Don’t Put Off Until Tomorrow What You Can Do Today - Neurosurgeons Address the Unmet Challenges of Glioblastoma
From left to right: Ashish Shah, MD, Ricardo J. Komotar, MD, FAANS, FACS, Michael E. Ivan, MD, MBS, FAANS
One of the most common brain tumors, glioblastoma (GBM), (glioblastoma stage 4) has no cure, and treatments over the last 20 years unfortunately have not improved survival.
By: Ashish Shah, MD, assistant professor of neurological surgery and director of clinical trials and translational research at University of Miami Miller School of Medicine, Michael E. Ivan, MD, MBS, FAANS and Ricardo J. Komotar, MD, FAANS, FACS, co-directors of Sylvester Comprehensive Cancer Center Brain Tumor Initiative, and medical advisory board members for The Glioblastoma Research Organization
More than 25,000 people in the United States are diagnosed with malignant brain tumors. One of the most common brain tumors, glioblastoma (GBM), has no cure, and treatments over the last 20 years unfortunately have not improved survival. Patients diagnosed with GBM live slightly over one year despite surgical removal, chemotherapy and radiation. For patients diagnosed with this terrible disease, there is no time to lose.
Organizations and academic institutions have taken the lead on addressing this unmet challenge. We know that addressing this fatal disease requires support and “buy-in” from the community, universities, scientists and physicians. Nonprofits such as The Glioblastoma Research Organization spearhead grassroots efforts to raise awareness for brain cancer and fundraise for instrumental research projects. Within our community, scientists are developing novel targeted therapeutics to attack the cancer’s genetic machinery and prevent cancer spread. Since every person’s brain cancer is inherently different, scientists invest in new culturing techniques to isolate and grow patient tumor cells in the laboratory. Using a novel technique, researchers have created “brain tumor organoids” that mimic the human brain and the tumor in a dish. Using these techniques, thousands of personalized medicines are being screened for rapid bench to bedside translation. New biological therapies are being investigated using viruses to selectively kill brain cancer cells, new cancer biomarkers are on the horizon and immunotherapies are now being repurposed for brain cancer.
As neurosurgeons, however, our task remains insurmountable at times. Brain tumors are often located in areas where a surgeon cannot safely remove them or simply cannot see them. Since patients do better when we remove the most amount of tumor, we strive to maximize the degree of tumor removal without damaging critical brain structures. In these settings, we have utilized a surgical technique called “awake craniotomy” to safely map the brains of our patients and protect important functional areas for speech or movement. Additionally, new hybrid technologies such as Stimulated Raman Histology and 5-ALA fluorescence guidance allow us to see microscopic “invisible” tumor cells, so we can selectively remove them in the operating room. Because some tumors are not seen on standard MRI, we have developed new imaging modalities such as Whole-Brain Magnetic Resonance Spectroscopy to identify hidden brain tumor projections and predict recurrence months earlier than before. These techniques have given us an edge while fighting the figurative behemoth named brain cancer, but there is still much work to be done. We will need buy-in from the community. We will need support from public and private organizations. And most importantly, we need the trust of our patients.
We certainly will not wait for tomorrow to fight this deadly disease.
Get to know the Glioblastoma Research Organization’s medical advisory board members here and learn more about glioblastoma research programs our nonprofit has fully funded at leading cancer centers around the U.S.