Cracking Glioblastoma’s Deadly Code: Research Focused on Improving Diagnosis and Genomics to Revolutionize Care

Brain Cancer’s Biggest Adversary: Neuro-Oncology Experts in Florida Take on Glioblastoma

Even with growing awareness of the devastating effects of glioblastoma, the most common and aggressive form of brain cancer, treatment options remain limited and patients typically survive just 15-18 months beyond diagnosis.

Researchers at the Miami Cancer Institute and Miami Neuroscience Institute, part of Baptist Health South Florida, are focusing their efforts to advance understanding of the disease and improve diagnostic, prognostic, and therapeutic outcomes.

Two distinct projects are currently in the works, and they are expected to revolutionize glioblastoma care. Under the skilled direction of neurooncologist, Dr. Manmeet Singh Ahluwalia, Fernandez Family Foundation Endowed Chair in Cancer Research, Chief of Medical Oncology, and Chief Scientiyc Ofycer & Deputy Director, Baptist Health challenges itself to
achieve the extraordinary.

The first research endeavor is funded by a $250,000 collaborative, investigator-initiated grant from NICO Corporation. Using NICO’s innovative technology, neurosurgeons are able to gather tissue samples from various locations in a single brain tumor while in the operating room. The PRESERVE GBM study will use these samples from different sections of glioblastoma to
study the heterogeneity and generate a comprehensive molecular and genetic proyle of an individual’s glioblastoma.

Building upon previous research, Dr. Ahluwalia and his team will apply the latest advances in genomics and transcriptomics, including gene panel sequencing, RNA sequencing, long non-coding RNA, and DNA methylation, to analyze the differences that lead to treatment resistance and therapeutic failure. The study will also serve as the largest, multi-institutional imaging research study to date, with the purpose of enhancing histopathological capabilities to support medical decision-making using non-invasive techniques.

“We still need more data but obtaining multiple samples of the tumor from various regions during surgery will help us better
understand these differential changes to devise more efficient treatment of Glioblastoma.”

-Dr. Manmeet Singh Ahluwalia

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An international clinical trial is also underway, with Dr. Ahluwalia serving as the overall study principal investigator. “This is an incredibly exciting and important study that has the potential to alter how we follow tumors in patients with brain tumors,” says Dr. Ahluwalia. Due to the nature of the blood-brain barrier, circulating tumor DNA (ctDNA) is not freely able to leak into a patient’s bloodstream. This protective mechanism negatively affects the sensitivity of biopsy results in patients with glioblastoma.

In an effort to improve non-invasive brain cancer detection measures, this prospective, multi-center, pivotal study was the yrst successful attempt in the state of Florida to implement low-intensity focused ultrasound (LIFU), which temporarily disrupts the blood-brain barrier, while performing liquid biopsy to diagnose glioblastoma. LIFU is routinely used to measure ctDNA in other forms of cancer, but until now, it has not been efycacious in brain cancer care. Oncologists and neurosurgeons agree that LIFU liquid biopsy is a markedly different experience than participation in a surgical biopsy. 

This ongoing study includes a blood draw and brain MRI before and after the LIFU procedure. Participating patients still undergo traditional surgical tumor resection. Data is then compared to determine whether ctDNA found in the blood resembles that found in biopsied tumor cells.

“Ultimately, we hope LIFU liquid biopsies become an integral part of glioblastoma management. They may help measure
treatment success or give clues when a therapy is not working, without having to go through invasive surgical biopsies that are associated with significant risk. It will also be a much less stressful experience for the patient."

-Dr. Manmeet Singh Ahluwalia

To learn more about the above clinical trials at Miami Cancer Institute and Miami Neuroscience Institute, and to learn how to participate click here.