Brain Tumor Clinical and Clinical Research Program

脑肿瘤临床和临床研究计划

• 批准号: 8554177
• 负责人: Howard Fine
• 金额: $ 361.71万
• 依托单位: DIVISION OF BASIC SCIENCES - NCI
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8554177
• 关键词: Adult; Autopsy; Basic Science; Biotechnology; Brain; Brain Neoplasms; Brain region; CC-5013; Cardiology; Caring; Central Nervous System Neoplasms; Cephalic; Cessation of life; Child; Clinic; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Communities; Consult; Consultations; Cultured Tumor Cells; Data; Disease; Distant; District of Columbia; Endocrinology; Ensure; Family; Fellowship; Freezing; Genomics; Glioma; Group Practice; Heart Arrest; Heterogeneity; Hospitals; Hour; Human; Institution; Institutional Review Boards; Joints; LY317615; Laboratories; Mails; Malignant Glioma; Malignant Neoplasms; Malignant neoplasm of brain; Maps; Medical Oncology; Medical Records; Medical center; Medicine; Mission; National Cancer Institute; National Heart, Lung, and Blood Institute; National Institute of Mental Health; National Institute of Neurological Disorders and Stroke; Natural History; Neurology; Neurosurgeon; Normal tissue morphology; Nurse Practitioners; Nursing Research; Oncologic Nursing; Oncologist; Oncology Nurse; Operative Surgical Procedures; Ophthalmology; Pain; Patients; Pharmacologic Substance; Physicians; Pituitary Neoplasms; Primary Brain Neoplasms; Protocols documentation; Psychiatry; Radiation; Radiation Oncology; Radiology Specialty; Recruitment Activity; Rehabilitation therapy; Research; Research Infrastructure; Research Personnel; Research Training; Resources; Running; Sampling; Scientist; Screening procedure; Second Opinions; Services; Social Work; Specialist; Specimen; Spinal Cord Neoplasms; Sterility; Talampanel; Tamoxifen; Tissue Sample; Tissues; Training; Training Programs; Translational Research; Travel; Tumor Stem Cells; Tumor Tissue; United States National Institutes of Health; Velcade; Washington; Work; base; cell growth; clinical care; effective therapy; end of life; follow-up; hemangioblastoma; hospice environment; improved; multidisciplinary; neoplastic cell; neuro-oncology; neurosurgery; novel; novel therapeutics; oncology service; palliation; pre-clinical; programs; standard care; tumor

The NOB has made substantial progress towards building an infrastructure necessary for fulfilling its mission of developing new and improved therapies for children and adults with brain and spinal cord tumors. Below are partial lists of accomplishments in the building of the Brain Tumor Clinical and Clinical Research Program: Established an NIH-wide multidisciplinary Brain Tumor Clinic with active participation from three different NCI Branches (ROB, MOCRU, CCRLP), five different NIH Institutions (NCI, NINDS, NEI, NHLBI, NIMH), and five different Clinical Center Programs (Neuroradiology, Psychiatry, Pain and Palliation, Rehabilitation Medicine, Social Work). Expertise represented in the clinic includes Medical Oncology, Radiation Oncology, Neurosurgery, Neurology, Ophthalmology, Cardiology, Psychiatry, Endocrinology, Social Work, and Rehabilitation Medicine; Assembled a primary neuro-oncology clinical care/research team, which now consists of 4 neuro-oncologists, 6 NOB-trained neuro-oncology nurse practitioners, 3 research nurses, 2 neuro-oncology fellows, 2 patient coordinators, 2 clinical trials specialists and 5 data managers; Established a robust neuro-oncology consultation service, in which local/regional patients are seen and followed at the NIH (all patients are accrued to a CNS tumor natural history protocol; distant patients may just have radiology/medical records reviewed; Serving as Chair of the Search Committee, Howard Fine helped recruit two new tenure track clinician/scientist brain tumor neurosurgeons to NINDS/NCI leading to a total of 5 clinically active brain tumor neurosurgeons in the Surgical Neurology Branch, NINDS; Activated more than 30 IRB approved clinical trials with an additional 4 expected to be approved in the coming months, for a total of 30 protocols compared to just 1 protocol existing for primary brain tumors at the NIH when the NOB was formed in 2000 (a prior radiation protocol that had accrued 500 new primary brain tumor patients (almost all gliomas) and between 2000-3000 follow-up patients over the last 12 months, up from < 10 patients with malignant brain tumor seen at NIH in the year before the NOB was formed (1999). Additionally, the NOB reviews 2-6 new mail-in patient consults per week.Provides almost all neuro-oncology services for Walter Reed Medical Center, the Portsmouth Naval Hospital, and the Naval Medical Center in Bethesda; Established close collaborative clinical programs with Johns Hopkins Medical Center, George Washington Medical Center, Fairfax Inova and Washington Hospital Center and a wide array of private neurosurgical, radiation, and oncology practice groups locally and nationally; Created one of only a few organized neuro-oncology fellowship training programs in the United Statesa three-institution joint research training program between the NIH, Johns Hopkins Medical Center, and Childrens National Medical Center in Washington, D.C.; Identified five compounds through the preclinical screening program that have since been brought forward to clinical trials at the NIH (CC8490, LY317615, Velcade + Tamoxifen, CC5013, Talampanel, MLN518, Sunitinib).We have also initiated a truly unique study that could only be accomplished at the NIH and the Clinical Center for all practical purposes. In an effort to try and understand the intra-tumor heterogeneity found within the brain of a patient with malignant gliomas at a functional and tumor stem cell levels it is necessary to obtain viable tumor and normal tissue for all regions of the brain. Obviously such a sampling can not be done on alive patient but unfortunately, we have found that autopsy specimens that are as fresh as 12 hours from death are too old to grow viable tissue. Thus, we initiated a unique trial where patients and families who wish to donate their brains to brain tumor research are admitted to the Clinical Center shortly prior to death for hospice/end of life care. Immediately upon cardiac arrest thepatients body is quickly brought down to the surgical suite and under sterile surgical conditions the brain is removed from the cranial vault by one of our neurosurgeons and then quickly dissected with all of the appropriate tissue samples immediate frozen and/or put into culture for tumor cell growth. This study will give us unprecedented opportunity to construct a tumor cell-based genomic microanatomical map of a human brain harboring a GBM. This trial typifies the close and intertwined functioning of the clinical and basic science research effort of the NOB.Activated more than 9 clinical trials as a direct result of translational work performed within the Neuro-Oncology Laboratory.

