Patients are guaranteed appointments within 72 hours and can typically see all the necessary providers (oncologists, radiation oncologists, neurosurgeons, and/or palliative care specialists) on the same day and in one facility. All patients are assigned to a navigator who knows their treatment goals, coordinates their tests and appointments, and helps see them through their care at Duke.
Call the referring provider team Monday through Friday between 8:00 a.m. and 4:30 p.m. at 866-385-3123 (1-866-DUKE-123) or email OncologyReferral@Duke.edu.
The Duke Center for Brain and Spine Metastasis (DCBSM) uniquely developed a program to offer patients with central nervous system malignancies the latest treatment and trial options. “Historically, patients with CNS cancer were excluded from trials; now, it’s the focus. We bring multiple areas of clinical expertise together to offer medical therapies in synergy with clinical trials for CNS cancers,” says Carey K. Anders, MD, DCBSM director. State-of-the-art treatments are offered to patients with first-time metastatic cancer and those with progression after previous treatment.
One innovative therapy showing promise at DCBSM is interstitial thermal therapy (LITT). Duke is one of the highest-volume centers in the U.S. offering this treatment. According to Anders, “Radiation therapy can cause necrosis with the brain over time, and LITT is a novel way to treat this challenging side effect of radiation. This is a great and less invasive approach for patients with radiation necrosis from previous radiation treatment.”
LITT has become a preferred treatment because it’s minimally invasive and enables precise targeting. LITT procedures are performed in Duke’s advanced intra-operative MRI suite using a robotic-assisted laser technique. Incisions are typically less than a centimeter, allowing most patients to be discharged the following day with a small dressing covering the incision.
“At Duke we are proud to have depth of experience in the full range of local and systemic therapies. This allows us to tailor a treatment approach that is best for the patient. LITT has proven to be a powerful option that has benefited many of our patients,” says Jordan M. Komisarow, MD, DCBSM surgical director.
LITT is among a growing list of cutting-edge therapies offered at DCBSM, including complex surgical resections, stereotactic radiation therapy, chemotherapy, targeted therapies, immunotherapy, and more. The team also leads many clinical trials pursuing the latest promising advances in brain and spine malignancy treatments. “The challenge in finding effective systemic treatments for CNS cancer is traversing the brain and tumor barrier, but we’re making headway in trials. A selective estrogen degrader discovered here is now being further studied in a trial evaluating elacestrant and CDK4/6 inhibitor in patients with breast cancer and brain metastasis,” says Anders.
Anders adds that the team is also exploring immunotherapy. “It has long been thought that the CNS was a sanctuary where immune cells might not reside, but we are now seeing responses to immunotherapies, especially in lung cancer and melanoma metastasis.” Other personalized approaches include tumor sequencing. “With our molecular tumor board, we sequence a patient’s tumors to evaluate tumor or circulating tumor DNA and alterations in tumor cells. Then, we can guide therapies to target them more precisely.”