The mission of the Brain Tumor Trials Collaborative (BTTC) is to develop and perform state-of-the-art clinical trials to advance treatments for patients with brain and spine tumors.
Information for Patients
Learn about our multidisciplinary approach to patient care, our clinical trials and the highly specialized care teams who lead them.
Learn more about our training programs or submit an application.
The Neuro-Oncology Clinic at NIH is comprised of a multidisciplinary team of physicians, other health care 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 NIH are free-of-charge
The Neuro-Oncology 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 Neuro-Oncology Clinic is changing normal operating procedures due to the novel coronavirus (COVID-19). Posted March 20, 2020.
- If you are scheduled for an appointment within the next 30 days, you will receive a phone call from a patient care coordinator or health care provider to discuss your visit and what to expect.
- If you need to schedule an appointment, your health care provider should contact us first.
Your care and safety remain our top priority and we appreciate your understanding during this time of continuous change. You can contact us at NCINOBReferrals@mail.nih.gov or 240-760-6010 with your questions or concerns.
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 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.
|Position||Degree Required||Contact Name||Contact Email|
|Post-doctoral Fellow - Brain tumors, lipid metabolism, cancer biology||Ph.D. or equivalent, M.D. or equivalent||Mioara Larionemail@example.com|
|Post-doctoral Fellow - Translational research, primary brain tumor||Ph.D. or equivalent, M.D. or equivalent||Jing Wu MD., PhD.||firstname.lastname@example.org|
|Nurse Practitioner - Neuro-oncology, clinical trials, inpatient/outpatient care||B.S./B.A. or equivalent, Other||Lauri Rimorin||Lauri.Rimorin@nih.gov|
NCI-CONNECT (Comprehensive Oncology Network Evaluating Rare CNS Tumors) aims to advance the understanding of rare adult central nervous system cancers to improve approaches to care and treatment.
With support from the investigators in the Neuro-Oncology Branch (NOB), we have developed robust programs addressing critical areas of brain and spine cancer research. Our investigators translate laboratory findings into clinical trials which are designed to assess whether a treatment is working and what the impact is on the patient. Each of the laboratory programs have the same goal – to improve brain and spine cancer patient care and outcomes.
Clinical Research Program
Led by Mark Gilbert, M.D. and Terri Armstrong, Ph.D., this program encompasses a growing portfolio of therapeutic brain and spine cancer clinical trials as well as a series of complementary non-therapeutic studies. The infrastructure that has been developed for clinical research has enabled our investigators to launch studies including phase 0 studies using both microdialysis techniques as well as post-treatment tumor resection to determine tumor drug delivery, phase I studies with pharmacokinetics and pharmacodynamics, and single arm phase II studies. Larger scale clinical trials are being done in the Brain Tumor Trials Collaborative and the NCI-CONNECT Clinical Trials Network, both led by the NOB. Notably, patient outcomes measures are integrated into each clinical trial, complementing ongoing work in the Patient Outcomes Program.
Patient Outcomes Program
Led by Terri Armstrong, Ph.D., this program is focused on implementing outcomes measures that assess brain and spine cancer patients during the course of their disease. Utilizing the Natural History Study with longitudinal collection of clinical characteristics, Patient Reported Outcomes measures to learn cancer risk information, and biologic samples including germline DNA for single nucleotide polymorphisms are collected for evaluation. Dr. Armstrong is also developing preclinical models for treatment-related toxicities including radiation-induced somnolence which may have an association with polymorphisms of select CLOCK genes.
Translational Research Program
Led by Jing Wu, M.D., Ph.D., this program is focused on the development of brain and spine cancer clinical trials that have strong preclinical science and rationale, enabling the clinical trial to be hypothesis-based with strong correlative biology. Studies with the novel targeted agent, TG02, led to the creation of a successful phase I trial. This program is also investigating the malignant transformation and hypermutation that occurs in a subset of patients harboring IDH-mutated gliomas. This translational research complements the work by Dr. Mioara Larion and the Cancer Metabolism Research Program, translating preclinical models and imaging biomarkers to clinical trials.
Initially led by Mark Gilbert, M.D., this program has recently transitioned its leadership to Masaki Terabe, Ph.D., and is focused on various aspects of translational and basic immunology, such as examining the biology of NK-T cells, potent mediators of immune response, in brain and spine cancers. These topics include:
- Developing techniques to assess the immune phenotype of brain and spine tumors
- Patient immunocompetence and metrics of peripheral response to immune modulators
- Evaluating the impact of treatment agents such as chemotherapy and corticosteroids on immune reactivity
- Achieving a better understanding of the mediators of an effective immune response such as immune cell trafficking
- Chemokine production in the tumor microenvironment
The Cancer Stem Cell Biology Program
Led by Zhengping Zhuang, M.D., Ph.D., this program focuses on his longstanding interest and expertise in evaluating hypoxia and pseudohypoxia as well as the role of HIF2α abnormalities in brain and spine cancer biology. The ongoing research is focused on understanding the functional impact of the genetic changes that may uncover early disease states and potential therapeutic opportunities.
Molecular and Cell Biology Program
Led by Chunzhang Yang, Ph.D., this program is focused on the biologic impacts of cancer-associated IDH mutations to uncover selective vulnerability of brain and spine cancers. These investigations have demonstrated that DNA repair pathways are compromised due to the effects of the IDH mutation and that Nrf2-mediated metabolic pathways, such as glutathione de-novo synthesis, support IDH-mutated cells by relieving metabolic stress and oxidative damage. These studies may have a direct link to clinical research as Dr. Jing Wu is developing a robust therapeutic program for patients with IDH-mutant tumors.
Cancer Metabolism Program
Led by Mioara Larion, Ph.D., this program is studying IDH-mutant gliomas, given the impact that this mutation has on tumor metabolism. Her investigations are exploring the impact of IDH mutations on cellular requirements for carbon sources, lipid metabolism at the molecular, organelle, and cellular levels as well as preclinical development of hyperpolarized MRI using 13C substrates to measure in vitro metabolic flux. Her research compliments the cell biology-focused research by Dr. Chunzhang Yang and the translational and clinical research on IDH-mutant tumors being performed by Dr. Jing Wu.