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Targeting pediatric brain cancer

By Matthew Greseth

Juvenile pilocytic astrocytoma (JPA), while rare, is the most common pediatric brain tumor. This type of tumor develops in astrocytes — star-shaped cells that surround and protect nerve cells— and is often benign and slow growing.

Research into this type of tumor is difficult due to the lack of an established cell line. Ramin Eskandari, M.D., director of pediatric neurosurgery at MUSC Children’s Health, and his team have solved this problem. In 2016, Eskandari removed a brain tumor from five-year-old Mary Scott Gallus. He then received permission from Mary Scott’s parents to use the resected tumor for research.

Eskandari gave part of the tumor to Arabinda Das, Ph.D., assistant professor in the Department of Neurosurgery. Das was able to purify and culture this low-grade tumor — the first-reported cell line for JPA. They named this brand new cell line MSG after Mary Scott Gallus.

Eskandari’s group also works on high-grade tumors and has developed a novel experimental treatment model targeting pediatric medulloblastoma that is detailed in the March 2017 Child’s Nervous System (doi: 10.1007/s00381-016-3305-x). When low-dose X-ray radiation was combined with immunotherapy (targeting HER2 or VEGF), T-cell-mediated cell death improved.

High-grade tumors are notorious for evading the body’s immune system. To combat this, Eskandari’s new treatment model uses a two-pronged approach. The first prong uses low-dose radiation that doesn’t kill tumor or brain cells; however, it shocks the immune system into recognizing the tumor as a foreign object. The second prong uses antibodies targeting proteins on the cell surface to enhance the immune cells’ ability to recognize the tumor. These in vitro results are tantalizing and warrant further investigation.