Saturday, April 15, 2017

Brain Metastasis Research: A Summary of Two Recent Reviews


Many types of cancer are capable of spreading or metastasizing to the brain including lung, breast, melanoma and colorectal cancer. There is no cure for metastatic cancer of any type, but treating brain metastasis poses unique challenges.
In two recent review articles, President-Elect of the Metastasis Research Society, Dr. Dihua Yu, and colleagues discuss what is currently known about the complex biology of brain metastasis and which therapies or strategies are most promising.

The brain is unique.  It supports and preserves neuron functions with a network of specialised cells including astrocytes and microglia, and is protected by the ‘blood-brain barrier,’ which separates the brain from the circulating bloodstream.  
So how do cancer cells survive in the foreign environment of the brain and grow into metastatic brain tumors? Simply put, these cells are endowed with aggressive traits that enable them to cross the blood-brain barrier, escape recognition by anti-cancer immune cells in the brain, use the existing brain vasculature for nourishment, and they can even ‘educate’ other normal cells in the brain to support their growth and survival.  
Unfortunately, the aggressive traits of metastatic brain tumors can also make them resistant to standard systemic cancer therapy. In addition, more than 80% of patients with metastatic brain cancer already have multiple metastatic tumors at the time of diagnosis, making them ineligible for surgery.

Dr. Yu and colleagues note that the support of cancer growth in the brain by surrounding resident brain cells is a major contributor to therapy resistance.  Therefore, counteracting the ability of metastatic cancer cells to communicate with resident cells of the surrounding microenvironment should increase the clinical benefit of standard therapies.
It may also be possible to target the unique metabolic needs of brain metastatic cancer cells therapeutically.   Metastatic cancer cells must alter their metabolism to survive and grow in the brain.  For example, cancer cells can adapt to use neurotransmitters of the brain as metabolites.  Cancer cells may also become addicted to certain metabolites that could potentially be limited. But, the concept of targeting metastatic cancer cell metabolism isn’t ready for primetime in the clinic because many aspects of these molecular pathways still need to be clarified.

Much insight in the field of brain metastasis is expected to come from studies with preclinical models that recapitulate the entire metastatic process, and the intimate interactions between tumor cells and cells within the tumor microenvironment (cells in the area surrounding the brain tumor). Moreover, advancements in neuroimaging techniques are providing new tools for live imaging.  This technology is increasing our understanding of metastasis in experimental models and improving diagnostics in patients.
The extensive characterization of genes (genomic characterization) and molecules that are transcribed from genes to create proteins (transcriptomic characterization) in metastatic tumors isolated from patients is also providing clues to how tumor cells that metastasized to the brain differ from normal cells and from each other.  Tumor cells may be heterogeneous (different) and endowed with different molecular features and abilities even if they are within the same tumor. 

With this information, new hypotheses on the molecular mechanisms that orchestrate the establishment and progression of brain metastases are developing and creating new opportunities to find therapies that target a specific molecular feature of brain metastatic cancer cells.

In addition to targeted molecular therapies, immunotherapies are emerging as a potentially efficacious strategy for the treatment of brain metastases.  These therapies don’t target brain metastatic cancer cells themselves, but instead enhance the function of immune cells to suppress tumor growth.  Clinical investigations are now demonstrating that the ability of immune checkpoint inhibitors to effectively inhibit metastatic brain tumors is similar to their ability to treat metastatic tumors outside of the brain.  However, they could produce severe side effects.  This concept is explored in another article here.

Despite encouraging progress in this field, the clinical management of patients with brain metastases is still challenging and financial support for studies on metastatic cancers is limited. Further effort is required and active cooperation among biologists, neuroscientists and oncologists is the key to targeting metastatic cells early and from different fronts.  

Source Articles:
About the Metastasis Research Society

The Metastasis Research Society (MRS) is a 31 year-old, non-profit, international professional society for researchers, clinicians, members of industry, and entrepreneurs who are dedicated to solving the problem of cancer metastasis.  The mission of the MRS is to support progressive research on any processes fundamental to metastasis. This includes supporting the exchange of information between all stakeholders in metastasis research and treatment via conferences, networking events, webinars, and the two official journals of the society (Clinical and Experimental Metastasis and Cancer and Metastasis Reviews).  We also strive to educate the public about metastatic cancer, and raise awareness about the funding discrepancy for metastatic research worldwide.


