On April 18, 2026, the world of neuro-oncology marked a series of extraordinary developments, highlighting both the daunting challenges of spinal cord tumors and the promise of new treatments. From a groundbreaking surgery in Pune, India, to a young boy’s courageous battle in the UK, and the U.S. FDA’s recognition of a potential game-changer drug, these stories collectively underscore the evolving landscape of care for those facing some of the most complex tumors known to medicine.
At Sahyadri Hospital in Pune, a neurosurgical team achieved what many would call a medical marvel: the successful removal of a 16.5-centimeter tumor from a patient’s spinal cord. According to the Times of India, this rare, long-segment intramedullary tumor extended from the brainstem, through the cervical spine, and down to the fourth thoracic vertebra. What made this case even more perilous was the tumor’s reach into the medulla oblongata, the critical area of the brainstem responsible for controlling vital functions like breathing and heart rate.
Dr. Jaydev Panchawagh, senior consultant neurosurgeon at Sahyadri Hospital, explained the stakes: "This was a challenging case due to the tumour's immense size and its proximity to critical neural structures. Our primary goal was to achieve maximal safe removal while preserving the patient's neurological function." The team relied on advanced microsurgical tools and intraoperative neuro-monitoring—a real-time system that alerts surgeons to nerve stress—to meticulously separate the tumor from delicate neural tissue. The risks were immense: any misstep could have resulted in permanent neurological deficits, including paralysis or even the loss of life-sustaining functions.
Such high-wire acts in the operating room are rare, in part because tumors like these—arising within the spinal cord and spanning multiple vertebral levels—are themselves uncommon. Yet, as specialists at Sahyadri Hospital noted, the symptoms can be all too familiar: persistent neck or back pain, limb weakness, sensory changes, or loss of coordination. Tragically, these signs are often mistaken for routine orthopedic problems, leading to delayed diagnosis and missed opportunities for early intervention. As the hospital’s team emphasized, "Early evaluation through MRI imaging and timely referral to specialised neuro-centres are vital for recovery to prevent lasting paralysis."
But not all patients are as fortunate as the Pune case. In the United Kingdom, 13-year-old James Lewis’s story, reported by PEOPLE and Kennedy News, reveals the heartbreaking reality when tumors entwine themselves so deeply with the spinal cord that surgery becomes impossible. In March 2021, James woke up numb from the waist down. His father, also named James Lewis, recalled, "I was very shocked. I remember thinking, ‘How can you not feel your legs?’ He tried to stand up and fell to the floor like jelly." Doctors soon diagnosed him with a benign but inoperable spinal cord tumor, about seven inches (17.8 cm) long—almost half the length of his spinal cord. The tumor was so tightly wrapped around the cord that, in his father’s words, "When they look at the tumor, the [spinal] cord isn't visible—you just see the cord going into the tumor and coming out of the bottom."
James’s journey has been grueling. Despite multiple surgeries and rounds of chemotherapy, he lost function in his legs, bowel, and bladder. The most recent surgery, performed in January 2026, has left him in rehabilitation, still unable to regain sensation or movement in his lower body. The loss has been deeply personal, too: "He was in the boxing gym twice [a] week from the age of 5 years old, which we had to stop due to him losing his proprioception and his sensation. He just completely lost his footwork," his father said. Yet, amid the devastation, James has found solace in fishing—a new hobby that’s brought him comfort and community. A GoFundMe campaign, started by a fellow angler, now seeks to fund an electric wheelchair for him.
For families like the Lewises, and for countless others facing aggressive brain and spinal cord tumors, hope often hinges on medical breakthroughs. Enter plixorafenib, an experimental drug that just earned FDA Breakthrough Therapy Designation for aggressive brain and spinal cord tumors, as reported by FORE Biotherapeutics and SurvivorNet. Plixorafenib’s promise lies in its innovative mechanism: it acts as both a dimer breaker and paradox breaker, targeting BRAF V600E mutations—a genetic alteration found in some of the most stubborn central nervous system tumors. Unlike previous BRAF inhibitors, which required combination therapy with MEK inhibitors (and the added toxicity that comes with it), plixorafenib works as a single-agent oral therapy.
The early clinical results have been nothing short of remarkable. In Phase 1/2a trials involving about 25 patients with BRAF V600-mutated primary CNS tumors who had not received prior MAPK inhibitors, the drug achieved a 67% overall response rate. The median duration of response was 17.8 months in V600-altered patients, and the clinical benefit rate exceeded 75 percent—meaning that three-quarters of patients saw their tumors shrink or stabilize. Side effects such as fatigue, nausea, and diarrhea were reported, but the rate of discontinuation due to drug-related adverse events was less than 2 percent. Notably, there were fewer liver complications than with standard alternatives.
Dr. Macarena de la Fuente, Chief of Neuro-Oncology at the University of Miami Miller School of Medicine, commented on the significance: "High-grade gliomas are aggressive primary brain tumors associated with poor outcomes despite multimodality treatment approaches. Therefore, there remains a critical need for novel treatments that are not only effective but also better tolerated."
With the FDA’s Breakthrough Therapy Designation, plixorafenib’s development will accelerate by six to twelve months, potentially reaching patients within 18 to 24 months if regulatory approval proceeds smoothly. FORE Biotherapeutics is currently conducting the FORTE basket study—a Phase 2 trial evaluating the drug across multiple tumor types. The BRAF V600E CNS basket met its interim efficacy analysis in September 2025, and topline results are expected by the end of 2026. If these results hold, the company plans to submit a New Drug Application under the accelerated approval pathway.
For patients and families navigating the uncertainties of spinal cord and brain tumors, these developments represent real, tangible progress. The stories from Pune, London, and the U.S. highlight both the immense challenges and the growing arsenal of solutions—surgical and pharmacological—available to those in need. As science advances and communities rally to support the vulnerable, the future for patients with spinal cord tumors appears, at last, a little brighter.