The Zimmerman lab is currently working on improving the way we treat pediatric cancer patients diagnosed with acute lymphoblastic leukemia (ALL). Glucocorticoids (steroids) are still one of the key parts of chemotherapy regimens that are often successful at curing ALL. Unfortunately, even when therapy is effective, steroids cause many terrible side effects and can lead to life-long problems for survivors. Dr. Zimmerman has been comparing two steroids dexamethasone (often given to children due to effectiveness, but much more toxic) and prednisone (given to adult patients), to see if there’s a way we can get prednisone to work similarly for children, without the extra toxicity.
Her lab is also investigating the role of a mitochondrial protein, VDAC2 (voltage dependent anion channel 2), in steroid induced ALL cell death. She has found that VDAC2 plays an important role in helping steroids kill ALL cells and is now working to define this mechanism.
Her team plans to knock out VDAC2 in multiple ALL cell lines to confirm that this makes cells more steroid resistant. They will also change the ability of the glucocorticoid receptor to interact with VDAC2 and test how this impacts both steroid sensitivity and the function of VDAC2. Once they have determined the key functions of VDAC2 that help steroids kill ALL cells, they can begin to design ways to target these functions to make steroid-resistant ALL cells respond to steroids better and to see if steroid-sensitive ALL cells can still be effectively treated with less toxic steroid doses, decreasing side effects. This could have huge implications for leukemia patients, and change the way we treat the disease.
Most recently, Monje and her team have been working to find ways to use CAR T-cell therapy to treat very deadly cancers of the brain or spinal cord occurring most commonly in children— including diffuse intrinsic pontine glioma (DIPG), which impacts the brainstem and has been (until recently) considered universally fatal.
A new study, using a CAR T-cell targeting GD2 has been more successful than anyone dared to imagine. The team is thrilled to be the first to demonstrate definite CAR T-cell efficacy against solid tumors and against DIPG. Not only have they found that this treatment is providing a great clinical benefit to its participants, but they have had one complete response and remains tumor free four years after diagnosis.
Monje says, “These results—which make me more hopeful about a cure than I have ever been—owe so much to philanthropy and the families and foundations that have put their faith in our research.”
“We are using stem cell models, cancer cell lines, and patient-derived models of Ewing sarcoma in the laboratory to identify targets for differentiation-based therapies. We are also working on targeting DNA replication stress in tumors using FDA-approved drugs and identifying novel approaches to activate tumor suppressors in sarcomas.
Not much progress has been made in the past two decades in the treatment of Ewing sarcoma (and other pediatric sarcomas, including osteosarcoma and rhabdomyosarcoma) so I am very interested in translating our work to the clinic. We used our stem cell model to identify that Ewing sarcoma tumors are uniquely sensitive to a particular combination of drugs-- inhibitors of ribonucleotide reductase (an enzyme involved in DNA synthesis) + drugs that inhibit the ATR/CHK1 pathway (involved in DNA damage repair). The combination of ribonucleotide reductase + ATR/CHK1 inhibitors is currently being tested in early phase clinical trials in adults and children, and we hope to be able test this drug combination in kids with relapsed or refractory Ewing sarcoma.”
-Dr. David Gordon
Dr. Kentsis' research focuses on complicated cancer biology - most specifically epigenetics and cellular plasticity- a phenomenon that relates both to the fundamental mechanisms of cancer pathogenesis and to the development of improved rational therapies.
There are several exciting projects happening in his lab, where most recent work has included a focus on rhabdoid tumors (a group of highly aggressive childhood cancers, which often occur in the brain and are known as atypical teratoid rhabdoid tumors- or ATRT), as well as promising new work that would change how a large group of children with aggressive Medulloblastoma are treated using genomic sequencing, RNA sequencing, and proteomic data.
In the traditional funding model, researchers cannot be nimble. If their research leads them to a new and important finding, they cannot redirect funds from other grants to pursue this promising information.
This is where Unravel comes in. Our goal at Unravel is to eliminate obstacles, bottlenecks, and barriers by providing unrestricted funding to help researchers translate ideas into new therapies. We do not ask researchers to take hours to write a grant. We select the best researchers knowing they are working tirelessly to find new, less toxic therapies for the children they are treating and their families.
We have created a Scientific Review Committee compiled of current pediatric research scientists, members of a pediatric research consortium, pharmaceutical industry scientists, and/or clinical trials coordinators. These individuals are in place to help us to identify pediatric cancer scientists with promising work that we can fund.
Alia Merla, PhD. Unravel’s Scientific Review Committee Chair
Emily Theisen, Ph.D., Center for Childhood Cancer, Columbus, OH
Dr. Thiesen is using a completely new approach for developing treatments for Ewing sarcoma based on the patients' DNA structure and how it interacts with other components in the cell.
Myron Evans, MD, Ph.D., Ben Towne Center for Childhood Cancer Research, Seattle, WA
Dr. Evans uses very cutting-edge tech to try and compare brain tumors to normally developing brain and find good drug targets. He's also working to improve the results from immunotherapy.
Kyle MacQuarrie, MD, Ph.D., Northwestern University/Feinberg School of Medicine, Chicago, IL
Dr. MacQuarrie is investigating the way that the organization of the cell nucleus relates to the biology of a pediatric soft tissue sarcoma.
Joanna Yi, MD, Ph.D., Baylor College of Medicine/Texas Children’s Hospital, Houston, TX
Dr. Yi investigates how genes are regulated in pediatric leukemia and identifies and characterizes new potential drugs with less toxicity than what is currently available.
Nick Vitanza, M.D., Seattle Childrens and Ben Towne Center for Childhood Cancer Research, Seattle, WA
Dr. Nick Vitanza is a pediatric neuro-oncologist who focuses on treating children with CNS tumors, including DIPG, DMG, and ATRT. He conducted groundbreaking research at NYU and Stanford, which led to clinical trials and recognition. At Seattle Children's, he leads their DIPG research and leads clinical trials for CNS CAR T cell therapies.
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