AI for surgery and the promise of electromagnetic fields

4 min read

AI tool decodes brain cancer's genome during surgery Scientists have designed an AI tool that can rapidly determine the molecular identity of a glioma tumour during the time taken to complete surgery. Understanding information about the tumour’s molecular type during surgery, rather than weeks later, could enable neurosurgeons to make decisions on how aggressive they should be in removal of the tumour. Removing too much when the tumour is less aggressive can affect a patient's neurologic and cognitive function. Likewise, removing too little when the tumour is highly aggressive may leave behind malignant tissue that can grow and spread quickly. 

The tool, called CHARM (Cryosection Histopathology Assessment and Review Machine), is freely available to other researchers. It has to be clinically validated through testing in real-world settings and cleared by the FDA before deployment in hospitals. 

The Brain Tumour Research Centre of Excellence at Imperial College London is also developing a tool for use during surgery to support decision-making to improve outcomes of patients. The research is focused on real-time differentiation of tumour cells and healthy brain tissue to ensure maximal tumour resection whilst protecting healthy brain tissue. This is of particular importance in diffuse gliomas where the margins of the tumour are not clear. 

P53 status, and G2/M cell cycle arrest, are determining factors in cell-death induction mediated by ELF-EMF in glioblastoma.  Electromagnetic fields (EMFs) are a group of radiations that can be produced by electrical currents in human-made devices or natural sources. Studies have reported the anti-cancer effects of the extremely low-frequency EMFs (ELF-EMFs) (0–300 Hz) against various cancers. 

The main aim of this study was to investigate the anti-tumour effect and plausible cellular/molecular mechanism of action of ELF-EMF on two human glioblastoma cell lines U87 and U251 with distinct genetic patterns, specifically according to their P53 status 

The study, published in Scientific Reports, suggests that G2/M arrest (stages in cell division) and increase in the cell size can be the main mechanism of apoptosis induction by these fields. These three (P53 status, G2/M arrest, and increase in the cell size) are similar between the ELF-EMF and the more widely known, Tumour Treating Fields. 

Treatments 

IL4R-Targeting Toxin MDNA55 Yields Promising OS in Recurrent Glioblastoma MDNA55 is an interleukin 4 receptor (IL4R)-targeting toxin in development for recurrent glioblastoma (rGBM). IL4R is overexpressed in glioblastoma as well as cells of the tumour microenvironment - high expression of IL4R is associated with poor clinical outcomes.  

The results of the open-label, phase 2b study of MDNA55 published in Neuro-Oncology, showed that MDNA55 demonstrated tumour control and promising survival in rGBM patients, and researchers stated that it may benefit rGBM patients when treated at high-dose irrespective of IL4R expression level. 

Reviews

Pediatric meningiomas: A literature review and diagnostic update Researchers performed a literature review and synthesis of paediatric meningioma studies comparing them with their adult counterparts. The review revealed that paediatric meningiomas differ from adult clinically (location, sex ratio), and in terms of aetiology (germline mutations), histopathology (a greater incidence of clear cell subtype), molecular biology and epigenetics. The review published in Neuro-Oncology Advances, concluded that further studies are needed to better understand the tumorigenesis of paediatric meningiomas and to optimise their stratification in terms of outcome and therapeutic strategy. 

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