Neuro-Oncology: A New Science Backed with a Century of Experience

More than 20,000 people in the United States will be diagnosed with cancers arising in brain or spinal cord this year, reports the American Cancer Society. Cancer is the second leading cause of death in children in the United States, with brain tumors' lethality second to only leukemia. Brain cancer poses a unique challenge to cancer research and neuroscience, and its study demands a unique research environment, one that recognizes the special nature of the central nervous system and the tumors that develop there.

Brain tumor research is a relatively modern science that parallels the explosion of molecular biology and modern neuroimaging. While the science is new, Mayo Clinic Cancer Center's Neuro-Oncology Program has its roots in Mayo's long history of brain cancer treatment and research stretching back over 100 years.

In the early 1900s Mayo neurosurgeons began performing craniotomies (surgical opening of the skull) for brain tumors. Researchers at Mayo helped create the first classification system for brain tumors (Kernohan System) and later added a new classification system, the St. Anne-Mayo system, which was adopted by the World Health Organization.

Mayo Clinic also introduced revolutionary technology with the first computed tomography (CT) scanner in clinical use and the first hospital-based magnetic resonance (MR) imaging unit in the United States. In 1984, Mayo introduced computer-assisted stereotactic neurosurgery, which revolutionized the approach to diagnosis and treatment of deep-seated lesions within the brain. In 1991, a Leksell Gamma Knife was installed at Saint Marys Hospital on the Rochester, Minn., campus. This is now one of the country's busiest units in terms of tumor treatment.

As a result of these breakthroughs, more and more brain tumor patients turned to Mayo Clinic for help, and today Mayo Clinic ranks as one of the largest brain tumor centers in the world. Patients are seen at all three Mayo Clinic campuses in Scottsdale/Phoenix, Ariz.; Jacksonville, Fla.; and Rochester, Minn. Many patients under treatment also participate in clinical trials and associated research, including studies of tumor biology, neuropathology, and epidemiology. This large patient base forms the foundation of the Neuro-Oncology Program.

The goals of the Neuro-Oncology Program are to:

• Identify mechanisms of primary brain tumor initiation and progression
• Identify risk factors that lead to development of primary brain tumors
• Identify and assess new biomarkers to diagnose brain tumors and to determine the prognosis, and predict the response to therapy of patients with brain tumors
• Develop new therapeutic approaches and new interventions that improve the overall survival, reduce symptoms and improve the quality of life for brain tumor patients

The program now comprises research and clinical application into four separate tumor types: astrocytoma, oligodendroglioma, medulloblastoma, and primary central nervous system lymphoma. This research is accomplished through the cooperative efforts of multi-disciplinary team members across the institution. In particular, the Neuro-Oncology Program capitalizes on Mayo's strengths in neurosurgery, epidemiology, molecular biology, neuropathology, and imaging, and integrates them with Mayo's extensive clinical and clinical trial experience in primary brain tumors to develop the most promising avenues of research.

One of the most robust research areas in the Neuro-Oncology Program is that of translational research. Designed to move laboratory discoveries from the bench to the bedside, translational research initiatives translate basic science findings to direct patient care applications. Mayo Clinic Cancer Center holds a highly competitive Specialized Program of Research Excellence (SPORE) Award in Brain Cancer from the National Cancer Institute — awarded specifically to further extremely promising translational research projects.

For more information on research initiatives in the Neuro-Oncology Program, visit our Ongoing Research and Research Advances Web pages.