“Autopsy tissue is absolutely critical if we want to cure more children with pediatric brain tumors. The biology of the tumor changes over time, and quite obviously the tumor at the time of death is the tumor that evaded therapy. It’s this tumor we need to learn about in order to treat it so that in future we will not need autopsies.”
– Michael Taylor MD, PhD Hospital for Sick Children, Toronto
Brain cancer is complex
Brain cancer is not a single disease. It consists of a dozen types and countless subtypes. Researchers need a critical mass of tissue samples to fully understand the pathology of each type and to better predict how tumors will behave and respond to targeted treatments.
How do you treat a tumor that keeps changing?
We need more information. The more researchers understand and model the changing biology behind childhood brain tumors, the more doctors will be able to create effective treatment plans. To understand children’s brain cancer better, researchers need to study a child’s tumor at diagnosis, recurrence – and if necessary, after death. Only then will we understand why our treatments work for some children and not others.
Why brain cancer is so difficult to beat
Children are growing and changing, and so are their tumors. In addition, tumors can be different from one spot to another, and different after treatment than at diagnosis. So, when a child dies from cancer, it may not even be the same type of cancer the child had at diagnosis.
Watch this video to hear leaders in the field of childhood cancer clearly explain why the gift of your child’s tissue is important:
Having healthy brain tissue, diseased tissue from the original surgery and autopsy tissue gives researchers the complete picture of the metamorphosis of a child’s disease. For example, it was only recently discovered that in recurrent medulloblastoma the child dies from a tumor that is completely different than the original tumor he/she was diagnosed with. This discovery was only made possible because of autopsy tissue donations. This discovery has changed the standard of care for recurrent medulloblastoma patients.
Recent Publications from Centers of Excellence
Harmonization of Post-mortem Donations for Pediatric Brain Tumors and Molecular Characterization of Difuse Midline Gliomas
Children diagnosed with brain tumors have the lowest overall survival of all pediatric cancers. To address the paucity of tissue for biological studies, we have established a comprehensive protocol for the coordination and processing of donated specimens at postmortem. Since 2010, 60 postmortem pediatric brain tumor donations from 26 institutions were coordinated and collected. Patient derived xenograft models and cell cultures were successfully created (76% and 44% of attempts respectively), irrespective of postmortem processing time. Histological analysis of mid-sagittal whole brain sections revealed evidence of treatment response, immune cell infiltration and the migratory path of infiltrating H3K27M DMG cells into other midline structures and cerebral lobes. Sequencing of primary and disseminated tumors confirmed the presence of oncogenic driver mutations and their obligate partners. Our findings highlight the importance of postmortem tissue donations as an invaluable resource to accelerate research, potentially leading to improved outcomes for children with aggressive brain tumors. Read Full Publication
Dr. Monje-Deisseroth and her team at Stanford University recently published a paper detailing how gliomas are able to “hijack” the brain's communication system.
Published in Nature: High-grade gliomas are lethal brain cancers whose progression is robustly regulated by neuronal activity. Activity-regulated release of growth factors promotes glioma growth, but this alone is insufficient to explain the effect that neuronal activity exerts on glioma progression. Here we show that neuron and glioma interactions include electrochemical communication through bona fide AMPA receptor-dependent neuron–glioma synapses. Read More
Congratulations to two of our Center of Excellence teams lead by Dr Javad Nazarian and Dr. Michelle Monje on their recent groundbreaking research publication. Due in part to increased access to post-mortem tissuethe teams were able to study a larger sample of DIPG tumors. Diffuse intrinsic pontine glioma is a lethal pediatric brain cancer characterized by H3K27M histone mutation. Nagaraja et al. characterize a large cohort of rare primary tumors and normal pontine tissue to reveal active regulatory element heterogeneity dependent upon the histone variant and cell context in which the mutation occurs. Read More
Research Breakthroughs Resulting from Autopsy Tissue
Why Autopsy Tissue is Needed to Empower Research