Young Investigators Program
The Darren Latimer Honorary Grant
VABC hopes to encourage bright young people to enter the field of brain cancer research after they graduate. We fund brain cancer-related projects to spark graduate students’ interest in the topic. After success at Northwestern University, this program is expanding to Duke University and many other institutions.
2009 Young Investigators Program
Led by Henry Friedman, MD at Duke University Medical Center
We are excited to announce that the Young Investigators Program is expanding to Duke University Medical Center. VABC will grant funds to support a graduate student’s summer research in neuro-oncology, to be overseen by Henry Friedman, MD, a member of VABC’s Medical Advisory Board.
2008 Young Investigators Program
Led by Dr. Jeffrey Raizer and Dr. Marcus Bredel at Northwestern University
VABC sponsors medical students who conduct brain tumor research at Northwestern University. Projects include developing a tissue analysis technique to study factors that play a key role in GBM proliferation and resistance to treatment. Students Rebecca DeBoer and Louis Ostrowsky were under the guidance of Dr. Jeffrey Raizer, head of Neuro-Oncology at Northwestern Medical Center, and Dr. Markus Bredel, Director of the Northwestern Brain Tumor Institute Research Program. The students attended the Society of Neuro-Oncology meeting in 2008.
Pictured, from left: Rebecca DeBoer, Dr. Jeffrey Raizer, and Louis Ostrowsky at the Society of Neuro-Oncology meeting.
The abstract that was accepted for poster presentation at SNO:
RESPONSE OF AN ADULT PATIENT WITH PINEOBLASTOMA TO VORINOSTAT AND RETINOIC ACID
Rebecca DeBoer, Hunt Batjer, Maryanne Marymont, Stewart Goldman, Matthew Walker, Numa Gottardi-Littell, Jeffrey Raizer
Rare in adults, pineoblastomas (PBLs) are malignant primitive neuroectodermal tumors (PNETs) with a propensity to disseminate along the neuraxis. The effectiveness of high dose chemotherapy in addition to radiotherapy (RT) has been demonstrated in newly diagnosed PBL. Alternatives remain to be investigated, especially in relapsed or refractory disease. Preclinical data show that vorinostat (suberoynlanilide hydroxamic acid), a potent selective inhibitor of histone deacetylases, has significant anti-tumor activity in medulloblastoma and other supratentorial PNET cells. Synergism between vorinostat and retinoic acid has been shown in preclinical studies. We report the case of an adult PBL patient with multiple complications who was treated with vorinostat and retinoic acid and had radiographic and clinical response. CASE: A 33-year old man presented with a 2-week history of severe headache, nausea, and vomiting in February 2006. He reported chronic neck pain that started 3 months earlier and was treated conservatively. MRI demonstrated a pineal region neoplasm with invasion into the tectum and leptomeningeal spread along the neuraxis. CSF cytology was unrevealing in several cervical and lumbar-region samplings. An open biopsy was performed with histopathologic impression ‘pineal parenchymal tumor with overall differentiation comprising focally PBL, WHO grade IV’. The patient received 1 cycle of high dose intravenous cyclophosphamide (CTX) per Gururangan et al (2003). Days later he was admitted with deep vein thrombosis and neutropenia. He developed typhlitis with sepsis, acute renal failure, and necrotic wounds requiring toe amputation. After a 2-month hospital course he went to rehabilitation and 1 month later he received craniospinal external beam RT with a primary site boost, from June 2006 to July 2006. Post-RT MRI showed improvement with significant residual disease. Two months after RT he was treated with CTX and etoposide. Within days he developed neutropenia, sepsis, and heel ulcers. He ultimately required a below-knee amputation for a gangrenous foot. MRI done 4 weeks after chemotherapy was unchanged compared to post-RT scan. Given the complications with chemotherapy, alternatives were considered. He was placed on a regimen of vorinostat and retinoic acid based on preclinical data suggesting synergy of this combination and efficacy in other small-blue-cell type tumors. In December 2006 he began 300 mg vorinostat daily with 160 mg retinoic acid for 21 days on and 7 days off. After 1 month of this regimen, MRI demonstrated a nearly complete response. In March 2007 the dose of vorinostat was escalated to 400 mg. Months later both agents were held due to high creatinine levels and vorinostat was then reduced to 300 mg. There were no other significant dose modifications. Both agents were stopped in December 2007, one year after the initial doses. He tolerated both medications well. His MRIs remain stable to date without evidence of tumor recurrence. This case suggests that vorinostat plus retinoic acid is active in PBL, warranting further investigation in this tumor type as well as others in the small-blue-cell tumor family.
Proposal from Northwestern University Feinberg School of Medicine
Initiative to further education in neuro-oncology at the medical school level:
Part I Objective: to foster academic pursuit among selected medical students who have demonstrated a serious interest in neuro-oncology.
The annual scientific meeting of the Society for Neuro-Oncology (SNO) provides the premiere educational opportunity for anyone interested in the field. As the SNO website indicates, this meeting is the most comprehensive review of cutting-edge laboratory and clinical research in the field of neuro-oncology. It is designed for physicians, scientists, nurses, and other specialists involved in the research, diagnosis, and treatment of central nervous system tumors. The meeting begins with an Education Day, at which attendees catch up with breaking areas of research and controversies in the field. The formal meeting follows, featuring presentations from various categories, such as cell biology, epidemiology, experimental therapeutics, pathology, neuro-cognitive studies, quality of life and symptom management, radiology, and stem cells. In addition to achieving the many educational objectives set forth by SNO, students who attend this meeting will gain an understanding of the culture of academic neuro-oncology and chat with people who have dedicated their careers to this field.
Therefore, we propose to send selected medical students who have demonstrated a serious interest in neuro-oncology to the SNO annual scientific meeting.
