Technological Adjuncts for Malignant Brain Tumor Surgery-Michael A. Vogelbaum, MD, PhD, FAANS Video

Michael A. Vogelbaum, MD, PhD, FAANS Video
Video Transcription
I'm going to discuss today the first in-human use of 5ALA with a 3D exoscope. This was performed in a first in-human clinical trial at Moffitt Cancer Center.  Here are my disclosures. The ones that are relevant to this presentation include the ones regarding funding.  Funding for this clinical trial was provided by Olympus, the manufacturer of the 3D exoscope. I developed this protocol independently and received no personal compensation.  And the exoscope itself was purchased at market rates by Moffitt Cancer Center. And Gliolan, or 5ALA, was purchased at market rates by Moffitt Cancer Center and used according  to its labeled indication. I have some unrelated conflicts that are shown. To put things in perspective, it's first important to understand where we are with respect to  treating gliomas in 2020. And unfortunately, we remain in the same place that we were when I started my independent career in 1999.  The outcomes are marginally better, and the standard therapies are the same. Surgical resection, followed by radiotherapy, cytotoxic chemotherapy, and perhaps we would  have the addition of alternating electrical fields. Most of our advances have been in understanding the biology and subclassification of these  tumors, but not so much in the way of therapy. When we talk about resection of gliomas, we need to understand what the goal is.  For high-grade or enhancing gliomas, we often talk about removal of all of the enhancing  tumor, whereas for low-grade gliomas, we talk about removal of all of the visible abnormality.  And it's important to keep this in mind when we think about what constitutes a complete resection.  Nonetheless, we have a growing body of evidence that shows that a more extensive resection is associated with