Making New Strides in Neuro-Oncology
Date: January 1, 2013
Chetan Bettegowda still remembers the day when he got the call that changed his life. Sitting with his mother, having lunch at home, he chatted briefly over the phone with the dean of students at Johns Hopkins School of Medicine, who told him that he had been accepted into the school’s M.D. program.
“It was one of the happiest moments of my life,” he says. “It was a dream-come-true to have the opportunity to study here. Even as a student, it always felt like a real privilege and honor to be part of the Hopkins legacy.”
Now an assistant professor of neurosurgery and oncology, Bettegowda is himself contributing to Hopkins’ legacy through a clinical program focusing on treating patients with brain tumors, as well as research to elucidate the genetics of brain cancers and biomarkers to track the progression of cancers in general.
Bettegowda discovered that neurosurgery and neuro-oncology were the perfect fits for his career while he was in medical school. “One of the most striking things as a student was being in clinic and seeing the profound relationships neurosurgeons have with these patients, even if it was just their first or second time meeting,” he remembers.
While a student, Bettegowda became fascinated with the complex anatomy that makes up the central nervous system. He also researched ways to take advantage of the low-oxygen environment inside tumors to attack them with bacteria that flourish under those conditions—research that’s now in ongoing phase 1 clinical trials.
After completing his program in 2005, Bettegowda stayed at Hopkins for his internship, residency and fellowship. Remaining where he’d started his training held definite advantages, he says, allowing him to continue working and learning from the same faculty who had supported him over the previous seven years. Those faculty include Bert Vogelstein, an international powerhouse in cancer research well known for his work on the tumor suppressor gene p53.
While working in Vogelstein’s lab, Bettegowda and colleagues Kenneth Kinzler and Nickolas Papadopoulos, among others, published groundbreaking work on the genetic basis of oligodendroglioma, the second most common form of brain cancer. The team discovered mutations in two genes previously unrecognized as being involved in this cancer, potential targets for future treatments. Their work was published last year in Science.
Recently, Bettegowda and his colleagues have been working on techniques to measure the cell-free DNA that most tumors shed into the bloodstream. The team has shown that this DNA can act as a way to track patients’ disease burden. At the time of diagnosis, levels of this cell-free DNA are typically high, but they usually decrease after treatment. If cancer recurs, levels of this DNA rise, acting as a warning beacon.
“We think this could be a useful tool to guide clinical decision making,” Bettegowda says.
By combining his research with a comprehensive program focusing on patients with gliomas, metastases, meningiomas and pituitary tumors, Bettegowda continues to strive toward his goal of potentially curing patients of these conditions. “It’s a very simple concept,” he says, “but every incremental improvement we make for our patients—from a new lab technique to a new way to eradicate their disease—is significant.
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