The logic behind the strategy rests on a well-known obstacle in neuro-oncology. The blood-brain barrier, the dense layer of tight junctions that lines cerebral capillaries and shields neural tissue from circulating molecules, also excludes most systemically delivered chemotherapies and many radiopharmaceuticals from reaching intracranial tumors in effective concentrations. By injecting the radioembolic agent through catheters navigated directly into the arteries supplying a tumor, clinicians could in principle bypass that barrier entirely, depositing both the occlusive polymer and the beta-emitting isotope on the tumor side of the circulation. Munir Ghesani, co-investigator and Associate Professor of Neurosurgery at the Icahn School of Medicine, described the combination as offering a distinct translational opportunity, citing the ischemic effect of embolization together with targeted radiation delivery that circumvents the blood-brain barrier as a way to maximize therapeutic efficacy.

Each component of the dual-action agent addresses a different axis of tumor control. TRUFILL n-BCA, or N-butyl cyanoacrylate, is a fast-polymerizing adhesive that solidifies on contact with blood, permanently occluding the vessels it fills. Cutting off a tumor’s arterial supply produces an ischemic effect, depriving the lesion of oxygen and nutrients and potentially shrinking it or reducing the risk of hemorrhage during subsequent surgery. Iodine-131, meanwhile, is a radioactive isotope of iodine that emits beta particles with a mean energy well suited to depositing dose over a range of several millimeters in tissue. Because those beta particles travel only a short distance, radiation is concentrated in and immediately around the vessels where the agent has lodged, which fall overwhelmingly within tumor tissue, while sparing the surrounding brain. Embedding the isotope in a solid embolic cast also prevents it from washing downstream into healthy circulation.

Alejandro Berenstein, MD, Director of the Vascular Malformations Research Center at Mount Sinai and co-lead of the research program, said the combination of targeted embolization with localized radiation delivery may offer a new way to treat tumors that are difficult to remove surgically or to manage with conventional radiation. The goal, he noted, is to deliver therapy precisely through the tumor’s own vascular network while limiting exposure to surrounding tissue. That framing highlights why meningiomas were chosen as the first target. These tumors arise from the meningeal coverings of the brain rather than from brain tissue itself, are typically supplied by branches of the external carotid circulation that are accessible to endovascular catheters, and are already sometimes embolized before surgical resection to reduce blood loss. A radioembolic that both devascularizes and irradiates the lesion could extend a familiar interventional workflow into a definitive therapy, particularly for tumors at the skull base or near critical structures where complete surgical removal carries high risk and where standard external-beam radiation has already been used or is unsuitable.

Under the agreement, the Mount Sinai team will collaborate with the neurovascular business to optimize the investigational formulation and its delivery approach and to evaluate safety and feasibility. Before any preclinical evaluation in living systems, the program will rely on patient-derived, 3D-printed vascular models and advanced imaging to assess how the agent distributes and localizes when injected through simulated tumor feeders. Such models, reconstructed from the actual vascular anatomy of individual patients, allow researchers to test catheter positioning, injection rates, and the resulting polymer cast geometry under controlled conditions, measuring precisely where the radioactive material would settle and how much dose would reach tumor versus adjacent healthy tissue. That engineering-heavy, simulation-first pathway is intended to de-risk the technology before it ever reaches an animal or a patient.

Benjamin Rapoport, MD, PhD, Scientific Director of Mount Sinai BioDesign, said the collaboration brings together clinical, engineering, imaging, and industry expertise to evaluate an innovative approach to neuro-oncology, and that the program provides a path for advancing the technology from controlled laboratory testing toward future clinical evaluation. Mount Sinai BioDesign, the health system’s biomedical design and development group, sits at the intersection of those disciplines, pairing surgeons and physicians with engineers who can translate a clinical concept into a manufacturable device or formulation. The research is explicitly intended to establish a foundation for potential future clinical studies, meaning that the current phase is preclinical: formulation optimization, bench testing, imaging validation, and safety and feasibility assessment, with no claim yet of proven benefit in patients.

