Chief
Mark R. Gilbert, M.D.
Senior Branch Administrator
Lilian E. Yang, MBA

Center for Cancer Research
National Cancer Institute

Building 82, Room 225
Bethesda, MD 20892-8202
240-760-6030

The Brain Tumor Clinic at NIH


Welcome to the Neuro-Oncology Branch (NOB) Brain Tumor Clinic.

The Brain Tumor Clinic is comprised of a multidisciplinary team of physicians, other healthcare providers, and scientists who are dedicated to developing new therapies and improving outcomes for patients with primary brain and spinal cord tumors.

We offer our patients:

  • Expert evaluation, examinations, tests and imaging
  • State-of-the-art neurosurgery and radiation therapy
  • Therapies based on the genetic characteristics of your specific tumor
  • Consultations and treatments at the Clinic are free-of-charge

The Brain Tumor Clinic is located at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland.

This is a joint program of the Center for Cancer Research at the National Cancer Institute and the National Institute of Neurological Disorders and Stroke.


Our Mission

The Neuro-Oncology Branch (NOB) is a trans-institutional initiative that launched in 2000. NOB is sponsored by both the National Cancer Institute (NCI) and the National Institute of Neurological Disorders and Stroke (NINDS). Our mission is to develop novel diagnostic and therapeutic agents for patients with primary central nervous system (CNS) tumors. The branch's strategic direction is founded on the belief that the continued application of the traditional and largely empiric approach to cancer drug development that has dominated oncology for three decades will likely result in only small, incremental progress in the treatment of patients with malignant gliomas.

Meaningful advances in patient outcomes will more likely result from therapeutic approaches based on a greater understanding of glioma genetics and biology with the subsequent application of that understanding toward individualized and targeted treatments for patients based on their specific tumor characteristics. Additionally, clinical investigations will incorporate tools to measure the impact of the disease on patient function.  This will typically include measures of symptom burden, quality of life, and cognitive function.

Although we understand that the idea of "personalized medicine" will only be fully realized through the engagement of the entire cancer research and cancer care enterprise, the NOB functions under the premise that within the protected clinical environment and immense scientific freedom of the NIH intramural program, we are ideally situated to build a small prototype of a biology-driven, individualized, patient-centric rational therapeutics program.


Patient Care


patient and physicianThe diagnosis of a brain tumor often causes many emotions and anxiety for the patient and their family. Reactions can range from denial and shock to anger and confusion. This can seem overwhelming and many patients and families feel like they do not know where to start.

We focus on you.  Our physicians and staff understand what you are feeling and your needs. Our team  provides you with a comprehensive plan that, together with your physician at home, will ensure you get the best treatment possible.  Learn more about our...


Make an Appointment

The diagnosis of a brain tumor can be a frightening and overwhelming experience; many patients feel it is urgent to get started with their care. Our support team will coordinate all your appointments and travel. Appointments are usually available within a few days. We also believe strongly in collaborating with your primary care physican (with your permission) to form your "expert care team." Call us at:

  • 1-866-251-9686 or 240-760-6010 (Monday–Friday,  9:00 am–5:00 pm EST)

Before your first visit, we may ask you to provide:

  • NIH clinical centerMedical records
  • CDs with MRIs, CTs, PET scans
  • List of medications

What are the costs?

  • Consultations are free-of-charge. 
  • After a patient is accepted on a study, treatments, tests and other services at the NIH Clinical Center are also free.
  • NIH does not cover expenses for medical services at other facilities.

Where is the clinic located?

  • On the NIH campus in Bethesda, Maryland, approximately 8 miles north of Washington, D.C.
  • The Brain Tumor Clinic is on the 13th floor of the Magnuson Clinical Center (Building 10).
  • Visitor information is available at NIH Clinical Center - Access and Directions (View Map).

Learn more...


About the NIH Clinical Center

The NIH Clinical Center in Bethesda, Maryland, is America's reseach hospital. As a federally funded facility, all consultations and treatments at the Clinical Center are free-of-charge. Patients and their families can focus on treatment instead of cost.