Part II Objective: to raise awareness of neuro-oncology broadly among medical students who have had little or no exposure to the field.
It is commonly understood that medical students’ curiosity and excitement about career options peak early in their education, yet they have little exposure to subspecialties such as neuro-oncology during medical school. At the Feinberg School of Medicine, the best forum for creating such exposure is the tried-and-true “lunch talk,” or presentation during the lunch break between classes. Lunch talks are the most popular means for student groups to promote their cause, and they use their limited funds to encourage attendance by providing food. Student groups often invite speakers to discuss their research or clinical experience in a given field, hoping to generate interest or at least educate students about their options. Because neuro-oncology is such a multifaceted field, there are many student groups who could sponsor a lunch talk related to neuro-oncology. However, since funding is tight, groups are often forced to narrow their programming down to a few topics, and smaller or lesser-known subspecialties may not make the cut.
Therefore, we propose to provide small “lunch talk” grants to student groups who want to sponsor presentations that will promote education about the field of neuro-oncology.
From the desk of Jeffrey Raizer, MD
Director, Medical Neuro-Oncology
Northwestern University, Feinberg School of Medicine
Robert H. Lurie Comprehensive Cancer Center
The goal is to use the Northwestern Young Investigators experience- fundraising and medical student research support- as a framework to bring this type of program to other cities.
The main goal of medical students working with me to stimulate academic research (basic or clinical) to entice or encourage students to pursue a career in neuro-oncology. They are mentored with the goal of having something to publish at the end of the project. Responsibilities are to complete the project. It is also beneficial for them to shadow clinics to see the patient side of things.
There is a broad need, both at Northwestern and in the industry as a whole, for this type of support and research.
From a student who participated in the Young Investigators Program in 2008
I have spent the summer working in the laboratory of Dr. Markus Bredel in the Department of Neurosurgery who serves as Director of the Northwestern Brain Tumor Institute Research Program. My goal has been to build upon and apply my experience in clinical research at Dana-Farber to Northwestern’s basic science and translational research effort.
Over the past few months I have worked with lab members developing a novel assay and tissue analysis technique to quantify protein expression in glioma tissue. We are studying a number of modulators of an important transcription factor that has previously been shown to play a key role in GBM proliferation and resistance to treatment. By using micro-array technology we are able to perform this analysis on over 200 different tumor samples at once. The next step is to compare the levels of protein abundance in the tumor to corresponding clinical data to determine if there is a correlation with overall survival or sensitivity to a specific treatment. These results may help us refine the prognosis and therapeutic decision-making for GBM patients based on their tumor’s unique molecular profile.
I have also been working on the creation and expansion of a tumor bank of samples collected from patient’s who undergo surgery at Northwestern Memorial Hospital with the goal of integrating genome wide and molecular analysis into the clinical practice of the Neuro-Oncology program. I will continue to work with Dr. Bredel over the coming year on this project. I will also continue to work with Dr. Raizer on on-going clinical research projects that may lead to publications in the form of clinical case studies and retrosepctive reviews. I also look forward to organizing a variety of educational programs on important topics in the field of Neuro-Oncology for my fellow classmates through a student group we founded last year called the Feinberg Cancer Society.
Thank You Letter
From students who participated in the Young Investigators Program in 2008
December 21, 2008
Dear Voices Against Brain Cancer,
We would like to thank you for sponsoring our trip to the Society for Neuro-Oncology’s 13th Annual Scientific Meeting this past November. As medical students who are interested in neuro-oncology, we greatly appreciated the opportunity to learn about the latest developments in the field from the scientists and clinicians on the frontlines.
The meeting program was full of exciting research presentations. Among the highlights were sessions about novel treatment strategies, such as immunotherapy and new combinations of targeted molecular agents, and evolving diagnostic tools, such as physiologic imaging and tumor biomarkers. We also learned about promising laboratory work on brain tumor stem cells and genomics. And finally, we enjoyed the session on epidemiology and quality of life studies, which covered topics such as caregiver burden, neurocognitive function assessment, and efficacy of acute rehabilitation.
The poster sessions were quite informative as well, as they included a wide variety of research abstracts from around the globe. We proudly presented two posters in collaboration with Dr. Jeffrey Raizer, the Director of Medical Neuro-Oncology at Northwestern University. One was a preliminary report of an on-going phase II trial in meningioma patients, and the other was a case report of a patient with a rare tumor who had an impressive response to a new treatment regimen.
In addition to being a tremendous educational experience, the meeting was a unique opportunity for us to meet neuro-oncologists from across the country—from young fellows to seasoned investigators—and get a good sense of what it is like to pursue an academic career in this important specialty. We were fortunate to have the chance to chat with the current president of the SNO, Dr. Susan Chang, as well as this year’s recipient of the Lifetime Achievement Award, Dr. Charlie Wilson, who is a legend in the field.
Indeed, the weekend was a source of inspiration to us, for which we are very grateful to Voices Against Brain Cancer.
Rebecca DeBoer, MD Candidate, Class of 2011
Louis Ostrowsky, MD Candidate, Class of 2011
Feinberg School of Medicine
Lunch Talk Summary
The lunch talk happened on December 1, 2008 on our medical school campus. It was publicized as a “Lunch talk with Dr. Jeffrey Raizer, Director of Medical Neuro-Oncology” and initially opened to 20 students on a first-come/first-serve basis, although we ended up including everyone who was interested in the end (about 30 people total). Over a delicious meal of Indian take-out, Dr. Raizer spoke to the room full of 1st and 2nd-year medical students about the field of Neuro-Oncology in general, how he ended up there, and why he liked practicing it.
Click here for a full list of research grants funded by Voices Against Brain Cancer.