The overall objective of the Brain Cancer Program is to translate insights into glial cell biology and cancer genetics into improved treatments for brain tumor patients. Advances in diagnostic imaging, neurological surgery, and radiation therapy have improved brain tumor treatment by making possible earlier detection, safer surgical removal, and more accurate radiation targeting. Nevertheless, treatment of malignant gliomas remains unsatisfactory on account of their diffuse infiltration throughout the brain and their inconsistent response to radiation and chemotherapy. The clinical research program is based on the premise that early identification of brain tumors using state-of-the-art imaging, coupled with precision stereotactic biopsy and resection a and consistent neuropathologic diagnosis and staging, is the best method for establishing a rational basis for treatment. A central aim of the overall research program is to develop an improved classification scheme of human gliomas based on the glial cell lineage and molecular genetics of individual tumors, that allows better prediction of differences in treatment responsiveness of gliomas that appear histopathologically identical but may be of different lineage origin and/or many have different genetic abnormalities. Basic research programs also include efforts to elucidate the biology of the precursor cells that give rise to normal and neoplastic CNS tissue, analysis of the interactions between glial cells and neurons, investigator of neurotransmitter receptor structure and function, analysis of the biology if inflammation in the CNS, development of improved therapeutic procedures, enhancement of imaging capacity and interpretation of the information obtained through non-invasive imaging techniques, and mechanistic analysis of the basis for neurological disease. In addition, the creation of the Center for Advanced Technologies (CAMT) has significantly enhanced our local imaging capabilities. Future aims are to initiate clinical investigation of the utility of differentiation markers in treatment stratification of patients with malignant astrocytoma; investigate the efficacy of functional imaging, particularly magnetic source imaging, in maximizing the benefit of surgical resection; implement clinical trials of noel therapeutic approaches; develop and implement methods to improve delivery of macromolecules to tumors; establish the utility of radiation beam-sharing as an improved adjunct therapy; establish new preclinical models for tumors of the CNS that more closely resemble human gliomas in their biology than do present animal models; expand and integrate into clinical application the studies of basic cellular and molecular mechanisms in neurological dysfunction (e.g. receptors and ion channels).
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