Referrals


Candidates for consultation include patients:

  • with newly diagnosed or recurrent primary tumors of the CNS
  • with systemic cancers that have metastasized to the CNS
  • without a formal diagnosis but with radiographic findings that are concerning for a brain tumor

physician evaluating patientNew Referrals:  1-866-251-9686 (toll-free) or 240-760-6010 (local)

All Other Inquiries:  240-760-6030

Our nurse practitioners contact any prospective patients within 24 hours after your call to collect basic information and give further instructions. We require a medical summary, relevant radiographic scans (MRI, CT, PET), pathology report, and additional materials as indicated.

With the patient’s permission, we keep their primary physician fully informed and involved in their care. After consultation, the Neuro-Oncology Branch physician (or nurse practitioner) will contact the patient's primary physician  to coordinate care and follow-up plans.


Our Scientific Research


brain scanPrimary tumors of the central nervous system (CNS) are the second leading cause of cancer mortality in people under the age of 34 and the fourth leading cause of cancer mortality in individuals under the age of 54. With the dramatic improvement in the treatment of childhood leukemia, cancers of the brain and spinal cord are quickly becoming the leading cause of cancer deaths in children in the United States.

New Strategies for Tumor Targeting. Although there have been many advances in neurosurgery, radiation oncology, and imaging of the nervous system, the treatments for patients with malignant brain and spinal cord tumors rarely result in a cure. The Neuro-Oncology Branch (NOB) is a critical component of the Brain Tumor Program at NIH.  In order to make major advances against these cancers, a multifaceted approach is needed.  We are developing  an integrated clinical, translational, and basic research program that engages the strengths and resources of both the National Cancer Institute (NCI) and the National Institute of Neurological Disorders and Stroke (NINDS) to develop novel experimental therapeutics for children and adults with tumors of the brain and spinal cord. Toward this end, our translational efforts will focus on new strategies for selective tumor targeting through:

  • Targeting unique genetic aspects of tumor and survival pathways
  • Exploring tumor cell metabolism as a possible vulnerable target
  • Enhancing the patient's immune response to the tumor

Additionally, the branch has undertaken a large national study to create a molecular classification of gliomas so that physicians will be able to give a more accurate prognosis to patients as well as select more appropriate treatments that have a greater likelihood of being effective in any individual tumor.

Molecular Classification. It is known that human gliomas (brain tumors) are a heterogeneous group of tumors; however, there are no pathologic classification schemas that reproducibly allow us to separate out biologically similar tumors. We have initiated a large cDNA microarray effort in collaboration with the Human Genome Project and the Cancer Genome Anatomy Project (CGAP) to develop a comprehensive and novel molecular classification schema for human gliomas based on a gene expression profile using cDNA microarray technology. We have constructed our own cDNA microarray "chips" which will be enhanced for new and selective genes thought to be important in glioma biology. This project will include hundreds of tumor specimens and offer an unprecedented opportunity for gene discovery, dissecting signal transduction pathways, and learning this exciting new technology.

Neurotoxicity. We have a growing interest in better understanding the cellular, molecular, and genetic basis for drug- and radiation-induced neurotoxicity.  We will be examining the clinical and genetic factors that predispose certain people to treatment-related toxicities so that we can further optimize treatment.  This would combine the best treatment for the cancer that has the lowest risk for side effects in an individual patient.

Brain Tumor Clinic. We have built an administrative and clinical infrastructure to see and treat pediatric and adult patients with primary tumors of the CNS at the NIH Clinical Center.  Patients receive oustanding clinical care by highly experienced providers who are experts in treatment and patient management.  We have also developed close relationships with outside institutions and with the collaborative cancer groups, specifically the CNS Tumor Consortium, and we have opened up a referral base for patients with CNS neoplasms and their physicians to obtain information and advice about potential therapeutic options. Through this flow of patients, we will have ready access to the relatively large numbers of patients that will be necessary to complete early clinical trials of the novel therapeutic agents as these agents come out of our laboratory investigations.