We encourage you to join our efforts and support metastatic cancer research and metastatic patient education globally by becoming an MRS member.  Click here to view membership categories and benefits, and join today.  Follow the MRS on Facebook and Twitter for up-to-date metastasis-related news.  Email metastasis.research@gmail.com for more information.



Wednesday, April 5, 2017

Northwest Arkansas Metsquerade


How the Northwest Arkansas Metsquerade came to be:


Pink ribbons are all around us in October and April announcing the seasons of Breast Cancer “awareness” throughout the country. Hundreds of millions of dollars are raised nationally for Breast Cancer, but a very small portion of this money is being allocated for Metastatic Breast Cancer (MBC). And while there is plenty of giving going on, there are very few advocates and organizations for MBC. One of our local outspoken advocates is Kelli Parker of Bella Vista, Arkansas. She was diagnosed at 26 with stage 1 breast cancer and metastasized to stage 4 by the age of 33. She did everything the early detection/awareness campaigns said she was supposed to do—double mastectomy, chemotherapy, radiation, hysterectomy, hormonal therapy, and more. Kelli realized that the current awareness and early detection approach is not working and is fighting for Metastatic Breast Cancer patients around the country and world.
One of the organizations she supports is METAvivor, a non-profit run primarily by women with MBC, which uses 100% of donations for research. 100%–this is unheard of in the non-profit sector. Imagine donating money to an organization that will maximize every dollar toward its goal. Knowing that the only key to making MBC a controllable chronic illness instead of a terminal one is more research, Kelli decided to throw her support to METAvivor.
In 2016 she came up with The First Annual Northwest Arkansas METSquerade idea as a way for the local community to specifically support the individuals with the only breast cancer that kills. She joined forces with another Northwest Arkansas woman with MBC, Lisa Quinn, to help make the Metsquerade happen. Lisa, age 37, was diagnosed with MBC in July 2015. She had no previous history with breast cancer. The idea behind the Metsquerade is to provide METAvivor with additional money to help research MBC, raise awareness to MBC, and to acknowledge the women and men living with metastatic breast cancer.


2016 Success

The 2016 Metsquerade was an enormous success! The event raised over $130,000 and was able to donate over $100,000 after event costs to Metavivor. The amount of money raised in the first year will fund two years of metastatic breast cancer research.

2016 Sponsors

The 2016 NWA Metsquerade sponsors included Diamond Sponsor 40/29, Gold Sponsors Coldwell Banker Harris McHaney & Faucette Real Estate Embassy Suites, Silver Sponsors Slim ChickensHunt Ventures, & Walmart, Elite Sponsor Harps Foods, and Plus Sponsor Highlands Oncology.


About METAvivor

METAvivor is dedicated to the specific fight of women and men living with stage 4 metastatic breast cancer. At the time of METAvivor’s founding, no organization was dedicated to funding research for the disease and no patient groups were speaking out about the death of stage 4 cancer research. While more and more people have taken up the cry for more stage IV research, METAvivor remains the sole US organization dedicated to awarding annual stage IV breast cancer research.”

METAvivor’s Mission

“METAvivor exists to sustain hope for those living with metastatic breast cancer (MBC). Passionately committed patients ourselves, we rally public attention to the urgent needs of the MBC community, help patients find strength through support and purpose, and make every dollar count as we work with researchers to regain longevity with quality of life.”

What METAvivor Does

Awareness
“We bring attention to the specific issues of stage 4 metastatic breast cancer, and raise public awareness about the facts of the disease. With 30% of breast cancer patients metastasizing, our goal is to see to it that 30% of breast cancer support and funding for research is dedicated to metastatic breast cancer.”
Research
“METAvivor awards research grants to individuals with a clinical or other doctoral degree who are actively engaged in areas of metastatic breast cancer research and whose proposals show distinct promise in making a difference for the stage 4 breast cancer community. The goal of our funding efforts is to transition metastatic breast cancer from a terminal diagnosis to a chronic, manageable disease with a decent quality of life.”
Funding
“METAvivor is run entirely by volunteers, most of who are living with metastatic breast cancer. Although we do not pay any salaries, we work to obtain grants and corporate sponsors to support our operation expenses. This allows us to ensure that donations can be entirely dedicated to our research grants that fund the cutting edge research that will ultimately save lives. Unless otherwise specified by the donor, 100% of every donation and 100% of proceeds from every fundraiser (after event expenses) goes into our research grants.”

To donate, attend, or learn more, please visit the NWA Metsquerade event page.