University of Michigan Brain Tumor Precision Medicine Program
Dr. Koschmann developed and co-facilitates the UM Brain Tumor Precision Medicine conference. In this multi-disciplinary and multi-institutional conference, molecular results from pediatric brain tumor patients are incorporated into their treatment. This includes tumor/ germline sequencing results from the Pediatric Mi-ONCOSEQ trial (Drs. Mody and Chinnaiyan, PIs), molecular results from the the University of Michigan Pathology and Cytogenetics and in vitro culture treatment studies performed in the Koschmann lab.
As a result of this program - we have established the following on-going projects:
- The UM CNS Targeted Agent Prediction (CNS-TAP) program: CNS-TAP is an algorithm for predicting the CNS activity of targeted therapies in pediatric neuro-oncology which evaluates likelihood of blood brain barrier (BBB) penetration of targeted agents with patient-specific tumor sequencing data. This computer-based algorithm will be continuously adapted using decisions and discussions from our precision medicine conference and then applied in a prospective clinical trial using multiple personalized agents. This program is active.
- Phase 2 Trial for Children with Newly Diagnosed or Recurrent High-Grade Glioma with PDGFR or FGFR Alterations: Dr. Koschmann and other investigators at the University of Michigan are currently developing a clinical trial incorporating the use of novel combinations of targeted therapy for pediatric patients with newly diagnosed and refractory DIPG or high-grade glioma with PDGFR or FGFR pathway alterations. The Koschmann lab will perform and analyze the biologic correlative research associated with this trial. We expect this trial to be available in Summer or Fall 2017.
- Cerebrospinal Fluid Tumor DNA (CSF-tDNA) to Study Treatment Response in Pediatric DIPG and High-Grade Glioma: Repeat tumor biopsy conveys considerable risk of neurologic injury to children with DIPG and thalamic high-grade glioma. Without tissue, targeted treatment is empiric rather than targeted, and treatment response is assessed using imprecise clinical and radiographic means. We are establishing a program to use lumbar puncture for the diagnosis, molecular characterization and treatment surveillance of these tumors using cell-free tumor DNA (tDNA) in cerebral spinal fluid (CSF). We expect this trial to be available in Summer or Fall 2017.