Dr. Ganesh Rao, The University of Texas MD Anderson Cancer Center

Preventing leptomeningeal disease after neurosurgery for metastatic carcinoma to the brain

Project Overview

The Brockman Foundation has supported research at The University of Texas MD Anderson Cancer Center (MDACC) to answer fundamental biological questions about metastatic brain cancer and its optimal treatment. Ganesh Rao, MD, the Principal Investigator on this project, is Professor of Neurosurgery at MDACC and a board-certified, practicing neurosurgeon with expertise in the management of patients with metastatic brain cancer.

Dr. Rao has published extensively on brain metastases, and his work includes a pivotal Phase 3 randomized trial establishing post-operative stereotactic radiosurgery as a standard of care in his field. He has authored over 100 manuscripts on a wide variety of topics in neurosurgical oncology. Debra Nana Yeboa, MD, Co-Principal Investigator on the research project, is an Assistant Professor of Radiation Oncology at MDACC, where she also holds a joint appointment as an Assistant Professor of Health Services Research. She also serves as the central nervous system (CNS) Radiation Oncology Section Director of Research and Radiation Oncology Division Clinical Research Council CNS liaison.

Brain cancer metastases are a common occurrence in patients with cancer affecting more than 300,000 people per year in the US alone. Several studies have demonstrated that the risk of developing leptomeningeal disease (LMD) after surgery may be as high as 28%. Surgical resection may see tumor cells spill into the Cerebral Spinal Fluid. There, and once disseminated, these cells may lead to LMD. Post-operative radiation may be insufficient to control the disease. Unfortunately, patients with LMD have very poor survival rates, often measured in just a few weeks.

Specifically, this clinical trial seeks to determine if using radiation prior to surgical removal of a brain metastasis decreases the incidence of LMD compared to the current standard of care. The current standard of care for resected brain metastases is to treat the surgical cavity after removal. The overall goal of this proposal is to identify which radiation strategy (pre- vs. post-operative radiation) has the more positive impact on overall survival and neurocognitive outcome in patients with metastatic brain cancers.

Project Highlights

  • Overview: Preventing leptomeningeal disease after neurosurgery for metastatic carcinoma to the brain