Our plan is to conduct early pilot and feasibility trials within the NIH Clinical Center and then to export the most promising of these therapeutic approaches to larger groups to do large-scale clinical trials.  The NOB and other NIH laboratories will be involved with these clinical trials to perform important correlative studies to optimize treatment, determine which tumors are most likely to respond and to examine mechanisms of resistance to therapy.  It is through this process that we hope to develop a unique NCI-sponsored, nationally coordinated therapeutics development program for tumors of the brain and spinal cord.


Brain Tumor Trials Collaborative


In Pursuit of a Cure


The mission of the BTTC is to develop and perform state-of-the-art clinical trials in a collaborative and collegial environment, advancing treatments for patients with brain tumors, merging good scientific method with concern for patient well-being and outcome.

  • About

    The BTTC was created in 2003 as a network of medical centers with the expertise and the desire to participate in state-of-the-art clinical trials investigating new treatments for malignant brain tumors. This network of institutions allows patients across a broad geographic range to participate in cutting-edge clinical trials and more rapidly determine the benefits of various therapies.

  • BTTC Clinical Trials

    The current treatment of malignant gliomas, the most common brain tumor in adults, remains challenging and less effective than desired. The BTTC has several trials that are either open or in development. These trials hope to deliver results that provide a more effective treatment therapy in controlling the tumor and increasing survival.

  • BTTC Doctors and Institutions

    Each of the participating BTTC institutions are committed to discovering new and effective therapies for the treatment of patients with brain tumors with compassion and understanding. The doctors who are participating in the BTTC are experts in their respective fields.



Neuro-Oncology Clinical Fellowship


clinician explaining brain scansThis is a joint program with the Neuro-Oncology Program at the Johns Hopkins Hospital in Baltimore, MD.  The goal is to prepare neurologists, medical oncologists, radiation oncologists and neurosurgeons for research careers in neuro-oncology. Training includes:

  • formal coursework in pharmacology and clinical research methodology, 
  • academic biweekly conferences, and
  • patient management from a pool of more than 2,000 brain tumor patients who are seen each year in our Brain Tumor Clinic.

Trainees will participate in developing and implementing clinical trials for adult brain tumor therapeutics. Fellows also have the opportunity to attend national scientific meetings and are mentored in pursuit of their clinical, basic, and translational brain tumor research interests.  For more information or to submit an application, please visit http://www.cc.nih.gov/training/gme/programs/neuro_oncology.html or contact NCINeuroOncology@mail.nih.gov.


News


Rare Cancer Moonshot Project

December 6, 2017

Dr. Mark Gilbert shares information about the new moonshot project focusing on rare brain tumors: bringing together scientists and clinicians while closely following the patient experience. Learn more...


Adding Immune-Based Treatments to Standard Glioblastoma Therapy

October 11, 2017

This clinical trial is testing standard therapy (surgery, radiation and temozolomide) plus immunotherapy with pembrolizumab with or without a cancer treatment vaccine for patients with newly diagnosed glioblastoma. Learn more...


Clinical Trial Aims to Study Immunotherapy for Central Nervous System Tumors

August 23, 2017

A new clinical trial aims to determine whether nivolumab, an immune checkpoint inhibitor, can improve control of cancer for patients with several types of tumors of the central nervous system (CNS). The CNS is composed of the brain and spinal cord and the cause of most CNS tumors in adults is unknown. Learn more...


Glioblastoma – Unraveling the Threads

August 3, 2017

Progress against the brain cancer glioblastoma has been slow. Drs. Gilbert and Armstrong of NCI’s Neuro-Oncology Branch discuss why and what’s being done to change that. Learn more...


Clinical Trial Explores New Glioblastoma Treatment Regimen

May 22, 2017

On average, a patient with glioblastoma lives for only about a year after diagnosis. In a new clinical trial, CCR researchers will test whether a combination of a vaccine made from the patient’s tumor with another immunotherapy treatment can increase survival rates. Learn more...


