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Neuro-Oncology (Brain and Spinal Cord Tumors) Program

The management of children with brain and spinal cord tumors is extremely complex. Pediatric brain cancers can be stubborn, and typically do not respond to traditional chemotherapy and radiation. in part because the brain is somewhat protected from medications (the blood-brain barrier), in part because surgery in the brain has to be quite refined to minimize injury to brain tissue, and in part because radiation treatment to the brain can cause injury to normal brain tissue.  To successfully manage and treat children with these tumors it takes a team of practitioners specifically focused on this area. The multidisciplinary Pediatric Neuro-Oncology program at the Johns Hopkins Kimmel Cancer Center in Baltimore is noted for the comprehensive care that is provided to all children diagnosed with a brain or spinal cord tumor and their families. Each year our practitioners treat between 80-100 children affected by these cancers tumors. A similar number of children's cases are reviewed as second opinions sent from around the world.

Subspecialists from a variety of disciplines at Johns Hopkins participate in a weekly tumor pediatric neuro-oncology conference, where each child’s case is presented and discussed in-depth, and an individually tailored treatment plan is worked out. These conferences include experts from the following areas:

  • Pediatric neuro-oncology
  • Pediatric neurosurgery
  • Pediatric radiation oncology
  • Pediatric neurology
  • Neuropathology
  • Neuroradiology
  • Neuro-ophthalmology
  • Neuropsychology
  • Social work

Neuro-Oncology Program Features

Experts with the program have access to rich resources, such as:

  • State-of-the-art neurosurgical technologies including 3D navigation systems and intraoperative MRI technology
  • Radiation therapy technologies that allow for the most precise delivery of radiation in an effort to spare normal brain tissue from the impact of radiation treatment. These include intensity-modulated radiation therapy (IMRT), which allows physicians to manipulate radiation beams to the shape of a tumor, and gamma knife, which focuses precise beams of radiation directly to a tumor.
  • Access to the most innovative clinical trials for children with newly diagnosed brain tumors as well as for those children requiring further treatment should the brain or spinal cord tumor return or progress
  • Access to other services as required including pediatric neurology, neuro-ophthalmology and endocrinology
  • Neuropsychological assessment to gauge the impact of the tumor and treatment on the ongoing development of the child
  • Ready access to social workers, child life specialists and others who make certain that all aspects of the child’s life are attended to during and after treatment

Hear Dr. Kenneth Cohen, director of the Pediatric Neuro-Oncology Program and clinical director of Pediatric Oncology, discuss childhood brain tumors:

Research

Cure will not come for many children with brain and spinal cord tumors without studying these tumors in the laboratory and using that gained knowledge to identify and test new treatments.  Some of our brain and spinal tumor experts also are laboratory scientists working on new discoveries to better treat children with brain and spinal tumors. Physicians with the program have access to researchers deep within the fields of neuroscience, neuropathology and tumor immunology, and work to bring new discoveries to patients as swiftly as possible.

Dr. Kenneth Cohen and colleagues are progressive in leading and participating in early-phase clinical trials offering patients access to the latest therapeutic advances. These trials include the newest molecularly targeted therapies, often being used for the first time in children with brain and spinal cord tumors.

Ongoing efforts include studying different mechanisms to deliver treatments to the brain, discovering new drug treatments for brain and spinal cord tumors, and learning how certain switches within the brain turn on tumor suppressor genes. These are genes that put the brakes on fast-growing cancer cells. 

One unique program run by Dr. Cohen is the Pilomyoxid Astrocytoma (PMA) Registry. Johns Hopkins experts were the first to identify this variant of a low-grade brain tumor in children. They now coordinate the registry to gather information regarding the natural history and response to treatment for children with PMAs.

Dr. Cohen is a member of the brain tumor steering committee and co-chair of the high-grade glioma committee for the Children’s Oncology Group (COG). 

Dr. Eric Raabe leads a laboratory team of graduate students, post-doctoral fellows and research assistants focused on finding new therapies for the most difficult to treat brain tumors. He is investigating metabolic changes downstream of key genetic changes in high-risk brain tumors. He has active research projects in poor-prognosis medulloblastoma, atypical teratoid/rhabdoid tumor, and aggressive glioma, including glioblastoma and recurrent pilocytic astrocytoma. He developed one of a handful of diffuse intrinsic pontine glioma (DIPG) cell lines, and is using this cell line in a collaborative effort through the COG to identify new therapies for DIPG, which is one of the most devastating childhood cancers. He hopes the research will lead to an understanding of what causes DIPG to form, and what allows DIPG to continue growing, in an effort to find medications that target the mutations. Read more.

Dr. Allison Martin is leading the effort to bring immunologic-based therapies to children with brain and spinal cord tumors through both laboratory and clinical research efforts. She is currently studying the role that immune checkpoints, the so-called “brakes” of the immune system, play in high-risk brain tumors including medulloblastoma, high grade glioma, and atypical teratoid/rhabdoid tumor. She is particularly interested in understanding how genetic mutations influence the interaction of these tumors with cells of the immune system. She hopes that this work will lead to novel therapies that utilize the body’s own immune system to fight brain and spinal cord tumors.

Make An Appointment

To make an appointment, please call our referral coordinator at 443-287-6997.

Physicians calling after hours or on weekends may call the Hopkins Access Line (HAL) 24 hours a day, at 410-955-9444 or 1-800-765-5447, and ask for the pediatric oncology attending physician.

Read more about appointments

Patient stories

 

Johns Hopkins Children's Center

Pediatric Oncology facilities are located in the Johns Hopkins Children's Center.

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