The Brain Tumor Center here at Wake Forest really has state-of-the-art technology in
really every area of brain tumor care. From a surgical standpoint, we have really the
most novel surgical techniques and equipment available in the operating room. In Radiation
Oncology, again, state-of-the-art treatment facilities including the newest version of
the Gamma Knife. We have a decades-long tradition of carrying
out clinical research in cancer patients at large and really almost a two-decade history
of doing multidisciplinary research for brain tumor patients. So we really know how to take
novel therapies, newer approaches, newer techniques and bring them to our patients, do them safely,
and monitor them carefully. We have been members of a National Cancer
Institute-funded Brain Tumor Consortium- it's currently called the Adult Brain Tumor Consortium-
and its predecessors for again almost 15 years. That has allowed us to take really the newest
in technology, the newest in cytotoxic therapy, the newest in targeted agents, all sorts of
approaches to combat brain tumors and bring them here to Winston-Salem to use in our patients
and to try to help our patients as they battle these terrible diseases.
The Adult Brain Tumor Consortium is made up of about 16 of the finest brain tumor institutions
in the country. It spans the country from the University of California in San Francisco,
MD Anderson, Memorial Sloan Kettering, Dana Farber, Mass General, Johns Hopkins, and down
here in the south, Wake Forest. And so we have had the ability to collaborate with some
of the best institutions in the country. And again, to bring some of those state-of-the-art,
new treatments to our community. We have also been very active in running clinical
trials and testing new ideas that originate right here from investigators at Wake Forest
either from the clinical side or from the laboratory side.
Finally, we, because of our reputation in clinical research, we get approached by many
of the industry partners around the country who are looking to test their new approaches,
new techniques, and new therapies. One of which is a very exciting trial that we've
just activated looking at vaccine therapy for patients with newly diagnosed glioblastoma-
a very malignant form of brain tumor. The concept of this trial not only involves
getting the immune system to fight cancer, but getting the immune system not to fight
just any cancer cells, but something called cancer stem cells. The current theory is that a tumor is made
up of a bunch of different cells, but only a small population of them really are the
"mama" cells, the ones that give birth to litter after litter of new tumor cells. And
it's thought that rather than targeting that whole mass of "baby" tumor cells as it were,
if we really want to stop tumors or get rid of them, we need to go after the "mama" and
"daddy" cells- the ones that generate those new tumor cells.
And those are called tumor stem cells. They're present probably in every tumor and there's
been a huge amount of work in brain tumors showing that there are such cells in glioblastomas
in particular. For patients who are eligible for the trial,
we actually remove dendritic cells, those immune-processing cells from their body, expose
it to a certain panel of antigens, and those antigens are proteins are present not only
on tumor cells at large, but are also heavily expressed on the tumor stem cells. We then
grow those cells out of the body, get them excited about fighting those particular antigens,
and then give them back to the patient. So this particular vaccine approach is novel
in that number one- it uses circulating dendritic cells an antigen presenting cell, but more
importantly, it tries to get those cells to target antigens or proteins or surface molecules
that are present not only on tumor cells at large, but on the stem cells, the one that
we think keeps that tumor coming back and growing.
The preliminary results with that type of an approach in smaller studies has been very
exciting. But that really doesn't prove anything. To prove it, you need a larger study and you
need a study where, again, half the patients get the vaccine and half the patients don't.
Where the patient arms are as well-matched as possible. And we're doing that study now.
We're one of about 16-20 institutions around the country involved in this particular study.
And we're very, very excited about the potential to really open up a new window- a whole new
modality of treating these tumors. Trying to get the best system to fight off
infection- the immune system- to try to turn that into the best way to fight off cancer.