Dialog Box


Cure Brain Cancer International Scientific Meeting 2014

Cure Brain Cancer Scientific Meeting


"Climbing hills can be done by individuals, but getting to a summit needs a team."

 - Professor Webster Cavenee, Ludwig Institute of Cancer Research


In his opening talk to international brain cancer researchers and clinicians, Professor Webster Cavenee from the Ludwig Institute, University of California San Diego deftly framed the current global approach to brain cancer research. The scientific meeting was held in Sydney in early May to bring together in one room the leaders in the field of neuro-oncology. 

This was a major coup for Australia; the attendees list read like the ‘who’s who’ of brain cancer research globally, including highly acclaimed scientists from the Ludwig Institute for Cancer Research and The University of Texas MD Anderson Cancer Center in the US, as well as from the Asian Fund for Cancer Research. And the key Australian researchers were also out in force; members of the existing Brain Cancer Discovery Collaborative (which spans 4 states and 6 research institutions) were augmented by the likes of Professor David Walker from BrizBrain and Spine, Professor Mark Rosenthal from the Royal Melbourne Hospital (who has recently joined Cure Brain Cancer’s Scientific Advisory Committee) and the gathering was honoured to include Professor Ian Frazer, from the Translational Research Institute in Brisbane, whose contributions to immunotherapy (in particular the cervical cancer vaccine) are legend. 

This is not the beginning of international collaboration on brain cancer, not a “one-off” transaction of ideas, but rather part of a continuum in an engaged relationship between all brain cancer researchers present. This movement was spearheaded by Cure Brain Cancer with an initial meeting a year before that set in motion a determination to tackle the disease at a global level. Since then, the initiative has been not only endorsed and adopted by a series of existing coalitions in North America, but is now counting Germany, the UK, Brazil and (all importantly) China amongst its membership; with a disease of such low incidence, the entrance of large countries is critical to success. Indeed, Dr Sujuan Ba from the NFCR and Asian Fund for Cancer Research spoke at the meeting of the monumental achievement of establishing the Tissue Bank Consortium in China that provides access to high quality GBM tissue around the world. 

And (despite the still terrible mortality rates for brain cancer) the mood was upbeat and optimistic. The collaboration that was started by little old Australia (punching above its weight) has not only gathered significant momentum, but is already active; exchanging ideas, information and data on a scale never before experienced.  At the meeting itself, scientists openly presented and disclosed their results and encouraged discussion around methodology. Furthermore, the meeting spawned specific agreements to share therapeutics, disease models, tissue and other expertise. 

As Michelle Stewart, Head of Research at Cure Brain Cancer said afterwards:


"The results were greater than we had expected and most attendees have spoken about a number of potential collaborative projects generated during the meeting. 

- Michelle Stewart, Head of Research, Cure Brain Cancer Foundation


Whilst the Australians were blown away by the stellar line up of international presenters who have all contributed significantly to the brain cancer literature, the international guests were equally impressed with the original work that was presented by the Australian speakers. 

So what was discussed at the meeting? What are the big bets that these scientists are focusing on? Three main themes emerged (mirroring the pillars of the Cure Brain Cancer research strategy) namely precision medicine, immunotherapy, and new approaches to clinical trials.


Precision Medicine


Despite dismal survival statistics, there is a rich bank of data and knowledge about brain cancer and glioblastoma (the most common form of brain cancer) in particular.  Much of this arose from the fortunate position of glioblastoma being one of the first three cancers profiled by The Cancer Genome Atlas.  By understanding the genetic changes that are in cancer cells researchers can develop more effective treatment strategies that are tailored to the genetic profile of each patient’s cancer (this is what we refer to as precision or personalised medicine).

As discussed by many of the researchers present including Professor Terrance Johns from Monash Institute of Medical Research and Dr Kerrie McDonald from the Lowy Cancer Research Centre, genomic and epigenomic analysis has defined the molecular architecture, disease subtypes, and core biochemical and signaling pathways of glioblastoma cells.  The net result is dozens of ‘druggable‘ targets for therapy.

Despite the promise of personalised medicine, discovery of druggable targets, and trialling of various treatments, research has shown that gliblastoma multiforme (GBM) cells mutate and rapidly adapt even during the course of treatment. Furthermore, as few as 10 cells left behind after surgery have the potential to grow into a new tumour. As one attendee commented:

"Every cell has the ability to differentiate, divide and make a tumour; the cells are almost virus-like in their ability to change."

- Professor Inder Verma, Salk Institute





The propensity for GBM (glioblastoma) cells to mutate and adapt to treatment is “bad news for drug therapy but good news for immunotherapy,” said Professor Ian Frazer AC CEO and director of research at the new Translational Research Institute in Brisbane, who remarked that neuro-oncology has finally entered “the era of tumour immunotherapy.”  Immunotherapy is a treatment that involves stimulating the bodies’ own defences against cancer. 

As the researchers discussed the results of immunotherapy clinical trials and the numerous, but well characterised, genetic faults and pathway malfunctions present, it became clear that combination therapies will become key. “All these various glitches need different approaches to treat, because some cells will become resistant to treatments in different ways,” said Professor Vermer,


"We may have to use a Swiss-army knife to attack the monster, and to offer patients hope."

- Professor Inder Verma, Salk Institute 


Clinical Trials


Another inherent problem in the richness of the data is that brain cancer is relatively rare, and we simply don’t have enough patients in any one country to test all combinations of treatments in clinical trials. Too often drugs that appear promising in early-phase trials fail, and we don’t always know why. One suggested solution, which was a hot topic of discussion, is to rethink clinical trial design. There are moves towards new dosing schedules, including more patients (especially those who may be currently excluded), and stratifying or grouping patients receiving particular therapies. Adaptive clinical trials are not unique to brain cancer and are being adopted more and more globally, but they are particularly relevant to brain cancer where survival rates mean we need results faster (there was a robust discussion about driving an acceptance of tumour shrinkage as a key output metric for the FDA rather than survival) and where there are so many varieties of the tumour, requiring multiple therapy combinations to be tested.


Many minds, one purpose


This was less of a discussion, and more of a practical meeting.  Overwhelmingly the group agreed that brain cancer is unacceptable and they are not focused on incremental increases in survival.  Instead, bold goals of using different paradigms were discussed at the scientific and funding levels. It is perhaps a testament to the group’s joint determination to do things differently that Mark Zawacki, the director of the Silicon Valley disruptive innovations organisation, 650 Labs, addressed the meeting with a talk entitled “Challenging conventional assumptions”; this is definitely something the group is already doing.


"This is our moment. The world is uniting in an unprecedented way to leverage investment, research information, drug development and clinical trials. All to the benefit of the patients."

 - Professor Webster Cavenee, Ludwig Institute of Cancer Research



Watch our video 'Meet The Researchers' to find out more