression of cancer.

Another treatment modality that has the potential to cure a patient completely is the ATACK method. This involves using intentionally mismatched donor lymphocytes, including T cells, NK cells, and NKT cells, which are targeted preferentially against cancer cells. Deliberately incompatible donor lymphocytes trigger a rejection-like reaction, effectively destroying cancer cells that might resist other treatments.

Conclusion

The Ommaya reservoir, in combination with advanced treatment methods, represents a promising approach to treating brain cancer. This technique offers new possibilities for treating patients with high-grade brain tumors who have no chance of recovery with traditional methods. Biotherapy International is committed to advancing these innovative treatment methods to achieve the best outcomes for its patients.

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