Mayo Clinic is translating cutting-edge molecular analysis of brain tumors into personalized treatment strategies, utilizing artificial intelligence and multiplatform molecular data to predict tumor behavior and optimize patient outcomes. This translational work encompasses both benign and malignant tumor types, guiding decisions on surgery, radiation therapy, and surveillance.
AI and Predictive Modeling
"AI modeling using genomic, methylation and other testing is transforming care for patients," said Gelareh Zadeh, M.D., Ph.D., chair of Neurosurgery at Mayo Clinic in Rochester, Minnesota. "We have established the clinical benefit and utility of this predictive modeling. What is needed now is widespread adoption of these approaches to personalize care and inform clinical trial design."
The integration of AI with molecular data allows for predictive modeling of tumor behavior, enabling clinicians to tailor treatment plans based on the specific characteristics of each patient's tumor. This approach aims to maximize patient outcomes and facilitate better-informed decisions regarding brain tumor care.
Meningioma Research
Dr. Zadeh's research includes a focus on meningiomas. A study published in Nature Medicine used multiplatform molecular, treatment, and outcome data to identify molecular predictors of treatment response in meningiomas. The study characterized the benefits of differential degrees of tumor resection and dural margin treatment across different molecular classifications and identified a group of molecularly defined radiotherapy-resistant meningiomas.
"Our research findings support the rationale for investigating radiotherapy results for meningiomas in the context of molecular classification," Dr. Zadeh stated. "We also need to consider clinical trials informed by molecular pathology to investigate treatments for radiotherapy-resistant meningiomas."
Glioma Subtype Discovery
Another study, published in Acta Neuropathologica, uncovered a novel group of IDH-mutant gliomas that share metabolic features with IDH-wild-type tumors. By integrating matched epigenome-wide methylome, transcriptome, and global metabolome data in patients with glioma, the researchers demonstrated the importance of characterizing each individual patient tumor.
"This metabolic heterogeneity among IDH-mutant gliomas has considerable implications for managing patients and for future clinical trials," Dr. Zadeh explained. "Genome-based classifications are commonly used in clinical practice. But it's important to remember that a tumor's genotype doesn't always reflect the phenotype and behavior. The metabolic profile can facilitate a more comprehensive understanding of glioma biology, when coupled with genomic data."
DNA Methylation Profiling
DNA methylation profiling is a crucial tool in understanding brain tumor biology. In a study published in Nature Medicine, Dr. Zadeh and colleagues described their use of methylation profiling to predict brain metastases from lung adenocarcinomas.
"We now have multiple clinically relevant classification and outcome prediction tools using methylation testing," Dr. Zadeh said. "Our focus is to reach more patients and be able to take our discoveries to all patients at the first step of their journey in managing their brain tumors and cancer care. The next step is to operationalize this technology — or a more accessible surrogate — into routine clinical workflows."
By understanding the specific genetic composition of a patient's tumor, clinicians can design the most effective treatment strategy and management care plan, prioritizing what is best for the patient.