NOB在建立一个基础设施方面取得了重大进展，以实现其为患有脑和脊髓肿瘤的儿童和成人开发新的和改进疗法的使命。以下是脑肿瘤临床和临床研究计划中成就的一部分清单：建立了一个NIH范围的多学科脑肿瘤诊所，并从三个不同的NCI分支（Rob，Mocru，CCRLP），五个不同的NIH NIH机构（NCI，NCI，NINDS，NINS，NII，NHLBI，NEURIA，NEURIA，NEURIA，NERIA，NERIA，NIMICAILIA，NIMHHHHHHHHHHH），五个不同的NIH机构（Rob，Mocru，ccrlp）积极参与，以及和痛苦，康复医学，社会工作）。该诊所代表的专业知识包括医学肿瘤学，辐射肿瘤学，神经外科，神经病学，眼科，心脏病学，精神病学，内分泌学，社会工作和康复医学；组建了一名主要神经肿瘤学临床护理/研究团队，该团队现在由4位神经肿瘤学家，6名NOB训练的神经肿瘤学护士从业人员，3名研究护士，2名神经肿瘤学研究员，2名患者协调员，2名患者协调员，2名临床试验专家和5名数据管理者； Established a robust neuro-oncology consultation service, in which local/regional patients are seen and followed at the NIH (all patients are accrued to a CNS tumor natural history protocol; distant patients may just have radiology/medical records reviewed; Serving as Chair of the Search Committee, Howard Fine helped recruit two new tenure track clinician/scientist brain tumor neurosurgeons to NINDS/NCI leading to a total of 5 clinically active brain在手术神经病学部门的肿瘤神经外科医生，NIND激活了30多个IRB批准的临床试验，预计将在未来几个月内批准另外4个IRB，而总共有30个方案，而NOB在2000年中成立了NOB的原发性脑部肿瘤（在2000年中成立了2000年的原发性500次摄取500次摄入型）（几乎是原生脑瘤）过去的12个月，从NOB成立前一年在NIH上看到的10例恶性脑肿瘤患者（1999年）。此外，NOB审查了2-6名新的邮寄患者每周咨询。为沃尔特·里德医疗中心，朴次茅斯海军医院和贝塞斯达的海军医疗中心提供了几乎所有神经肿瘤服务；与约翰·霍普金斯医学中心，乔治·华盛顿医疗中心，费尔法克斯·诺瓦和华盛顿医院中心建立了密切合作的临床计划，以及各种私人神经外科，辐射，辐射和肿瘤学实践在当地和全国范围内；在美国，美国国立卫生研究院，约翰·霍普金斯医学中心和华盛顿特区的儿童国家医学中心之间，在美国三个机构联合研究培训计划中创建了仅有的少数有组织的神经肿瘤学奖学金培训计划之一；通过临床前筛查计划鉴定出的五种化合物，此后已在NIH（CC8490，LY317615，Velcade + Tamoxifen，CC5013，Talampanel，MLN518，Sunitinib，Sunitinib）中提出了临床。 为了尝试并了解在功能性和肿瘤干细胞水平的恶性神经胶质瘤患者的大脑中发现的肿瘤内异质性，有必要为大脑的所有区域获得可行的肿瘤和正常组织。 显然，这样的抽样不能对活着的患者进行，但不幸的是，我们发现尸检标本与死亡12小时一样新鲜，无法长大，无法生长可行的组织。 因此，我们开始了一项独特的试验，希望将大脑捐赠给脑肿瘤研究的患者和家庭在死亡之前不久就将其临床中心接受临床中心。 心脏骤停后立即将患者的身体迅速降低到手术套件，在无菌手术条件下，我们的一个神经外科医生将大脑从颅库中清除，然后立即与所有适当的组织样品迅速解剖，并将其直接冷冻并放入培养物中以供肿瘤细胞生长。 这项研究将为我们提供前所未有的机会，可以构建具有GBM的人脑的基于肿瘤细胞的基因组微解剖图。这项试验代表了NOB的临床和基础科学研究工作的紧密和交织在一起的功能，这是在神经肿瘤学实验室内进行的转化工作的直接结果激活了9多个临床试验。