Integrated Oncology Research Explores New Pathways for Treatment of Primary and Metastatic Brain Cancer

 

At Baptist Health Miami Cancer Institute, parallel lines of research are underway to develop transformative approaches to maximize tumor control while protecting neurocognitive function during brain tumor treatment. This first-of-its-kind research is led by Rupesh Kotecha, M.D., Chief of Radiosurgery and Director of the Central Nervous System Metastasis Program and Yazmin Odia, M.D., Chief of Neuro-Oncology. In a separate report, Miami Cancer Institute’s Chief of Medical Oncology and Chief Scientific Officer & Deputy Director, Manmeet Ahluwalia, M.D., MBA, FASCO, is focused on generating tissue-agnostic therapies for the treatment of primary brain tumors. These groundbreaking initiatives are paving the way to overcome current challenges and the limited treatment options for patients suffering from brain metastases.

Azeliragon: A novel therapy for Metastatic Brain Cancer

Rupesh Kotecha, MD

Building upon a foundation of groundbreaking oncology research at Baptist Health, Dr. Kotecha and Dr. Odia's study tests a new combinatorial regimen on patients using new medication and stereotactic radiosurgery. The therapeutic agent Azeliragon, is a blood brain barrier-permeating antagonist of the receptor for advanced glycation end products, known to protect against neuroinflammation. “This Phase I/II study will determine the maximum safe dosage of the medication to be given with radiosurgery, while also tapering corticosteroids,” explains Odia.

“The study is the first of its kind and has the potential to overcome cancer’s resistance pathways and improve response rates, while protecting against inflammation in the brain,” shares Kotecha.

Assessing the role of Tissue-Agnostic Therapies

Yazmin Odia, MD

 

The report led by Dr. Ahluwalia, is fresh-off-the press in the academic journal, Trends in Cancer. This manuscript is focused on analyzing the use of tissue-agnostic therapeutics in patients with primary brain tumors (PBTs).

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The study highlights the recent approval of novel tissue-agnostic therapeutics by regulatory bodies worldwide, driven by compelling data from trials showcasing their efficacy and safety across various tumor histologies. Ahluwalia and colleagues discuss the current and potential impact of these specific therapies on PBTs and propose additional tissue-agnostic targets that may hold promise for next-generation sequencing.

Advancements in this space have been largely led by basket trials, which assess targeted therapies based on the molecular profiles of diverse cancers, emerging as a cornerstone of precision medicine. However, the complexity of PBTs, characterized by genetic, epigenetic, and immunological heterogeneity, presents unique challenges. Dr. Ahluwalia notes the importance of understanding these innate differences to maximize the impact of tissue-agnostic therapies.

Manmeet Singh Ahluwalia, MD, MBA, FASCO

Despite the promise of tissue-agnostic therapeutics, there is limited representation of different PBTs in current studies which limits widespread adoption. “It is becoming increasingly crucial for individuals with primary brain tumors to undergo molecular profiles, enabling the maximization of therapeutic options based on individualized characteristics and for real-world analytics to capture this data. These tissue-agnostic approvals, as the new frontier of precision oncology, hold promise for improved treatment outcomes of gliomas,” adds Ahluwalia.

Pushing the Boundaries

The convergence of Drs. Kotecha, Odia and Ahluwalia's research underscores a fusion of innovation and collaboration at the Miami Cancer Institute. These clinical trials have widespread implications for the future of brain cancer treatment and precision medicine. Miami Cancer Institute remains steadfast in its commitment to pushing the boundaries of possibility, empowering patients with new hope and providing tangible solutions in their battle against brain cancer. With unwavering dedication and a relentless pursuit of excellence, the Miami Cancer Institute continues to redefine the standards for oncology care.