Dr. Jonathan Finlay – Translational Research Grant
Nationwide Children’s Hospital
Brain cancer not only is the second most common type of cancer in childhood and adolescence but now represents the major cause of both cancer-related deaths and deaths from any disease, in children between 1 and 19 years of age.
Medulloblastoma is the most common malignant type of brain cancer, and it occurs predominantly in young children (under 6-10 years of age). While traditional approaches of surgery, radiation therapy and standard dose chemotherapy have improved the cure rates of older children with medulloblastoma, the “price” of cure with such approaches has proven too high in younger children, due to the profoundly damaging effects of radiation therapy on the developing brain of the young child.
Jonathan Finlay, MD, an internationally recognized authority in the management of childhood brain tumors, joined Nationwide Children’s Hospital and The Ohio State University in 2014 as director of the Neuro-Oncology Program. Prior to coming to Nationwide Children’s, Dr. Finlay was the director of the Brain Tumor Program at Children’s Hospital Los Angeles and served as professor of Pediatrics, Neurology & Neurological Surgery at the Keck School of Medicine, University of Southern California. Between 1982 and 2003, he held faculty positions in Pediatric Oncology at Stanford University (1980-1982), University of Wisconsin-Madison (1982-1987), University of Pennsylvania and the Children’s Hospital of Philadelphia (1987-1989), Cornell University/Memorial Sloan-Kettering Cancer Center (1989-1993) and New York University (1997-2003).
Dr. Finlay initially pioneered a chemotherapy-only strategy to avoid radiation therapy for young children with medulloblastoma and other malignant brain tumors of young children back in 2001. He has continued to lead this effort for over 25 years, through the development, conduct and completion of three sequential multi-national prospective clinical trials known as the Head Start protocols. Indeed, the Pediatric Cancer Research Foundation funded support of the third Head Start protocol over a decade ago. The recently opened Head Start 4 protocol is a randomized clinical trial hosted at and coordinated by Nationwide Children’s, along with Children’s Hospital Los Angeles, with over 40 treatment centers set to participate from around the world. It is investigating a tailored radiotherapy-minimizing approach to the treatment of newly diagnosed medulloblastoma and other malignant embryonal tumors of the brain of young children, through the use of clinical and molecular risk classifications of intensive chemotherapy. Head Start 4 will also be the first research endeavor to operate within the Nationwide Children’s NEXT Consortium, a collaborative research model for investigator-initiated studies that contribute to the early development of promising new therapies for childhood cancer and blood diseases.
The current grant support by the Pediatric Cancer Research Foundation enables the NEXT Consortium to prospectively study the potential of monitoring the response of these diseases to treatment, by evaluating cerebrospinal fluid samples (liquid biopsies) for microscopic markers of tumor cells known as microRNA molecules, which are specific for particular types of malignant childhood brain tumors. Dr. Finlay hypothesizes that monitoring these markers may allow the determination of who can safely avoid radiation therapy following the initial drug therapy and who yet will require either radiation therapy or more innovative approaches to improve outcome.