Middlesex County man battles brain tumor with help of technology, clinical trial

Courier News
January 23, 2011

In the spring of 2011, 71-year-old Bashir Khan appeared to his family to be uncharacteristically emotional and forgetful, and at times, had trouble forming words.

His daughters, who are doctors, insisted that he be checked out by a neurologist, and after a series of tests, he was handed a diagnosis that no one wants to hear. The Parlin resident was suffering from a malignant brain tumor.

But with the help of a trial drug and a special pacemaker, Khan’s chances of extending his life have improved, according to Khan’s daughter, Dr. Rizwana Khan.

“My father was born in a small village in Pakistan. He is a very strong, self-made man with a strong personality, and he is determined to fight this. His outlook is  amazingly positive,” Dr. Khan said.

Khan sought the help of Dr. Joseph C. Landolfi, director of Neuro Oncology, JFK Brain Tumor Center at JFK Medical Center, Edison.

Dr. Landolfi offered Khan a glimmer of hope when he told him about a new trial  offered at JFK that could help him. But in order to participate in the trial, Khan would have to undergo an MRI every eight weeks.

“The first course of action after Khan was diagnosed was surgery, but upon examination, he was found to have a low heart rate. He was then seen by a cardiac specialist, who anticipated that Khan would have to undergo a series of MRI exams and recommended that he be outfitted with the Ensura MRI SureScan Pacemaker by Medtronics Inc.

“Traditionally, patients with pacemakers have not been allowed to go through magnetic resonance imaging because the pacemaker and the wire of the pacemaker act like an antenna and the energy that the MRI emits can get absorbed by the antenna and can send electric signals to the heart, which can result in an arrhythmia that can cause the heart to stop,” said Dr. Noam S. Eshkar, chief of Neuro Radiology at JFK Medical Center.

Eshkar said the new Medtronics pacemaker is the first such device that allows a patient to go through an MRI exam.

The pacemaker made it possible for Khan to participate in the ImmunoCellular ICT-107 brain tumor vaccine trial at JFK, which has nine participants, and there are approximately 35 participants around the country, according to Landolfi.

“The brain tumor trial is testing a vaccine that is developed from the patient’s own blood,” Landolfi said. “We attach proteins to the patient’s immune cells and then inject it back into the patient, which then directs the body to attack the proteins on the tumor. It essentially mounts his body’s immune system to attack the tumor.”

According to Landolfi, the trial offers the hope for a more effective treatment of an extremely aggressive brain tumor.

“The fact that Khan is using the new Medtronic pacemaker and also is participating in the ICT-107 brain tumor trial, make him clearly a cutting-edge patient,” Eshkar said. “These are both very recent innovations.”

“The vaccine used in the clinical trial is helping to improve his quality of life and his chances for survival,” Landolfi said. “The new pacemaker is allowing him to get the MRI scans he needs to continue to monitor his progress in the trial.”

The results from the Phase I ICT-107 trial conducted at Cedars-Sinai Ledical Center in Los Angeles showed a two-year survival rate of 80 percent, versus the typical  standard of care that produces a 26 percent survival rate, according to Landolfi.

“The hope is that we will see as compelling data in the phase II trial as we have seen in phase I, although we don’t like to use Phase I data to look at survival data,” Landolfi said.

Khan will continue to receive monthly chemotherapy treatments, in addition to the vaccine administered through the trial for up to 12 months, then will be monitored with serial scans to detect whether the disease has returned.

“If we had an incompatible pacemaker, we would have been forced to do CAT scans, which would not have been as good as evaluating the tumor with an MRI, or shut the pacemaker off during the MRI, which would have put him at risk,” Landolfi said. “This solution makes it ideal.”

Khan’s daughter believes that her father has a very good chance of surviving well beyond the average life expectancy for a patient with his diagnosis.

“My father was the first in his village in Pakistan to earn a master’s degree,” she said. “He is extremely positive and determined. He has never complained through this whole ordeal.”

Khan worked as a supervisor for Pakistan International Airlines until 1973. He retired from Saudi Arabian Airlines in 1998 but continued to help his son manage his limousine business until he diagnosed.

Khan, a practitioner of Islam, said his faith plays a pivotal role in his outlook, though he is unable to pray the customary five times each day.

“I pray as often as I can,” Khan said, “and I know it’s having a positive impact on my life.”