The industrial partnership matters as much as the scientific one. TRUFILL n-BCA is an established, regulated product in the neurovascular arsenal, and adapting it as a carrier for Iodine-131 requires careful control of radiochemical stability, polymerization kinetics in the presence of the isotope, radiation dose to the delivered material itself, and sterilization and handling procedures for a radioactive investigational agent. Working with the manufacturer’s neurovascular business gives the academic team access to formulation expertise, manufacturing capability, and regulatory experience that small academic labs rarely possess. Joshua B. Bederson, MD, the Leonard I. Malis, MD / Corinne and Joseph Graber Professor of Neurosurgery and System Chair for the Department of Neurosurgery at Mount Sinai Health System, described the joint research effort as exactly the kind of innovative, integrative work Mount Sinai BioDesign was built for, saying that bringing together scientists, clinicians, and engineers with deep experience in health system integration, alongside major industry leaders, has allowed the team to move from problem to solution faster than ever and to develop a next generation of tools for clinicians and patients.

The endovascular suite is where such a therapy would ultimately be delivered, and the imaging infrastructure of a modern academic center is central to both the research plan and any eventual clinical use. Real-time fluoroscopy and digital subtraction angiography guide catheters from a femoral artery puncture into the small branches feeding a meningioma, while advanced cross-sectional imaging can afterward map where the embolic cast resides and model the radiation dose distribution in three dimensions. Embedding that workflow within a single health system that spans interventional neuroradiology, neurosurgery, radiation physics, nuclear medicine, and biomedical engineering is what allows a concept like a liquid radioembolic to be iterated rapidly: a vascular anatomy suggests a delivery challenge, engineers modify the formulation or the model, and imaging verifies the result, all within one institutional loop.

The broader significance lies in a growing trend in oncology toward locoregional radiopharmaceutical delivery, in which radioactive agents are placed inside or immediately beside a tumor rather than beamed through healthy tissue from outside. Liver-directed radioembolization with microspheres carrying Yttrium-90 is already an established example of the principle, and applying an analogous concept to brain tumors, where the blood-brain barrier and the proximity of eloquent neural tissue make both drugs and radiation harder to deliver, could fill a significant unmet need. Meningiomas that recur after surgery and radiation, or that encase arteries and cranial nerves at the skull base, currently have limited options, and a therapy that combines mechanical devascularization with internally deposited beta radiation would attack such lesions on two fronts simultaneously.

Substantial work remains before the approach can be tested in people. The current agreement covers optimization of the formulation, laboratory evaluation in patient-derived vascular models, and progression to preclinical studies assessing safety and feasibility, a sequence the investigators describe as foundational for potential future clinical trials. Questions about dose calibration, the longevity of the polymer-isotope cast within vessels, the behavior of the agent in vascular territories shared by normal tissue, and the selection of patients most likely to benefit will all need rigorous answers. But the collaboration signals that one of the largest academic health systems in the New York metropolitan area, with more than 600 research and clinical laboratories and a neurosurgical department long associated with innovation in vascular and tumor therapy, is betting that the fastest route to new neuro-oncology tools runs through the tumor’s own plumbing. If the laboratory and preclinical phases bear out the promise of the dual-action liquid radioembolic, patients with hard-to-treat brain tumors may one day receive a therapy delivered through a catheter the width of a strand of spaghetti, radiation and all, aimed from within the vessels that sustain the disease itself.

Subject of Research: A liquid radioembolic agent combining Iodine-131 and n-BCA embolization for targeted treatment of brain tumors

Article Title: Mount Sinai announces collaborative research agreement to evaluate novel liquid radioembolic agent for brain tumors

Article References: Mount Sinai announces collaborative research agreement to evaluate novel liquid radioembolic agent for brain tumors. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: Mount Sinai, Johnson & Johnson, Cerenovus, radioembolization, Iodine-131, TRUFILL n-BCA, meningioma, brain tumors, blood-brain barrier, interventional neuroradiology, 3D-printed vascular models, neuro-oncology