Recently in the spotlight has been news that a “ brain cancer programme at Addenbrooke's could help revolutionise NHS treatment”
Dr Helen Bulbeck from our sister charity brainstrust said that, while genomic sequencing was undoubtedly an area that would lead to patient benefit in the future, it was really important that our community understood exactly what was being announced.
She said: “This isn’t a new treatment but the first steps on a pathway that one day could revolutionise how we diagnose and treat brain tumours. Of course, these advances are to be applauded and are the result of research funding and scientific endeavour. However, currently the future for those diagnosed remains uncertain with few treatment options and invasive interventions the reality. We would always urge responsible reporting of news like this to avoid delivering false hope. A generation of patients that have had little to celebrate in terms of progress need something concrete to give them hope.”
Our Director of Research Dr Karen Noble said ““To make the most of any genomic understanding or improved diagnostics then we must pursue the pathway to new therapeutics and UK based clinical trials. The route to this is the discovery science of the type that we fund at our research centres. It is also why we lobby Government to support us in our mission. The world of brain tumours is one of uncertainty but what we can say without doubt is that more research funding will take us closer to a cure, if we don’t fund that research there will be no progress and opportunities like those that could come from this Cambridge research will be lost. “
We cannot let that happen.
By fundraising and campaigning we are enabling researchers to pursue our vision of a cure for all brain tumours.
As well as campaigning for Government funding we of course fund our own research and it is these researchers who have been very much our focus during the past fortnight as we have been conducting annual Centre reviews. A chance to check on progress and future plans, we welcome these opportunities as they illustrate our centres impact and influence and provide an idea of what more funding could achieve.
BRAIN UK at the University of Southampton is the world’s first national virtual brain tissue bank, a unique and hugely important resource for researchers working across the UK, funded by Brain Tumour Research.
The purpose of BRAIN UK is to make the very extensive and comprehensive NHS Neuropathology archives available to the national and international neuroscience research community.
When a person develops a brain tumour, they are usually referred to an NHS Neuroscience centre for specialist care. At these centres, the experts who are involved in investigations such as brain scans, work to identify exactly where the tumour is located. Then a Neurosurgeon performs an operation to take a sample of the tumour tissue (a biopsy) which is sent to the laboratory where a Neuropathologist looks down the microscope, and with other investigations such as genetic tests, identifies exactly which of about 120 different brain tumour types is present. This knowledge guides the correct treatment which may, for example, include surgery, radiotherapy or chemotherapy. The tumour tissue left over is then stored according to national guidelines in the archives of all departments.
This process takes place in 26 NHS regional Neuroscience centres in Great Britain and has done so for over 40 years. Taken together nationally, the result is an enormous collection of several hundred thousand tumour tissue samples which forms an important resource for research to better understand how tumours arise and how they might be better treated.
BRAIN UK is a collaboration between all British NHS Neuroscience centres to allow brain tumour researchers to access these samples. In the past year BRAIN UK sourced samples for 11 new tumour studies, bringing the total to 72 tumour studies supported since 2014 when it was founded by brainstrust.
17 papers have been published in 2021 for which BRAIN UK provided cases.
BRAIN UK provides tissue for all three of our Research Centres and this of course includes our partnership with Imperial College which encompasses both surgical and research teams across two West London locations – Charing Cross Hospital and Hammersmith Hospital.
When asked about the importance and relevance of their area of research and its contribution to the brain tumour research arena our Imperial centre said.
