In a rare through-the-eyelid surgery, neurosurgeon Omar Arnaout, MD of Brigham and Women’s Hospital’s Department of Neurosurgery and collaborators from the Division of Plastic and Reconstructive Surgery recently removed a recurring meningioma from the roof of the orbit. The patient, age 76, bypassed the ICU and was discharged to home the next day, with only non-prescription pain medication.
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Could understanding a patient’s personal network of friends and family provide important clues to health and illness, and even guide care? Neurologist Amar Dhand, MD, DPhil, of Department of Neurology at Brigham and Women’s Hospital, is investigating the relationship of  personal networks and stroke, with some surprising findings.
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Image from E. A. Chiocca, et al, Regulatable interleukin-12 gene therapy in patients with recurrent high-grade glioma: Results of a phase 1 trial. Sci. Transl. Med. 11, eaaw5680 (2019). Reprinted with permission from AAAS.

In a recent clinical trial in patients with recurrent high-grade gliomas, investigators from Brigham and Women’s Hospital set out to test the safety and effectiveness of controlling the powerful immunotherapy human interleukin-12 (hIL-12) by using an oral activator to control when the gene gets turned on. While hIL-12 can stimulate many branches of the immune system, previous clinical trials that leveraged it were halted because of toxicity.
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When following a patient for brain tumor recurrence, standard assessments fall short:  Imaging and clinical exams each occur only a few times per year, and patient questionnaires capture only a moment in time and may be unreliable due to the challenge of accurate self-assessment amidst insidious decline.
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Using expanded, state-of-the-art capabilities in autonomic testing, Peter Novak, MD, PhD, chief of the Division of Autonomic Neurology at Brigham and Women’s Hospital, is driving better understanding of hard-to-diagnose patients with orthostatic intolerance.
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To address the challenge of glioblastoma (GBM) recurrence and treatment resistance, a research team from Brigham and Women’s Hospital has reported success using a novel method to co-opt the tumor cells’ molecular machinery. The result makes the tumor more vulnerable to treatment. By delivering molecules that modify gene expression in the tumor, investigators have shown a significant survival benefit in a mouse model of GBM.
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Meningiomas and pituitary tumors traditionally have been regarded as surgically treated disease. However, some patients with these tumors face recurrence, premature morbidity and mortality. This challenge has motivated researchers at Brigham and Women’s Hospital to zero in on molecular targets that shed light on prognosis and suggest novel pathways for biological treatments.
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Physician-investigators in the Department of Neurosurgery at Brigham and Women’s Hospital are leading clinical trials of cutting-edge approaches for treating glioblastoma. Clinical trials are currently underway for patients with recurrent, progressive glioblastoma as well as patients newly diagnosed with high-grade gliomas as investigators pursue new treatment options to stimulate a patient’s immune system to recognize and eliminate cancer in the brain.
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Vikram (Vik) Khurana, MD, PhD, chief of the Division of Movement Disorders in the Department of Neurology at Brigham and Women’s Hospital, with colleagues and collaborators around the world, is building a research engine poised to deliver therapies that precisely target specific disease mechanisms in individual patients with Parkinson’s disease and related disorders.
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What if you could know, from a pre-operative MRI, whether a glioma was likely to have a genetic mutation that significantly alters prognosis?

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