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Neurosurgery Happenings

Investigational Trial Hopes to Develop New Test that Could Eliminate Unnecessary Surgeries

If it weren't for a head-to-head collision in a collegiate soccer game, there is no telling how long it would have been before Leslie Sommers would have discovered she had a brain tumor. She was 20 years old, playing soccer at Wittenburg University in Springfield, Ohio in 2010 when she collided with another player. She went to a nearby hospital to ensure there was no damage. A CT scan and an MRI showed something on her brain, but it wasn't concerning to Leslie or her doctors. "Even the radiologist and neurosurgeon who looked at it thought it was probably just something I was born with," she remembers. So, she was surprised six months later when a follow-up MRI showed that the spot had grown.

"That's when my parents started doing a lot of research," Leslie says, "and they decided UC was the place to be because of the Tumor Board." After they transferred care to UC, the Tumor Board decided in 2011 that Leslie did need an operation to determine what was on her brain. Doctors found and removed a grade 3 astrocytoma glioma that required chemotherapy and radiation.

Leslie took it all in stride, but was disappointed when a year later, doctors told her they thought the tumor had returned and that she would have to have another craniotomy. This time though, doctors didn't find a tumor during surgery.

Dr. Matthew Garrett working in his laboratory

UC Assistant Professor of Neurosurgery, Matthew Garrett, MD, PhD, says this is quite common. "Some of our therapies, when they work," he explains, "look like tumor." This happens so often, that 30% of surgeries for what looked like a recurrent tumor on MRI are later determined to be just the effects of radiation. Dr. Garrett thinks there is a better way to determine if a tumor has returned. He thinks that measuring the amount of tumor burden in a patient's spinal fluid will give doctors a more accurate way to determine what's happening inside their brain. 

The Institutional Review Board, or IRB, just approved an investigational trial led by Dr. Garrett which will allow him to test out this theory. This type of test is sometimes referred to as a liquid biopsy, and is being developed by other institutions to test for different kinds of cancer. Dr. Garrett's trial will specifically focus on patients who have glioblastoma, the most aggressive form of brain tumor. "Right now, we have no great way to measure whether our chemotherapy is working or if the tumor is growing back," says Dr. Garrett. 

Dr. Garrett believes the first phase of the trial will show that the tumor amount in patients' spinal fluid will decrease after the patient undergoes surgery, chemotherapy and radiation. Then, it will increase if the tumor returns. "We'll be able to diagnose them early so we know when the tumor is coming back before the MRI is positive," says Dr. Garrett.

Right now, Dr. Garrett and his colleagues, Soma Sengupta, MD, PhD, and Trish Wise-Draper, MD, PhD, are recruiting patients who have been newly diagnosed with glioblastoma to volunteer for the study.

Sommers, who is now a teacher, wife and mother (and still tumor-free) hopes this works. She says, "I think it would be pretty incredible if you could prevent the possible horrific happenings that could result from brain surgery."

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