Support: Neurosurgeon Research Education Foundation (NREF) Research Grant Award.
Principle Investigator: D.M. Sciubba
Metastatic spine tumors customarily appear in patients as part of a widespread proliferation of cancerous tissue. The vital role of the spinal cord makes metastasis to this region an ominous and devastating milestone in most patients, often resulting in crippling pain, dangerous instability, and neurological deficits. High dose chemotherapy and radiotherapy regimens have shown limited efficacy due to poor drug penetration through the osseous elements and dose-limiting systemic toxicities.
To maximize drug exposure and decrease systemic toxicity, anti-tumor agents can be incorporated into local drug delivery systems for intra-operative administration, some of which we have studied in our laboratory. Bone Morphogenic Proteins (BMPs) are particularly relevant when considering local delivery of chemotherapy to metastatic spine tumors due to its current use in spine fusion surgery.
Spinal metastasis model in rat by Mantha et al. showing drilling of L6
vertebrae with resultant tumor growth and spinal cord compression.
Borrowed from Mantha et al., J Neurosurg March 2005
However, due to the unknown impact that BMPs may have on a tumor resection bed, commercially available BMPs (2 & 7) are contraindicated in patients with a history of spine tumor. Unfortunately, patients undergoing spine surgery for tumor could potentially benefit greatly from the fusion-generating capacity of BMPs, since such patients are often at increased risk for non-union due to advanced age, osteopenia/osteoporosis, corticosteroid use, radiation therapy, and cachexia. In this study, we seek to establish preclinical data regarding effects of BMPs on spine tumors by reporting the histological and clinical outcomes that BMP-2 and BMP-7 have on human breast cancer growing in the nude rat spine.