Brain Tumor Clinical and Clinical Research Program

NOB在建立必要的基础设施方面取得了实质性进展，以履行其使命，即为患有脑和脊髓肿瘤的儿童和成人开发新的和改进的疗法。以下是脑肿瘤临床和临床研究计划建设的部分成就列表：在三个不同的NCI分支机构的积极参与下，建立了NIH范围内的多学科脑肿瘤诊所（ROB，MOCRU，CCRLP），五个不同的NIH机构（NCI，NINDS，NEI，NHLBI，NIMH）和五个不同的临床中心计划（神经放射学，精神病学，疼痛和姑息，康复医学，社会工作）。诊所的专业知识包括肿瘤内科、放射肿瘤科、神经外科、神经科、眼科、心脏科、精神科、内分泌科、社会工作和康复医学;组建了一个主要的神经肿瘤学临床护理/研究团队，目前包括4名神经肿瘤学家、6名接受过NOB培训的神经肿瘤学执业护士、3名研究护士、2名神经肿瘤学研究员、2名患者协调员，2名临床试验专家和5名数据管理员;建立了强大的神经肿瘤咨询服务，在NIH为当地/区域患者提供咨询和随访（所有患者都应参加CNS肿瘤自然史方案;远处患者可能仅需要回顾放射学/医疗记录;作为遴选委员会主席，霍华德费恩帮助招募了两名新的终身制临床医生/科学家脑肿瘤神经外科医生到NINDS/NCI导致NINDS外科神经病学分支共有5名临床活跃的脑肿瘤神经外科医生;启动了30多项IRB批准的临床试验，预计未来几个月将批准另外4项临床试验，相比之下，当NOB在2000年成立时，NIH只有一个针对原发性脑肿瘤的方案（之前的放射方案总共招募了不到10名患者）。 简而言之，NOB能够在短时间内完成以下工作（并继续）：每年有200多名原发性脑肿瘤患者参加NOB IRB批准的临床试验;超过500名新的原发性脑肿瘤患者（几乎所有的神经胶质瘤）和2000-3000名随访患者在过去的12个月，而在NOB成立的前一年（1999年），NIH发现的恶性脑肿瘤患者不到10例。此外，NOB每周审查2-6例新的邮寄患者咨询。为沃尔特里德医疗中心、朴茨茅斯海军医院和贝塞斯达的海军医疗中心提供几乎所有的神经肿瘤学服务;与约翰霍普金斯医疗中心、乔治华盛顿医疗中心、费尔法克斯Inova和华盛顿医院中心以及当地和全国范围内的各种私人神经外科、放射和肿瘤学实践团体建立了密切的合作临床项目;创建了美国仅有的几个有组织的神经肿瘤学奖学金培训项目之一-一个由美国国立卫生研究院、约翰霍普金斯医学中心和华盛顿，华盛顿特区的儿童国家医学中心组成的三个机构联合研究培训项目;通过临床前筛选项目确定了5种化合物，此后已在NIH进行临床试验（CC 8490、LY 317615、万珂+他莫昔芬、CC 5013、Talampanel、MLN 518、舒尼替尼）。作为神经肿瘤学实验室内进行的翻译工作的直接结果，启动了9项以上的临床试验。

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 motnhs, 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 less than 10 patients in total). In short, the NOB has been able to accomplish the following in a short period of time (and continues): Accrues more than 200 primary brain tumor patients to NOB IRB-approved clinical trials per year; Saw greater than 500 new primary brain tumor patients (almost all gliomas) and between 2000-3000 follow-up patients over the last 12 months, up from less than 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). Activated more than 9 clinical trials as a direct result of translational work performed within the Neuro-Oncology Laboratory.