ORLANDO—A fortuitous meeting between Kiminobu Sugaya, PhD, a researcher internationally known for his stem cell work involving Alzheimer’s disease, and Melvin Field, MD, a Florida Hospital neurosurgeon specializing in minimally invasive brain surgeries, led to a grant that asked the question: What’s the difference between a stem cell in a brain tumor compared to a regular tumor cell?

 

“Dr. Sugaya and I talked about why we don’t start looking at stem cells for brain tumors,” said Field, surgical director of the Florida Hospital Cancer Institute Brain and Spine Tumor Program. “After some casual dinners talking about ways these cells could be related, we decided to take the next step.”

 

Field and Sugaya established protocols to remove brain tumors from patients who were candidates for surgery, and study the stem cells’ uniqueness.

 

“We wondered whether the stem cells from the tumor were regular stem cells your body would normally make,” said Field. “No one had really looked at the difference.”

 

On Oct. 26, Field presented the results of his team’s research studying stem cells in malignant brain tumors at the Congress of Neurological Surgeons’ annual meeting in New Orleans. The research won the Congress of Neurological Surgeons’ coveted BrainLAB Neurosurgery Award. Every year, the award is presented to a neurosurgeon practicing in a non-academic setting with the best research related to central nervous system tumors.

 

“We were particularly pleased with the award because there were a good number of abstract submissions this year,” said Field, whose research was also recognized as a Top 10 abstract.

 

This study performed in Orlando identifies a specific gene marker present in brain tumor stem cells that is not present in normal non-tumor stem cells in the brain. Tumor stem cells are thought to play a critical role in making malignant brain tumors resistant to current treatments including chemotherapy and radiation therapies. The discovery of this marker provides hope to doctors and researchers that future treatments to block or target this gene may significantly improve survival in patients with the most aggressive form of brain cancer called glioblastoma multiforme.

 

“During the study, we looked at different genes that we know different stem cells make,” explained Field, “We also looked at genes that would prevent the stem cells from becoming regular cells. One of those cells is nanog. Other people who’ve looked at this gene say it’s not really made in the brain.”

 

Field and Sugaya knew from previous research that nanog would actually prevent cells from becoming regular cells. “If you have a stem cell that has the gene nanog in it, it will prevent it from differentiating it to a regular kind of cell.”

 

Field said the Florida Hospital-University of Central Florida (UCF) team involved in the research—including Sergey Bushnev, MD, Nicholas Avgeropoulos, MD, and Angel Alvarez, MD—also looked at several other genes thought to play a role in stem cells.

 

“We found that nanog is indeed made by the tumor stem cells and it’s not made by the regular stem cells in the brain,” he said. “And the tumors that then differentiate into cells that are responsive to radiation and chemotherapy don’t make this gene, nanog. The only ones that make nanog are tumor cells. We thought of this gene, nanog, as very specific just as brain cancer tumor cells.

 

That assumption was the study genesis, which is pretty important to identify a gene that’s very specific just to this type of cell. By finding that, now we can start to work on ways to stop or block that gene, or to regulate that gene, so that perhaps those cells can then become more responsive to treatment.”
The team’s finding is the first of its kind—groundbreaking in the field of stem cell research because it could enable physicians to treat brain tumor patients more effectively, potentially resulting in better outcomes for this uniformly fatal tumor.