PARP Inhibitors May be Effective in Brain, Other Cancers With IDH Mutations

April 24, 2017

Two separate studies have revealed new insights into the function of genetic mutations commonly found in a form of brain cancer as well as several other cancers and, in the process, identified a potential new treatment strategy. Learn more…


Brain Cancer’s Cholesterol Addiction May Offer New Strategy

December 26, 2016

Brain cancer cells are heavily dependent on a constant supply of cholesterol to survive, a new study suggests. And in mice with brain tumors, treatment with a cholesterol-depleting drug slowed tumor growth and improved survival. Learn more…


Study Tests the Safety and Efficacy of Combination Therapy in Adults with Astrocytoma and Glioblastoma

December 2, 2016

A two-part clinical trial of a multikinase inhibitor plus chemotherapy in patients with two types of brain tumors is enrolling. The study will be open to patients with anaplastic astrocytoma, an uncommon malignant brain tumor that develops from star-shaped brain cells called astrocytes and glioblastoma, the most common and aggressive form of astrocytoma. Learn more…


Breaching the Blood–Brain Barrier

August 10, 2016

Despite the development of gene sequencing and targeted cancer treatments se advances, the biological equivalent of a brick wall — the blood–brain barrier — has remained almost impenetrable. Dr. Sadhana Jackson shares how researchers are on a quest to breach the blood-brain barrier to treat brain cancer. Learn more…


Clinical Trial to Study Long-Term Progression of Brain and Spine Cancers

August 8, 2016

Dr. Mark Gilbert describes an ambitious new clinical trial that, for the first time, will study the long-term progression of brain and spine cancers. The 10,000 atient trial is the largest of its kind and will follow patients throughout the course of their disease. In addition to identifying optimal treatments for common brain and spine cancers, the study focuses on treatment discovery for rare, overlooked cancers. Learn more…


Trials Produce Practice-Changing Results for Brain Cancer

June 9, 2016

Results from two clinical trials show that treating patients with the chemotherapy drug temozolomide in addition to radiation therapy increased overall and progression-free survival. Learn more…


With Immunotherapy, Glimmers of Progress Against Glioblastoma

March 8, 2016

Researchers who specialize in brain cancer are optimistic about immunotherapy’s prospects for improving outcomes in patients with this aggressive form of brain cancer. Learn more…


Genome Study Links Misfolded DNA to Brain Tumors

January 12, 2016

Changes in the packaging of DNA in the cell nucleus may activate growth-promoting genes that cause cancer. Learn more…


Patient with Brain Tumor Responds Dramatically to Targeted Therapy

December 3, 2015

A patient with a papillary craniopharyngioma saw his tumor shrink more than 80 percent after treatment with a targeted drug that inhibits a mutant form of the BRAF protein. Learn more…


Genomic Underpinnings of Brain Tumors Expanded

June 10, 2015

TCGA researchers analyzed nearly 300 cases of diffuse low- and intermediate-grade gliomas, which together comprise lower-grade gliomas. LGGs occur mainly in adults and include astrocytomas, oligodendrogliomas and oligoastrocytomas. Learn more…


"Flipping the Switch": An Interview with Dr. Mark Gilbert, Chief of NIH’s Neuro-Oncology Branch

February 18, 2015

In November 2014, Mark Gilbert, M.D., became chief of the NIH Neuro-Oncology Branch. NCI's Dr. Mark Gilbert discusses new developments in neuro-oncology and the priorities of the Neuro-Oncology Branch. Learn more…


Neuro-Oncology Branch Welcomes Dr. Mark Gilbert as New Branch Chief

October 30, 2014

Dr. Gilbert's vision is to build a highly collaborative, robust translational research program centered on finding treatments for brain and other central nervous system tumors.  Learn more about Dr. Gilbert…


A New "America's Neuro-Oncologist" at the National Cancer Institute

October 28, 2014

"Having had the pleasure of working together with Dr. Gilbert on a number of projects in recent years, I can attest to his expertise, professionalism, and dedication to the brain tumor community, said David Arons, Chief Public Policy and Advocacy Officer, National Brain Tumor Society. "Dr. Gilbert is an excellent fit, and we look forward to working with him as he develops his programs and priorities for the Neuro-Oncology Branch moving forward."  Read more…