“Since our research programme is translational and is taking a multifaceted collaborative approach to solving the problems posed by brain tumours it is more likely to have a major impact overall on the patient pathway and their outcome and survival. We are tacking a very pragmatic approach and tackling all the difficult problems that hamper advances in brain tumour outcomes. These include early diagnosis and monitoring, better imaging, intraoperative tumour and brain function detection leading to safer resection. Interrogating tumour and its environment in the live patient at surgery to better our understanding but also allowing detection of drug delivery. Developing new and repurposed drugs and demonstrating in the preclinical laboratory that these are excellent candidates for clinical trial. Developing a range of novel treatment approaches from metabolic manipulation and immune modulation to synthetic lethality gene therapy and oligonucleotide agents in nanoparticle delivery systems. We are also developing a range of options to deliver such tailored therapy directly to the tumour cells. As such this comprehensive programme with the right investment, enough dedicated time and co-ordination is likely to have a very major impact on getting closer to a cure.”
Professor Oliver Hanemann at our University of Plymouth Centre believes that to understand high grade tumours you need to understand low grade tumours and along with his team their collaborative centre identifies new molecules and mechanisms underlying brain tumourigenesis with a focus on low grade tumours. As part of that they also try to understand what distinguishes low from high grade tumours. During a progressive 2021 they have exposed a novel mechanism used by brain tumour initiating cells that is essential for tumour growth and submitted the findings for publication. They have characterised new drug targets and successfully used and published the results of using repurposed drugs as well as new first-in-class drugs. They have also been successful in securing extra grants from additional funders.
The Plymouth Centre of Excellence is unusual in that it focuses on understanding low grade tumours although non-malignant tumours are twice as common as malignant tumours. Meningiomas are the most common primary brain tumour overall with the majority being non-malignant. There is currently no drug treatment available for meningioma. The team at Plymouth investigate meningioma and other understudied tumours such as low-grade glioma, schwannoma and defined subgroups of ependymoma. They have a translational focus and use or repurpose compounds in their pre-clinical models. Their work has, and is, triggering clinical trials.
Finally, on Tuesday we visited our Queen Mary University of London Centre of Excellence.
Principal Investigator Professor Silvia Marino told us “In our centre, we have set up a system to directly compare normal and malignant cells from the same patient. This comparison allows us to cancel out changes of no importance, leaving us with information about genes that are likely to play a role in glioblastoma growth. These changes can be found in the genetic code (DNA) or changes that make DNA accessible (epigenetic).
"We have developed a new experimental system which encompasses an entire clinical and research pathway. The research journey starts with the patient who donates their brain tumour for our research. This tissue is then used to establish tumour cell cultures in the laboratory and derive genetic and molecular information. This information is then analysed with mathematical and statistical methods to understand if there are any drugs that can be used to slow down or even halt tumour growth.”
This strong research framework has enabled Professor Marino to secure additional and complementary funding from major stakeholders, who have traditionally been reluctant to invest in brain tumour research because of a perceived weakness of the available research projects.
The research that they are currently undertaking has the potential to significantly impact on patients’ health. Gaining a better understanding of the pathobiology and development of high-grade brain tumours, is essential for drug development. The significant investments the Centre have attracted from the NIHR and clinical charities is a testimony to the impact the project is expected to have in the field.
As part of the review process, we also take feedback and thoughts from independent experts and comments reported to us have included;
“The establishment of the Centre of Excellence at QMUL by Brain Tumour Research has underpinned the development of a critical mass of clinical and scientific neuro-oncology researchers and has facilitated accrual of significant external income to expand the research programme. An exemplar of the vision of Brain Tumour Research for its Centres of Excellence.”
“As understanding of the pathobiology and development of high-grade brain tumours, is essential for drug development, this project has the potential to significantly impact on patients’ health. The Centre has attracted significant investments from the NIHR and clinical charities which is a testimony to the impact the project is expected to have in the field.”
Finally this week we move from research to corporate fundraising and we hope that those of you who can influence your workplace to support us as a Charity of the Year or similar, do so.
More fundraising and more lobbying means more money and more awareness and that means more research and if I may reuse Dr Noble’s quote from the beginning of this update “The world of brain tumours is one of uncertainty but what we can say without doubt is that more research funding will take us closer to a cure, if we don’t fund that research there will be no progress.”
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