Advancing the care of brain tumor patients lies in a better understanding of the causes and mechanisms of tumor development. Basic science research efforts at the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center are focused on identifying the genetic, cellular, and molecular biology of malignant and benign brain tumors, investigating the mechanisms of tumor formation, and exploring new therapeutic developments of brain tumor treatment.
One example of the promising research being conducted by the Burkhardt Brain Tumor Center researchers and physicians involves further investigation of the process of apoptosis, or programmed cell death, as it presents in brain tumor cells.
Normally, when a cell acquires DNA damage that it cannot repair properly, the cell should eliminate itself through the process of apoptosis. Tumors result, in part, when genetic mutations occur and the apoptosis mechanism fails to eliminate the cell. Institute researchers are studying the mechanisms by which brain tumor cells have eliminated their ability to undergo apoptosis.
Cleveland Clinic researchers are also working to identify genes that could serve as molecular diagnostic and/or prognostic indicators, or potential therapeutic targets for glioblastoma and other gliomas. By enhancing the detailed understanding of the structure of tumor cells and the mechanisms that control their growth, researchers are striving to identify therapeutic agents that show the greatest promise to address individual tumor types, such as glioblastoma.
This research is coordinated through the Burkhardt Brain Tumor Center and the Lerner Research Institute and includes efforts in the Departments of Molecular Biology, Cancer Biology, Neuroscience and the Center for Surgical Research.
The cornerstone of the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center is Translational Therapeutics. The program, directed by Dr. Michael Vogelbaum, is designed with aggressive pre-clinical testing of the most promising anti-cancer agents. One goal is to accelerate the lengthy and expensive process of testing new drugs targeted against brain tumors and to safely move them into clinical trials as quickly as possible, for the benefit of patients.
Physicians, researchers and scientists involved in this area work with both pharmaceutical companies and other medical institutions to identify, obtain and test new compounds. The Burkhardt Brain Tumor Center's multi-million dollar efforts, including an international search for all potential brain tumor-relevant therapies, have yielded several promising agents for testing.
Testing of new agents involves evaluating the toxicity and efficacy of these compounds in the laboratory and in animals that have brain tumors. In addition, we are also investigating the optimal route of delivery of these drugs.
Because many new therapeutic agents cannot penetrate the central nervous system, researchers are exploring alternative delivery methods. In addition to investigating the efficacy of oral delivery, researchers evaluate the efficacy of the agents when delivered intracerebrally-directly into the brain-via a specialized neurosurgical technique called convection enhanced delivery (CED).
The staff is focused on translating these pre-clinical results into Phase I and II clinical trials - giving the brain tumor patient more therapeutic treatment options by broadening the horizon of potential tools we may use to manage this deadly disease.
Our Center for Translational Therapeutics has started research projects with a number of pharmaceutical and biotechnology companies, ranging in size from small startup firms to some of the largest publicly traded companies. What these companies have in common are novel drugs that are close to or in clinical trial and which are rationally designed to be effective against malignant gliomas given the molecular and genetic makeup of these tumors.
Brain tumor clinical trials are designed to identify treatments that are potentially more effective and/or have fewer side effects than standard brain tumor treatments. Clinical trials are recommended for patients with tumors where results of treatment are generally poor, or that are considered incurable with conventional treatment. Clinical trials also are recommended for most pediatric patients with brain tumors.
Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center patients have access to numerous brain tumor clinical trials, some designed by Cleveland Clinic physicians, others as a part of multi-center trials in partnership with pharmaceutical companies or research consortia. The Burkhardt Brain Tumor Center actively participates in several of these clinical trial groups, including:
- Adult Brain Tumor Consortium (ABTC)
- Southwest Oncology Group (SWOG)
- Radiation Therapy Oncology Group (RTOG)
- American College of Surgeons Oncology Group (AcoSOG)
- Children's Oncology Group (COG)
These associations contribute to the exciting environment of clinical trial research and development, discussion and the sharing of data that is so important to the dynamic evolution of the therapeutic protocols of tomorrow's brain tumor treatments.
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