Michael Punsoni, MD
Awards
Advance RI-CTR Pilot Projects Program (Cycle 9)
"Evaluating ApoE4 genotype status as a risk factor for radiation toxicity in older patients with glioblastoma"
Contact-PI: Sasmit Sarangi, MD
Gliomas continue to represent a significant healthcare burden and contribute disproportionately to cancer mortality, particularly in older adults. Patient-centric outcomes research in gliomas has the potential to be leveraged for developing new areas of clinical and translational research in RI. This will help in creating new collaborative efforts geared towards development of new therapeutic strategies for these patients and the design of clinical trials specifically for older adults to improve tolerability of current treatment.
Primary brain tumors, specifically glioblastomas, continue to represent a challenging disease where progress in therapy has been incremental and there is an unmet need for improving therapeutic regimen for older adults who are susceptible to side effects from current standard first-line therapeutic regimens. This study seeks to develop a clinico-pathologic outcomes database to assess correlations between patient-specific and tumor-specific factors contributing to acute treatment toxicity within the first 12 weeks of therapy and overall outcomes. A major area of focus will be assessing toxicity of therapy in patients with risk factors for neurogenerative conditions (ApoE4 genotype), as well as patients with subclinical neurodegenerative conditions (as identified on pathological samples and on blood-based biomarker assays for neuronal damage).
- Specific Aim 1: Create an individual patient level clinical outcomes database (retrospective and prospective) for patients >65y with glioblastoma.
- Specific Aim 2: Perform outcome correlations focused on the detection of known tumor genetic alterations which affects outcome (such as PTEN alterations and EGFR amplification) and presence of amyloid/tau deposits, via immunostaining/microarray of pathological samples in the brain tumor biobank. Incorporate matched blood sample-based cognitive biomarker analysis, including ApoE genotyping, for outcome correlations.
For specific Aim1, the goal will be to create a redcap-based database for collection of patient-level demographic, clinical and pathological criteria with a patient level chart review. Patients will be identified through review of the electronic healthcare system at Rhode Island Hospital.
For Specific Aim 2, existing clinically obtained tissue samples will be used for neurodegenerative pathological changes, as well as blood based ApoE genotyping and biomarker assessment for identification of subclinical neurodegenerative changes. The goal will be to assess how these patient and tumor-factors alter tolerability of therapy and uncover novel associations.