The 2023 Miles for Mary Research Seminar will be held on November 6, 2023. This Seminar benefits Brain Cancer Research at the Massachusetts General Hospital Cancer Center. Dr. Elizabeth Gerstner, neuro-oncologist at the Mass General Cancer Center will explain recent developments in treatment of brain tumors, especially glioblastoma.

Massachusetts General Hospital, as part of the Dana-Farber Harvard Cancer Center, has been selected as one of five sites nationally to participate in the Glioma Therapeutics Network (GTN) funded by the NIH to focus on new treatments for Glioblastoma.

Although it is unfortunately true that, to date, all large trials of immunotherapy treatments of glioblastoma have been negative, despite success for other cancers that have spread to the brain (for example, metastatic melanoma), researchers resolutely continue to search for better treatments. Multiple clinical trials are being conducted in hospitals around the world and a comprehensive listing of that work can be found at the National Brain Tumor Society website. During the research seminar, Dr. Gerstner will highlight some of the promising novel approaches being explored in clinical trials.

Dr. Elizabeth Gerstner is a clinical neuro-oncologist at the Mass General Cancer Center. She obtained her bachelor's degree in neuroscience from Brown University and pursued her medical degree at Columbia University College of Physicians and Surgeons, where she served as Chief Resident in Neurology while completing her residency training. Dr. Gerstner then attended Harvard Medical School to earn her Masters in Medical Science.

Dr. Gerstner's research is focused on using neuro-imaging to probe tumor biology as well as determining how to incorporate promising imaging techniques into clinic trials. She has extensive experience working with clinical trials of new possible treatments of brain cancer and serves as the Primary Investigator (PI) or co-PI of two multi-institutional trials (American College of Radiology Imaging Network (ACRIN) 6684 and an Adult Brain Tumor Consortium trial) that incorporate advance MRI imaging to answer clinically and biologically relevant questions. In addition, Dr. Gerstner collaborates with a strong group of imaging researchers at Harvard's Martinos Center for Biomedical Imaging with expertise in analyzing the complex datasets generated through this research. She participates in the Quantitative Imaging Network, an NIH funded group looking to improve the role of quantitative imaging for clinical decision making in oncology by the development and validation of data acquisition, analysis methods, and tools to tailor treatment to individual patients and to predict or monitor the response to drug or radiation therapy.

Dr. Gerstner's research accomplishments have been recognized by a number of prestigious awards, including the Clinical Research Scholar, awarded by Massachusetts General Hospital Cancer Center and the Claflin Distinguished Scholar Award. She has been featured in many notable medical journals highlighting her research in collaboration with colleagues at Mass General and various physician-scientists from other prominent medical institutions.

Past Seminars

• 2022: Seminar
• 2021: Seminar
• 2020: Seminar
• 2019: Intro I, Intro II, Seminar Part I, Seminar Part II, Q&A
• 2018: Intro, Seminar
• 2017: Intro, Seminar
• 2016: Intro, Seminar
• 2015: Intro, Presentation, Q&A
• November 2014: Seminar
• June 2014: Intro, Dr. Gerstner
• 2013: Intro, Dr. Gerstner

Bavituximab Trial

New preliminary data from a small trial by Dr. Gerstner suggests some promise of a novel immunotherapy drug called Bavituximab. Bavituximab is a novel drug that targets phosphatidylserine, an immunosuppressive molecule on tumor blood vessels and tumor cells. By targeting phosphatidylserine, bavituximab can activate immune cells and trigger them to target the tumor. Dr Gerstner conducted a small Phase II trial in patients with newly diagnosed glioblastoma adding bavituximab to standard treatment with radiation and temozolomide chemotherapy. The results suggested that bavituximab may increase the proportion of patients alive at 12 months compared to historical controls (i.e., how we expect patients to do with just standard of care treatment). In addition, she was able to show that bavituximab was having an impact on immune cells within the tumor microenvironment, and patients who lived longer had a decrease in blood flow to the tumor. The next step will be to see if she can conduct a larger, confirmatory trial with the potential to add an additional immunomodulatory agent to boost the benefit of bavituximab’s effects in glioblastoma.

Targeting GITR

Dr. Rakesh Jain, a collaborator of Dr. Gerstner, published exciting data in mice showing that targeting an immunosuppressive molecule, GITR (glucocorticoid-induced TNFR-related protein), can increase survival in mice implanted with glioblastoma tumor cells. GITR plays a role in regulating the activity of highly immunosuppressive regulatory T cells. By combining 1) a drug that targets GITR, 2) a drug that removes the break on the immune system, and 3) standard of care chemotherapy and radiation, he was able to improve survival in mice to 40% compared to 0% in mice who did not receive the combination therapy. Based on this promising data, Drs. Gerstner and Jain are exploring opportunities to conduct a clinical trial in humans to confirm the benefits of this promising approach.

Abemaciclib Trial

Based on work from Dr. Julie Miller, who presented in 2020 at the Miles for Mary Research Seminar, a clinical trial of a CDK4/6 inhibitor, Abemaciclib, in recurrent IDH (isocitrate dehydrogenase) mutant gliomas was conditionally approved to be run through an NIH funded national brain tumor clinical trials consortium.