August 23, 2024
Did you know that there are over 120 different types of brain tumors, and about 27,000 people are diagnosed with malignant brain tumors in the United States each year? While not all brain tumors are cancerous, those that are can be particularly aggressive and challenging to treat. Progress in brain cancer treatment has been slow, but there is hope on the horizon. At The University of Kansas Cancer Center, dedicated researchers are making strides in diagnosing and treating brain cancers, as well as managing their side effects.
Cancer center researchers, including Tolga Tuncer, MD, assistant professor of Neurosurgery and Medical Oncology, are working on transdisciplinary approaches that include the combination of new biological and targeted therapies, immunotherapy with radiation to combat primary brain tumors and the use of genetic insights to guide treatments for brain metastases.
Below, Dr. Tuncer shares the critical role of a multidisciplinary team in brain cancer care and offers a glimpse into the evolving field of brain cancer research.
What makes the brain cancer research team at The University of Kansas Cancer Center unique?
Our brain cancer research team is distinguished by its multidisciplinary expertise. We have the rare combination of two medical oncologists/neuro-oncologists with dual board certification. There are only 330 people in the U.S. who hold this dual certification. I also have a background in radiation oncology. This unique blend of expertise allows for a comprehensive understanding of both cancer treatment and neurological conditions like seizures, which can be critical for patients with brain tumors.
Our team is comprehensive, with multiple specialists in each area of brain cancer care. We have two board-certified neuro-oncologists, four neurosurgeons, two full-time neuropathologists, a neuropsychologist and a dedicated support team. We also have two dedicated brain tumor nurse navigators to guide patients. This broad expertise ensures that every patient receives the highest standard of care.
In 2024-2025, we were ranked number 26 in Neurology and Neurosurgery by U.S. News & World Report, an impressive achievement that highlights our commitment to excellence. This ranking underscores our advanced surgical capabilities and innovative approaches to brain cancer treatment.
How does this multidisciplinary approach benefit patients?
There is no one-size-fits-all approach when it comes to treating brain tumors. In addition to factoring each tumor’s biological qualities, you also must balance treatment with quality of life. This integrated approach means that while the neurologist can manage neurological complications such as seizures, the medical oncologist focuses on treating tumors that have metastasized to the brain. This synergy ensures that all aspects of a patient's condition are addressed, leading to more effective and personalized care.
How has the brain cancer research program grown over the last two years?
We have seen remarkable growth, starting from zero patients, and now enrolling 20 to 25 patients per year in clinical trials. This expansion reflects our commitment to advancing brain cancer treatment and offering patients access to leading-edge therapies.
What are some of the clinical trials currently offered at the cancer center?
We are conducting several frontline, groundbreaking clinical trials. One notable trial involves GammaTile, a form of radiation therapy. It uses thin tiles – which are no bigger than a paperclip – that are infused with radiation. During brain tumor surgery, the surgeon places GammaTiles in the tumor to deliver immediate radiation directly to the tumor cells. Glioblastoma is prone to rapid early progression, which means the tumor has the potential to regrow between surgery and postoperative chemotherapy. Giving radiation at the time of surgery limits its ability to grow. The tile's design also ensures that the radiation is precisely delivered and limits radiation exposure to healthy brain tissue.
GammaTile therapy is currently approved for recurrent and newly diagnosed malignant (cancerous) tumors. Now, we are looking at the use of GammaTile in people with newly diagnosed glioblastoma, which is one of the most complex and difficult-to-treat cancers. The current standard of treatment for this group often does not provide long-term control or improve overall survival. This trial aims to assess if GammaTile, combined with standard care, is safe, well-tolerated and can improve patient outcomes.
Additionally, KU Cancer Center is the lead site for a randomized phase II/III glioblastoma vaccine trial. This trial is interesting in that people may join the trial before a diagnosis. If glioblastoma is suspected, a neurosurgeon removes a part of the tumor for analysis. We obtain a small piece of that tumor and profile it based on DNA mutations. A personalized peptide vaccine targeting specific antigens then stimulate the immune system to attack cancer cells.
In another study, we are studying a new treatment for a type of brain cancer called MGMT methylated glioblastoma. It is comparing whether adding a drug called lomustine to the standard treatment of temozolomide (a chemotherapy drug) and radiation therapy helps shrink or stabilize the cancer better than using just temozolomide and radiation alone.
What about basic research efforts in brain cancer?
Basic science lays the groundwork for advancements in treatment. True bench to bedside work only happens at academic medical centers and National Cancer Institute-designated comprehensive centers like The University of Kansas Cancer Center.
For example, one of our radiation oncologists, Dr. David Akhavan, is also a basic scientist. His laboratory is developing CAR T-cell therapies to better treat brain tumors by overcoming the challenge of getting these immune cells to infiltrate and survive in the tumor microenvironment. Several CAR T-cell therapies are already approved for treating certain blood cancers, and now we are looking at using it in solid tumors. Dr. Akhavan and his research team are working to overcome the obstacles that prevent CAR T-cell therapy from being effective against brain tumors. His research aims to translate promising cell-based immunotherapy from preclinical models to effective treatments for brain cancer patients.
What does the future hold for brain cancer research?
In 15 to 20 years, we can expect a vastly different landscape where more people benefit from the latest technology and treatments.
We are moving towards adaptive trials that target specific gene pathways in tumors. After surgery, we will rapidly identify these pathways and use existing drugs to treat them, with real-time feedback guiding the process. This approach will expand into different patient groups and accelerate finding effective treatments. Additionally, advancements in artificial intelligence (AI) will enhance our ability to analyze massive amounts of data quickly, allowing us to evaluate new therapies in a matter of weeks to months rather than years. AI will help researchers and physicians sort through complex data to find the most promising treatment options, although it will also change how we think about innovation in the field.
With our rapid growth and dedication to innovation, we are poised to make significant advancements in brain cancer treatment. The vision for the program is to be within top 10 brain tumor centers of excellence within a couple of years. Our expanding clinical trials and continuous pursuit of excellence ensure that we remain at the forefront of brain cancer research.