Sylvester Brain Tumor Institute Launches to Personalize Brain Cancer Treatment

Stephen D. Nimer, MD

Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine announced the formation of the Sylvester Brain Tumor Institute (SBTI) to elevate brain cancer care and research in South Florida and beyond.

“The Sylvester Brain Tumor Institute will further enable Sylvester to increase the impact of its research and clinical work, creating a thriving environment for generating new discoveries, as well as a superb place to train brain tumor-focused physicians and staff,” said Stephen D. Nimer, MD, director of Sylvester, Oscar de la Renta Endowed Chair in Cancer Research and executive dean for research at the Miller School. “The institute will promote more new discoveries that will help patients with brain tumors worldwide.”

SBTI will bridge multiple disciplines, bringing together experts in many fields of brain tumor patient care and research and many departments within the Miller School to collaborate on these very difficult-to-treat forms of cancer, with the goal of bringing more targeted, personalized care to Sylvester brain cancer patients. A major challenge in neuro-oncology is glioblastoma, the most common kind of brain cancer and one which is nearly always deadly. The average survival time after diagnosis with this kind of brain cancer is just 12 to 18 months and five-year survival is only around 7%.

Over the last few years, Sylvester has recruited luminary faculty and established institutes for pancreatic cancer and multiple myeloma. SBTI will join these other institutes in their pursuit of better treatment outcomes for difficult-to-treat cancers. SBTI’s leaders are expanding their work beyond glioblastoma to other types of adult and pediatric brain cancers.

Multidisciplinary Teams to Tackle a Tough Cancer

Glioblastoma is notoriously difficult to treat in part because tumors are very different from patient to patient, said SBTI’s director, Antonio Iavarone, MD, who is also deputy director of Sylvester and professor of neurological surgery and biochemistry and molecular biology at the Miller School. Such a challenging problem to solve requires multiple areas of expertise.

“The institute will allow us to have a critical mass of clinicians, surgeons, translational scientists and basic scientists working together toward a goal of generating treatments that are tailored to each individual patient at Sylvester,” Dr Iavarone said. “This is a complex and ambitious goal. You need multiple people with complementary expertise working together—this is what has driven the creation of the SBTI.”

Along with Dr Iavarone, SBTI’s leadership will include Macarena de la Fuente, MD, co-director of clinical neuro-oncology, who is also an associate professor of neurology and chief of the neuro-oncology division at the Miller School; Ricardo Komotar, MD, surgical director of SBTI, who is also professor and program director in neurosurgery and director of surgical neuro-oncology at the Miller School; and Anna Lasorella, MD, director of Sylvester’s Precision Medicine Initiative, co-director of Basic and Translational Research and professor of biochemistry and molecular biology at Miller School.

Tailored Laboratory Models

To work toward new personalized treatments for glioblastoma patients, the SBTI researchers will take a multidisciplinary approach that entails creating unique laboratory models of each patient’s tumor. Dr Komotar’s team will lead the collection of biopsied tissue from patients who undergo brain surgery, typically the first step in glioblastoma treatment. That tissue will then be used to create two types of models: patient-derived organoids, which are miniature tumors grown in the lab from biopsied cancer cells, and patient-derived xenografts, where tumor cells are re-grown in the laboratory and studied in pre-clinical models.

This approach will allow the scientists to not only study the biology of different brain tumors in detail, but to test different drugs on the patients’ tumors in the lab. Ultimately, they hope to offer patients precision treatments based directly on these studies. In the near term, the studies inform treatment recommendations using already-approved drugs and lead to new clinical trials for newly discovered kinds of treatments.

“Because each patient is so different, we really need to have patient-derived material for our molecular studies and the translational work that is carried out in the lab,” Dr Lasorella said.

The SBTI researchers are also studying how glioblastoma evolves when it recurs after treatment. By understanding how the tumors change and develop treatment resistance, they will be able to develop new treatments that prevent the cancers from recurring in the first place.

Improving Clinical Trials and Patient Care

“Over the last few decades, many clinical trials have failed because, in a way, we’re trying to paint all these tumors with one brush,” said Dr de la Fuente. “We know these are tumors are very different from patient to patient and one treatment to fit all is not going to be broadly successful.”

The patient-centered approach to studying glioblastoma will allow Dr de la Fuente and her team to speed more leading-edge treatments to early-phase clinical trials and ultimately FDA approval. The SBTI researchers will also look for biomarkers in the glioblastoma lab models that may predict how different patients will respond to certain treatments. With enough of those biomarkers identified, the team would be able to offer personalized care to brain cancer patients more rapidly.

The formation of the institute represents years of work by Sylvester researchers and physicians.

“Our goal for the past decade has been to establish an institute and center of excellence for studying brain tumors in South Florida to bring the best possible care to brain cancer patients,” said Dr Komotar. “It’s incredibly satisfying to see it come to fruition.”