Cincinnati—The University of Cincinnati (UC) is launching a new Brain Tumor Molecular Therapeutics Program aimed at understanding the biological mechanisms of cancer’s spread to the brain and developing more effective ways to treat the condition.
A total of $6.5 million—a $2 million gift from the Harold C. Schott Foundation and $4.5 million in additional funds from the UC College of Medicine and its departments of cancer and cell biology, internal medicine (hematology-oncology division), neurosurgery and radiation oncology—has been committed to build the interdisciplinary translational research and patient care program dedicated exclusively to tackling the growing problem of brain metastasis.
The Harold C. Schott Foundation’s contribution will establish an endowed chair of molecular therapeutics. This private funding—teamed with the additional $4.5 million from UC—provides the initial support to launch the program.
The UC-based program is believed to be the first comprehensive brain metastasis-specific translational research program in the United States. It is collaboration between the UC Cancer Institute and the UC Neuroscience Institute, two prominent initiatives at the College of Medicine and UC Health.
According to the National Cancer Institute, more than 170,000 people are diagnosed annually with a secondary cancer that has spread to the brain.
Brain metastases are secondary tumor sites that occur when cancer spreads from the point of origin to another organ or part of the body. Circulating tumor cells can be detected in the blood of cancer patients; however, not all these patients will develop brain metastases. A better understanding of how and why cancers metastasize to the brain would allow researchers to develop specific therapies to treat existing brain metastases and possibly prevent their formation.
"For a long time brain metastases have been treated as an orphan disease—given little research funding and stalling any progress toward improved treatment strategies,” says Ronald Warnick, MD, director of the UC Brain Tumor Center and professor of neurosurgery at the College of Medicine. "We hope to change that through this new program by investigating mechanisms by which the primary cancer gains access to the bloodstream and establishes tumors in the brain.”
The new molecular therapeutics program will allow UC to build a subspecialized research team that will collaborate with the existing multidisciplinary brain tumor clinicians and surgeons to address the problem of brain metastases through translational research and original clinical trials.
"We have relatively good therapies for secondary metastases to the liver and bone … but brain metastases are a very unique problem. There are limited treatment options if surgery and/or stereotactic radiosurgery fail to eradicate the cancer,” says Olivier Rixe, MD, PhD, a UC Health medical oncologist and director of the experimental therapeutics program at the College of Medicine. "There must be a higher level of innovation in our approach to brain metastases in order to impact people suffering from this disease.”
Scientists have hypothesized that a tumor blood-brain barrier prevents drug penetration and uptake into the normal brain and brain metastases, but Rixe says scientists have such a rudimentary understanding of the biology of brain metastases that they need to start from scratch to move forward.
"Does the tumor blood-brain barrier exist? Do surrounding normal brain cells increase drug resistance? How does the brain microenvironment lead to chemotherapy resistance? These are all basic questions we will seek to answer in the new molecular therapeutics program,” he adds. "We will translate these pre-clinical findings into specific clinical trials for patients with brain metastases. This is why the support of the Harold C. Schott Foundation is crucial: As a comprehensive program supporting a bench-to-bedside effort, we ultimately hope to impact the prognosis of this disease.”
Currently, most patients with brain metastases are excluded from phase-1 clinical trials. Rixe says clinical trials must be redesigned to evaluate these emerging therapies in patients with brain metastases. The molecular therapeutics program will help launch new molecular therapy clinical trials specifically targeting brain metastases.
The UC College of Medicine is currently recruiting for three new faculty members to conduct laboratory and pre-clinical research studies aimed at understanding the biology of brain metastases. The Harold C. Schott Foundation gift was made to establish an endowed chair of molecular therapeutics in brain tumors, creating a permanent source of funding for the program.
"This endowed chair gift will be instrumental in our ability to attract a world-class, nationally recognized expert to lead this program,” adds Andrew Filak, MD, interim dean of the College of Medicine. "Endowed chairs provide a strong signal to prospective candidates that we are committed to this initiative, expediting our ability to recruit a top-notch candidate. It also provides security during the ebbs and flows of NIH (National Institutes of Health) research funding so that progress is not hindered”
"This is a problem that has personally touched our family, and we know the expertise exists right here in Cincinnati to build a top-notch brain metastases research and patient care program that will make a difference for patients and their families,” says L. Thomas Hiltz, trustee for the Harold C. Schott Foundation and member of the UC Neuroscience Institute Board of Advisors.
In addition to the enhanced translational research effort, the molecular therapeutics program also includes a new patient support program that pairs patients recently treated for brain metastases with a mentor who has a similar diagnosis and age. Patients will also have access to an interactive brain metastases-specific website (ucbraintumorcenter.com/metastatic) which will include frequently asked questions, treatment options, hope stories, patient support group information, clinical trials and emerging research updates.
"The UC Brain Tumor Molecular Therapeutics Program is the first major initiative to be supported jointly by the UC Neuroscience Institute and the newly established UC Cancer Institute. We are excited to see the two Institutes working collaboratively to develop an innovative new program devoted to basic and translational research with the goal of improving the outcome of patients with brain metastases,” says George Atweh, MD, hematology oncology division chief and director of the UC Cancer Institute.
"To see this program coming to fruition in the midst of so much patient need and advocacy by our board and institutional supporters—it’s a very special moment for our team and our community,” says John Tew, MD, clinical director of the UC Neuroscience Institute and professor of neurosurgery at the College of Medicine.