The research team of Terence (Terry) C. Burns, M.D., Ph.D., is developing regenerative strategies to optimize neurological function and quality of life for patients with brain tumors, neurological injuries and neurodegenerative diseases. Diverse factors including aging, genetics and accumulated molecular stress increase risk of both neurological disease and certain brain tumors. Unfortunately, standard anti-proliferative treatments for brain tumors cause additional injury to the surrounding brain. Dr. Burns' work seeks to enhance defenses against the molecular changes occurring in tumors, aging and neurodegeneration to prolong both survival and quality of life. Although encouraging progress has been made in treating models of several neurological diseases, these have rarely predicted success in human clinical trials. Using cutting-edge genetic, molecular, bioinformatics and bioengineering strategies, Dr. Burns is leading efforts to understand and overcome the challenges of clinical translation for neuroregenerative therapies.
- Radiation-induced brain injury. Although radiation remains important in the treatment of brain tumors, it causes damage to normal brain cells as well as tumor cells, yielding problems with memory, concentration and attention in long-term survivors. Though radiation can now be precisely targeted to minimize surrounding brain injury, regenerative strategies are needed to preserve normal cognitive function for patients with diffuse brain tumors and restore cognitive function in prior brain radiation.
- Microglial biology. Microglia are the brain's immune cells that help defend against brain tumors, and mitigate injury and neurodegeneration. However, their function is impaired by the aged brain microenvironment. They are also inhibited by factors tumors secrete to escape detection. Strategies to optimize microglial function will almost certainly prove a critical component of comprehensive therapies to defeat brain tumors and restore normal brain function.
- Cell-based regenerative therapies. The profoundly complex wiring of the human brain currently impedes accurate replacement of injured adult neurons. However, certain progenitor cells appear to be promising avenues to reach infiltrative tumor cells, improve brain immune function, enhance neuronal plasticity and replace selectively vulnerable glia. Together, these and other actions of select implanted cells may improve survival and enhance cognitive outcomes in patients with brain tumors and other neurological diseases.
- Clinical translation. Available disease models of brain tumors, neurological disease and central nervous system injury mimic certain features of human disease but have typically failed to predict which therapies will be successful when tested in human clinical trials. New insights have revealed how and why mice can only tell part of the story. A multidisciplinary effort is harnessing previously unattainable insights from individual patients to guide comprehensive therapies targeting complex molecular realities of human disease.
Significance to patient care
Diligent efforts in the field have focused on prolonging survival for patients with brain tumors. Although much more work is still needed, survival rates for certain cancers and brain tumors has started to improve. With this increased survival, the progressive neurological and cognitive consequences of prior anti-tumor therapies are increasingly evident. Many of the mechanisms of radiation-induced brain damage mirror those of aging, neurodegeneration and traumatic injuries.
Dr. Burns and his colleagues believe it is not enough to just survive after treatment for brain tumors. As such, intensive efforts are underway to not only maximize survival but also optimize cognitive function and quality of life for patients with neuro-oncologic conditions and those previously treated for brain tumors. This work is synergistic with broader efforts to enhance defenses against neurodegenerative diseases and develop effective regenerative therapies for neurological injuries.
- Recipient, Newman Award, San Francisco Neurological Society, 2015
- Recipient, Resident Award, Basic Science, Western Neurosurgical Society, 2014
- Recipient, Best Oral Presentation Award, Stanford Neuroscience Forum, 2014
- Recipient, Edwin Boldrey Award for Neuroscience, San Francisco Neurological Society, 2014
- Runner-up, Academy Award, American Academy of Neurological Surgery, 2014
- Recipient, Basic Science Resident Award, Western Neurosurgical Society, 2011