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A week before 57-year-old Bonny Hall and her Sunnybrook doctors were set to make medical history, she was – understandably so – a bit on edge.
“Nervous. Anxious. Excited, because someone has to go first,” reported Bonny, who was about to become the first person to have her blood-brain barrier (BBB) breached in a non-invasive way, so that chemotherapy drugs could reach her brain tumour.
In November 2015, Bonny was the first participant in a groundbreaking clinical research trial at Sunnybrook that is testing the ability of focused ultrasound to temporarily open the BBB and allow medication to reach targeted areas. Everyone has a barrier that lines their brain’s blood vessels and restricts the passage of substances from the bloodstream into the brain. It does this to protect the brain from disease and toxins.
“Some of the most exciting therapeutics for the treatment of malignant brain tumours cannot reach the tumour cells because of the barrier,” says Dr. Todd Mainprize, lead neurosurgeon in Sunnybrook’s Hurvitz Brain Sciences Program and principal investigator of the trial that will enrol as many as 10 patients. “This technique will open up new opportunities to deliver potentially much more effective treatments.”
This technique will open up new opportunities to deliver potentially much more effective treatments.
Dr. Mainprize’s team successfully bypassed Bonny’s BBB by using a helmet-like focused ultrasound device, guided by real-time magnetic resonance imaging, to direct waves of ultrasound energy toward the blood vessels near her tumour. The focused ultrasound waves caused microscopic bubbles, previously injected into Bonny’s bloodstream, to vibrate and loosen the tight junctions of the cells that comprise the BBB. This allowed a chemotherapy drug – also infused intravenously – to flow through the barrier and reach Bonny’s tumour.
“This isn’t just about a brain tumour,” Bonny says, noting the procedure also has the potential to revolutionize treatment of dementias like Alzheimer’s disease and some mental illnesses.
Bonny’s participation in the trial was a truly selfless act, as she won’t derive any direct benefit from it. The trial’s primary aims are to test the therapy’s safety and preliminary efficacy – a critical step before conducting larger studies with more patients. Following the procedure, Dr. Mainprize removed portions of Bonny’s tumour through traditional neurosurgery, just as he will do for other trial participants.
What Bonny wants most now is a sense of normalcy. “I just want to be a normal mom, a normal grandma…just a normal wife.”
However, her contribution to medical science guarantees she will always be regarded as extraordinary.
If you’d like to support life-saving innovation at Sunnybrook, donate now.