Searching for the earliest signs of brain cancer

Research by King’s College London and King’s College Hospital NHS Foundation Trust has found that brain tumours in young adults can be benign for years before they become highly aggressive.

A study by the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London and King’s College Hospital NHS Foundation Trust has identified microscopic clusters of cells where malignant change can start, making tumours more aggressive.

Funded by the Medical Research Council (UK), Psychiatry Research Trust, and the Inman Charity, this study has been published in Neuro-Oncology Advances.

The study analysed pieces of living human brain tissue from 20 people undergoing brain tumour surgery at King’s College Hospital NHS Foundation Trust, one of the largest neuro-oncology centres in Europe.

The researchers found groups of tumour cells clustered around blood vessels and believe that these sites could be the seedbeds for malignant progression, the process by which a tumour becomes a fast growing and uncontrolled cancer.

To study the brain tissue, neurosurgeons cooled the surface of the brain. They then took a sample and placed it into a cerebrospinal fluid solution. Once it had been transported to the lab, the tissue was placed into a miniaturised incubation chamber specially designed for this study and bathed in a solution that makes the living tumour cells fluoresce and more easily studied under a microscope.

Dr Gerald Finnerty, Lead author at King’s IoPPN and Honorary Consultant Neurologist at King’s College Hospital NHS Foundation Trust, said:

This research is hugely significant. The “hotspots” found exhibited many of the hallmarks of cancer. The ability to pinpoint areas at high risk of malignancy gives us a much better chance of establishing why the brain tumour becomes malignant.

Brain cancers are difficult to treat because they are so invasive. Even after surgery and chemoradiotherapy there is still a high risk that some cancerous cells can be left behind, increasing the likelihood that the cancer will return. This unfortunately means that many of the young adults it affects do not survive beyond a year.

Dr Alastair Kirby, King’s College London, first author on the study said:

It has been a privilege to work with brain tumour patients and our neurosurgical team to deliver this highly innovative research. Live human brain tissue offers great opportunities to study how a person’s brain tumour responds to treatments. This will revolutionise therapy and bring precision medicine of brain cancer one step closer.

King’s Health Partners Neurosciences deliver outstanding research and education, and drive excellence in care and equity for patients with neurological conditions.

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