Collaboration has long been recognized as a way to expedite discovery, summarized in the 1500s by John Heywood’s epigram, “Two heads are better than one.” And for tough problems like brain cancer, many are better than two.
The Lerner Research Institute recognizes that the quickest way to the biggest impact on human health is through physician-scientist collaborations within disease-based Centers of Excellence in research.
The newest, resulting from joint initiatives of Gene Barnett, MD, MBA, Vice-Chair, Neurological Surgery; Director, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center (the clinical brain tumor center known as the BBTC), and Janet Houghton, PhD, Chair, Cancer Biology, representing cancer research, is the Brain Tumor Research Center (BTRC) of Excellence. Under the leadership of Steven Rosenfeld, MD, PhD, Cancer Biology with secondary appointment in the BBTC, the mission of this first Center of Excellence in cancer research is to “translate” scientific findings into diagnostic and therapeutic interventions to improve the lives of patients afflicted with brain tumors.
Dr. Rosenfeld is no stranger to the gravity of the disease or the desperate need for better treatments. He lost his mother 35 years ago to glioblastoma, the most aggressive and common primary brain tumor. Noting that the treatments and outcomes have improved alarmingly little since that time, Dr. Rosenfeld is determined to find help for these patients.
The personal experience has driven his research and clinical interests to benefit a broader community, including the building of a nationally recognized brain tumor program at the University of Alabama, Birmingham.
He is excited about the opportunity to orchestrate a strong program here: “Cleveland Clinic has an extraordinary set of resources to offer brain tumor patients,” says Dr. Rosenfeld.
His approach is to define the clinical problems posed by brain tumors and then develop teams of experts to address them. These teams consist of professionals with a wide variety of expertise, including those who did not initially realize their applicability to brain tumor research prior to Dr. Rosenfeld’s nudging. “A strength that distinguishes LRI and Cleveland Clinic is the ‘us’ over ‘me’ mentality and the ability to foster collaborations. The disease itself is difficult, and tackling it requires communication among many specialties, all pulling in the same direction. The traditional ‘siloed’ approach does not work. This Center of Excellence is the glue that sticks researched solutions to clinical problems.”
Within the BTRC, four focus groups coordinate the efforts of scientists and clinicians into the most pertinent areas of challenges posed by brain tumors. Each focus group has a core of 5-6 clinical and laboratory investigators that cross departmental and institutional lines, drawing from expertise of highest regard from areas spanning cell biology, immunology, and oncology, to name a few.
A group led by Candece Gladson, MD, Cancer Biology, addresses the cellular signaling pathways involved in new blood vessel formation (angiogenesis), which tumors need in order to grow. Pre-clinical studies have identified several anti-angiogenesis strategies for testing, hoping to emerge with new treatments for patients.
Another group is acutely interested in not only how tumor cells invade other tissues, but also how they escape the body’s natural defense, the immune system.
A third group brings novel anti-cancer agents to clinical trial. Some promising ongoing studies include examining ways to get medications past the brain’s “blood-brain barrier,” which would normally “protect” the brain from such compounds. Dealing with increased pressure on the brain caused by a growing tumor is also under investigation, as are new surgical approaches and treating the tumor cells with heat.
Headed by Jeremy Rich, MD, Chair, Stem Cell Biology and Regenerative Medicine, a fourth group aims to find ways to define and eliminate “brain tumor stem cells,” which are thought responsible for inducing chemo- and radio-resistant tumors.
Throughout the focus groups, the Center views research trainees as a tremendous asset at Cleveland Clinic, and many investigators serve as mentors. The Center will also expand upon an Ohio-wide brain tumor research network developed by Dr. Gladson, where efforts at Cleveland Clinic, Case Western Reserve University, Ohio State University, Nationwide Children's Hospital, the University of Cincinnati, and Cincinnati Children's Hospital come together against brain cancer.
According to Dr. Rosenfeld, “At the end of the day, it’s meaningless unless we connect to a larger community. It’s not for notoriety. We are here to serve patients, and that is what this is about.”
George Stark, PhD, Distinguished Scientist, LRI, Emeritus Professor of Genetics, Case Western Reserve University, and former Institute Chair of the LRI, is an internationally recognized leader in science. Now he leads donor efforts by launching the Laboratory Research Partnership Initiative with a personal gift.
In this Initiative, a gift of $150K over three years supports crucial early-stage assistance to a laboratory that holds great promise for new approaches to challenging medical problems. It is hoped that this new program will support a vital unmet need: helping LRI scientists explore their novel ideas and generate initial results that will attract substantial outside funding, such as a five-year grant from the National Institutes of Health, which could elevate important scientific discoveries to the next level.
“As Chair of the LRI from 1992 to 2002, I came to appreciate the enormous value of enabling scientists to pursue good ideas at an early stage before they have had the opportunity to obtain enough preliminary results to secure external funding fro the National institutes of Health and other agencies,” Dr. Stark says. “Seed funding at the right time can generate enormous benefits later. I hope that others will join this effort to facilitate ground-breaking research and personally observe the results of their commitment.”