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Why study Brain tumour
Biology???
Richard Grundy
Overview
• Paediatric oncology is one of the medical
success stories of the 80’s-90’s
• Steady improvement on the overall
survival of children with cancer BUT not
CNS tumours – Only 50% survive
• 10,000 life years lost and considerable
morbidity
• Plateau and Stasis : More recently small
advances only are being made and for
some tumours little progress at all
• Fight Fire with Fire
Children’s Brain Tumours : The Issues
Brain tumours
are relatively
rare
Children’s Brain Tumours : The Issues
Poor understanding
of disease biology
Brain tumours
are relatively
rare
Children’s Brain Tumours : The Issues
Poor understanding
of disease biology
Brain tumours
are relatively
rare
No accurate disease
stratification
Broadly based
treatment
strategies
Children’s Brain Tumours : The Issues
Poor understanding
of disease biology
Brain tumours
are relatively
rare
No accurate disease
stratification
Broadly based
/aggressive treatment
strategies
High Mortality/
Morbidity
Children’s Brain Tumours : The Issues
Poor understanding
of disease biology
Brain tumours
are relatively
rare
Low Priority for
Molecular research
No accurate disease
stratification
Broadly based
treatment
strategies
High Mortality/
Morbidity
Children’s Brain Tumours : The Issues
Lack of molecular
targets for new
treatment
approaches
Poor understanding
of disease biology
Brain tumours
are relatively
rare
Low Priority for
Molecular research
No accurate disease
stratification
Broadly based
treatment
strategies
High Mortality/
Morbidity
Children’s Brain Tumours : The Issues
Lack of molecular
targets for new
treatment
approaches
Poor understanding
of disease biology
Brain tumours
are relatively
rare
Low Priority for
Molecular research
No accurate disease
stratification
Broadly based
treatment
strategies
High Mortality/
Morbidity
Key Hypotheses
• Tumours arising in different anatomical
locations are genetically distinct entities.
• Tumours arising indifferent age groups have
distinct genetic aberrations.
• Tumours of different histological grade have
distinct genetic fingerprints.
• Genetic markers can predict outcome in
childhood CNS tumours.
• Tumourigenesis arises from disordered neural
development and involves distinct tumour
specific pathways.
• Development of large data sets linked to
clinical parameters will enable the discovery
of novel targets for therapy.
Biological studies
• Using Biological studies to better
understand or find :
– ‘Markers’ that help us predict outcome or
best treatment
– pathways involved in the development of
brain tumours
– Where Brain tumours come from
– New Drug Treatments
Improved Patient
Management &
Outcome
International &
National
Clinical Trials
& Biological
studies
Improved
Diagnostic
& Prognostic
Imaging
High resolution
Molecular analysis
of tumour samples
Children’s Brain
Tumour
Research Centre
Fingerprint’ provides
Novel prognostic
Markers & targets
for therapy
Identification of
molecular
‘fingerprint’
Understanding
‘Why’ in the
context of the
Normal
development
of the Brain
Why Does
Treatment Fail ?
Need New Drug
Development
and Delivery