Dr. Morris Groves of Texas Oncology
Why are we here this morning?
Nihilists do not attend Head for the Cure Races.
VALUING AND HONORING A LIFE:
We are here because, in the abstract, we value human life. But our reason for being here is NOT abstract. We’re here because someone we value is threatened. And when you value someone, you work to keep, protect, and help that person. Thank you for putting that concept of value into action here today, and for being true to your own values.
I would be remiss if I did not mention that some of you are here in honor and memory of a person who lost their battle with a brain tumor. Thank you for mustering up the strength to be here to further support those who are now in this battle. Your steadfastness is an inspiration. You serve as another pillar of strength for patients and their families.
I paraphrase one of my favorite authors, Ray Kurzweil, ” … we are the only species that goes beyond our limitations – we didn’t stay in caves, we didn’t even stay on the planet, and we’re not going to stay within the limitations of our biology. People are fooling themselves when they say they have accepted the consequences of disease”.
We will fight these diseases, and we will not give up until WE have finished the job to OUR satisfaction. And we each have the sovereignty to say when “I am satisfied”.
THE PROBLEM, THE BIOLOGY:
Your body contains between 10-100 trillion cells. A typical brain tumor will contain 10-100 billion cells. Each tumor cell has about 25 thousand genes (sequences of DNA), and typically 3-10 genes are misbehaving in any given tumor.
But no two brain tumors are exactly alike, even though there are overlapping abnormalities between patients tumors. And within a specific patient’s tumor, the individual tumor cells can also be different, genetically.
All brain tumors are caused by a hijacking of the tumor DNA (the software that runs a cell) or of the control systems that support that DNA, i.e.: genetics and
epigenetics. These genetic and epigenetic changes allow tumor cells to grow, migrate, call blood vessels to themselves, and resist signals to stop growing. Tumors also play tricks on the immune system to avoid immune recognition and destruction.
Obviously we are dealing with a very complex problem. And that complexity is why we still do not have universally satisfactory outcomes for all patients. We are still in the process of reverse engineering (fully understanding) what makes a tumor a tumor, and forward engineering the fixes to the problem.
EVIDENCE OF PROGRESS
But things are slowly improving. In 1980, it was discovered that with radiation you could treat just the brain tumor plus a small margin around it, rather than the whole brain, and thus have less neurological damage.
Twenty-five years later, in 2005, the addition of chemotherapy to the radiation, improved outcomes for patients. This improvement was 150% at the 2-year time point from diagnosis, and roughly 800% at the 5-year time point!
And more recently in November 2014, data was presented that the addition of the Optune device, an electrical device sending an oscillating electrical field
through the tumor, appears to improve the 2-year outcomes gained in 2005 by about another 50%!
Now these are obviously important and welcomed advances, but sadly, the numbers of patients who make it to 5 years is still too low.
Now is our time get really creative and energized to move things forward even faster.
NEXT WAVE OF ADVANCES
The next advances will be based on a deeper understanding of the genetics and epigenetics of every patient’s tumor. Drugs will target the specific signature of
your tumor. We will uncloak the tumor from your immune system and then rev up and guide your immune system to completely destroy the tumor.
A recent excting example of such an approach is the new EGFR viii brain tumor vaccine. We have been testing the vaccine here in Austin (and I’ll note that some patients in the audience received this vaccine). Importantly, based on the early results, the vaccine just received FDA breakthrough therapy designation so as to help move it along the path to FDA approval so everyone whose tumor contains the appropriate genetic signature can receive it, if it is eventually shown to be of benefit. Someday, we will be able to correct the brain damage that was done by the tumor (another engineering endeavor).
SPEED/WHAT YOU CAN DO
Every day that we do not make advances, we lose someone we did not have to lose. In order for us to prove whether a new treatment helps we must have patients help in testing these new treatments. We have had many patients participate in experimental treatments (as an example, the vaccine noted above), and are grateful for their participation. But more are needed. We need as many people as possible participating, so that we do not wait years for a go/no go decision. With everyone on board we can get answers in weeks or months rather than years. All the advances I mentioned earlier were once experimental treatments. The next idea we test could be the one that shatters all prior records.
Lastly, the Austin Brain Tumor Center and Texas Oncology are fortunate to have a brilliant brain tumor researcher joining us from MDACC, in just a couple of
days, Dr. Charles Conrad. He has developed of a number of new and promising brain tumor treatments, one of which if the delta 24 oncolytic virus. He and I, along with our TxO team, will be working very hard on many exciting advanced treatments, to try to eliminate these tumors.
Please encourage everyone you know with a brain tumor to seek out the latest experimental options like the ones we offer and that HFTC supports. It is the only way we will conquer these diseases.
And isn’t that the most important thing we can do when it comes to the people we value who are suffering with these problems?
Have a great day!