New Year. New Hope. More Help From Team at Duke.

“We are in a major, new era of rapid advances in brain tumor research!”

Each year we receive a most welcome letter from the Brain Tumor Center of Duke University. It explains how the funds we have contributed are being used to find causes and cures for pediatric brain tumors. This year, the letter we received was very positive, as was a conversation with one of the key players on the team who was happy to report considerable progress since our discussion a year ago.

In the letter from Dr. Bigner, M.D., Ph.D., the Edwin L. Jones Jr. and Lucille Finch Jones Cancer Research Professor, he stated unequivocally, “We are in a major new era of rapid advances in brain tumor research. The ability to identify molecular targets with… genome technology is allowing us to identify new and previously unknown molecular therapeutic targets in malignant brain tumor cells.”

The letter goes on to explain other advances, including important work being done with a group of drugs called “small molecular inhibitors” and an epidemiology study that has been launched investigating some of the potential causes of childhood and adult brain tumors.

It is also important to note the team’s deep sense of appreciation for Foundation contributions. “Without your support” said Dr. Bigner et al, “we would not be able to move forward in this battle against childhood brain tumors.”

From Bench to Bedside
The total effort from the Duke team falls into three primary arenas. On the laboratory side, work is being done by a talented group of researchers under the direction of Dr. Bigner. The hope is to take these encouraging studies made on the “lab bench” to the clinical side. Here Dr. Henry Friedman and others are working with promising drugs and clinical trials. Finally, the strength of the team is completed under the surgical excellence and guidance of Dr. Allan Friedman, world-renowned tumor and vascular neurosurgeon.

Dr. Henry Friedman Sheds Light
To further explain areas of progress noted in the letter, we turned to Dr. Henry Friedman who was very happy to shed some light on what is meant by the drugs called “molecular inhibitors.” Said Dr. Friedman; “The new push in cancer treatment, not just in brain tumors, is to devise therapies that target pathways that have gone wrong.” He continued, “When a cell becomes cancerous, pathways, the means by which cancer cells grow and proliferate, start to behave in abnormal ways. The hope is to identify errant pathways and then develop a drug that targets them.”

“We have seen encouraging results with a drug named Gleevac that has been used in the treatment of Chronic Myelogenous Lukemia. Gleevac is an inhibitor of a single abnormal event that appears to cause CML. The drug produces an incredible response rate of over 90%. The hope is that similar path abnormalities can be discovered in brain tumors which will allow us to use drug therapy to target those brain tumors more selectively.”

According to Dr. Friedman there is good news and bad news. “The good news is this is a much more rational way to target cancer,” he said. “The bad news is that brain tumors, especially malignant gliomas, are much different than CML so it is not likely any one drug will push the button as effectively as Gleevac does in CML. Nonetheless, we are enthusiastically studying adult and childhood tumors and malignant gliomas. We are looking at malfunctioning pathways and then considering drugs which have been developed all across the country, not just at Duke, which can treat these pathways and possibly lead to a more effective intervention.”

Another major focus of research that Dr. Friedman commented on is the genomic area. He described this as “a very promising area since investigations here give us a chance to learn what has gone wrong genetically in an individual’s DNA. Once you know the genetic changes you may be able to fix them on a molecular level.” He added, “While it is a more selective approach than traditional chemotherapy, it is also a challenge since a brain tumor does not typically have just one abnormality.”

A Long But Hopeful Year Later
When asked if he felt it had been a noteworthy year, Dr. Friedman responded, “Absolutely! Last year, we were discussing Emerging Growth Factor Receptors as one kind of potentially hopeful drug. Now, there is a whole range of drugs that we are looking at, a whole range of inhibitors and lots of different pathways. We have more pathways to focus on and more drugs to target them with.” And we would add, The Foundation has a larger, more determined contributor base to arm these brilliant researchers and clinicians with the resources, equipment, and unwavering support they need.