IBTA e-News – February 2013

By 15th February 2013e-News Archive

Dear Friend,

Important dates and deadlines: Rare Disease Day is 28 February. All brain tumours are categorised as "rare" or "less common" cancers and hence are "rare diseases". 28 February is also the deadline for the regular rate fee for those planning to attend the EORTC-EANO-ESMO Trends in Central Nervous System Malignancies Conference in Prague on 22-23 March. Abstracts for the 19th Neuro-Tumor Club Dinner meeting at the AACR Annual Meeting are due by 8 March. The final RSVP for the dinner meeting is 1 April. Early registration deadlines for the combined ASNO/ISNO meeting in Mumbai during 21-24 March are 20 February and 10 March. The Editor-in-Chief of the SNO journal Neuro-Oncology Dr Alfred W.K. Yung retires at the end of 2013 and applications for the position close on 31 March. The early rate registration date for the European Cancer Congress 2013 is 9 April and the abstract submission deadline is 17 April. The IBTA will have displays at both the Prague and Mumbai conferences and will distribute copies of its 2013 "Brain Tumour" magazine subject to it being printed in time.

Highly eloquent gliomas: Neurosurgeons at the Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität, München, Germany, have reported on the successful resection of 47 supratentorial gliomas which were primarily evaluated to be non-resectable at another neurosurgical department. Techniques used included pre and intraoperative brain mapping and monitoring (IOM) by motor evoked potentials (MEPs). Median survival was 14.8 months. Four patients had a new motor or language deficit which remained permanent.

Predicting brain tumours: Northwestern Medicine (USA) researchers have developed a new method for predicting and monitoring an individual patient's brain tumor growth. The method, which the researchers hope to offer as an iPad app or upload to a website, uses a personalized patient-specific approach that accounts for tumor features such as 3-dimensional shape, density and growth rate. It could enable rapid assessment of whether or not a therapy is working.

Meningiomas: An international team of researchers has identified four new genetic suspects to add to the already-identified neurofibromin 2 as being relevant to the development of meningiomas. This may lead to personalised medical therapies for meningiomas which currently are primarily managed surgically. See here for abstract of their article in the journal Science.

Research developments: Researchers at the University of Michigan have reported that a Diffusion abnormality index (DAI) shows promise as an imaging biomarker to measure brain tumor response to radiation therapy ... Researchers have found that the molecule TIC10 had potent effects against glioblastoma in mouse models. It activates the gene for a protein called TRAIL (tumour-necrosis-factor-related-apoptosis-inducing ligand) but other researchers are sceptical about TRAIL-based strategies ... In a review of the literature researchers from Kazakhstan have discussed the role of infectious agents in the carcinogenesis of brain and head and neck cancers and possible novel approaches ... Research at the University of Mississippi has identified two molecules miR-7 and KLF4 that "may serve as biomarkers or therapeutic targets for brain metastasis of breast cancer" ... Researchers in Queensland (Australia) have discovered a protein EphA3 present in about half of all cases of GBM. An antibody treatment is already undergoing trials in leukaemia patients in the USA. The research is published in Cancer Cell ... A report arising from an EORTC-sponsored meeting about brain metastases was included in a selection by the Editor-in-Chief of twelve key articles appearing in late 2012 in the European Journal of Cancer. The report (which can be downloaded from here) was authored by Matthias Preusser and others.

The future of QALY: A controversial European proposal to do away with QALY (Quality-adjusted life years) and substitute a "cost per remission" approach might pose challenges for new therapies directed against brain tumours. Health Technology Assessment (HTA) agencies have adopted different methods of evaluating and approving subsidisation for new brain tumour therapies and have been open to arguments about the absence of alternative treatments and the lethal and "orphan" nature of the disease. The "cost per remission" approach - subject to further explanation - appears to focus on an aspect of disease management that is not common in brain tumour experiences. Rather than narrowing the focus of HTAs they should be encouraged to adopt a broader perspective e.g. taking into consideration concepts such as the likely beneficial effects of extended survival and improved quality of life not only for patients but for their caregivers and family.

Grief and depression: Controversy has arisen over plans to revise the criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders 5 (D.S.M. 5) to be released in May 2013. Critics fear that depression may become overdiagnosed because of the proposed removal of the "bereavement exclusion" which cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts. The nature of the brain tumour journey can cause depression and anxiety disorders not only in patients but also among caregivers and family members.

Neuro-oncology patients and spiritual needs: A survey of nurses who had looked after neuro-oncology patients by University of Nottingham (UK) researchers has found that while there is an awareness of the spiritual needs of patients and their relatives there are questions as to whether or not nurses are the most appropriate professionals to support spiritual care.

Paediatric patients: A review in the Lancet Oncology journal advises using molecularly targeted therapies with pediatric cancer patients only in the context of a clinical trial. "The growth of cancer cells isn't that different than a growth of a 7-pound baby into a 210-pound teenage linebacker. Now, you shut down those growth pathways in an adult and it might not be a big deal, but you shut down those same pathways at a critical time in childhood development and you can have real problems", says Dr Lia Gore from the University of Colorado Cancer Center.

Neuromuscular assessment: Researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University, the Beth Israel Deaconess Medical Center (BIDMC), and Hebrew SeniorLife, Boston, recently completed the first clinical study of a new rapid neuroassessment device they developed to quantitatively measure neuromuscular performance. It involves a person using a stylus to follow a moving target around a circle on a computer tablet. They now intend to study its use for groups of people with neuromuscular pathologies, such as those who suffered concussions or have multiple sclerosis. Asked by the IBTA's E News if they planned to study its potential use with brain tumour patients they said they had not but are happy to talk with anyone who is interested. Contact Dr Lily Kim (lily.kim@wyss.harvard.edu)  or Dr Leia Stirling (leia.stirling@wyss.harvard.edu) at the Wyss Institute.

New book: This is a link to a 3-minute You Tube video interview with Dr Alyx B. Porter of the Mayo Clinic who is the co-author of a new book for patients Navigating Life with a Brain Tumor. It has been published in conjunction with the American Academy of Neurology as part of the Neurology Now book series. The IBTA has not yet seen the book but plans to review it in the near future and will upload a review on its website to join fourteen other brain tumour-relevant books that have been reviewed previously.

African-American and white brain tumor rates: Comparisons of brain and CNS tumor incidence and death rates between African-Americans and whites for 2005-2009 show higher rates for whites in both measurements and for both sexes but there is no discussion of the findings.

ASCO International: ASCO (American Society of Clinical Oncology) International has announced a commitment to doubling its international program over the next four years. Additional priority areas include: oncology training for non-specialists; innovation grants; and virtual mentors. The forthcoming issue of the IBTA's Brain Tumour magazine contains several articles about the challenges (and rewards) of undertaking brain tumour work in developing countries.

Company developments:  The Children's Hospital of Philadelphia (CHOP) and BGI-Shenzhen in China have signed a formal agreement to collaborate on research into next-generation sequencing and analysis of pediatric brain tumours, in support of the Childhood Brain Tumour Tissue Consortium (CBTTC). Novocure has launched a website dedicated to its glioblastoma clinical trial.

Thank you for all your continuing support.

Denis Strangman (Chair and Co-Director)
International Brain Tumour Alliance IBTA
www.theibta.org

Kathy Oliver (Co-Director)
PO Box 244, Tadworth, Surrey
KT20 5WQ, United Kingdom
Tel:+ (44) + (0) + 1737 813872
Fax: + (44) + (0) +1737 812712
Mob: + (44) + (0) + 777 571 2569

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