By: Joslyn Cassano | Published: February 20, 2023
The Miami Clinical and Translational Science Institute (CTSI) has supported Miller School of Medicine brain and tumor neurosurgeon Michael Ivan, M.D., since early in his career, when a CTSI pilot award helped further his research in glioblastoma (GBM), an aggressive brain cancer that can be difficult to treat.
While looking at outcomes for glioblastoma patients, the associate professor of neurological surgery discovered that a subset of patients with Hispanic heritage were living significantly longer with GBM than other patients with the same diagnosis.
In 2017, Dr. Ivan and his team began a deeper investigation, utilizing his CTSI pilot award. “With a combination of our own data and working with the Florida Cancer database, we were able to show that there’s a subset of Hispanics with a gene mutation that we believe protects them from this cancer,” he said.
The previously undiscovered gene mutation appears to have a protective factor, not necessarily in preventing the cancer, but in increasing the survival time for glioblastoma patients of European Hispanic descent. “The CTSI award allowed us to start looking at this in a much more granular detail,” said Dr. Ivan.
“It’s an area of tremendous exploration and science and discovery that makes it exciting. Every week that goes by, you’re hopeful that some new progress that is being made is going to make a difference.” — Michael Ivan, M.D.
In 2020, the Director of Research at the Sylvester Comprehensive Cancer Center’s Brain Tumor Initiative and his team were awarded a Magic Leap grant for his work using augmented reality in the diagnosis and treatment of GBM.
By creating software that can render a three-dimensional image of a tumor during surgery, Dr. Ivan’s team has made it possible for neurosurgeons to do instantaneous pathology while operating.
GBM invades the brain with wispy, finger-like offshoots, providing neurosurgeons with the challenge of removing cancerous areas without damaging healthy brain tissue. A glioblastoma is not a homogenous entity; it is different ones combined. Each area of the tumor is different from the other areas within the same patient, says Dr. Ivan.
The new technology, which has received additional funding outside the Magic Leap grant and will soon go to clinical trial, gives a GBM patient’s medical team a fuller understanding of the tumor and a real-time image of parts that may have remained after surgery.
A pathology report that once took 45 minutes to produce, can be in the hands of the medical team in less than one minute. The increased speed allows the neurosurgeon to make decisions in the operating room on when to resect and when not to resect, allowing for a better, more thorough surgery and potentially resulting in a longer survival time.
In addition, data captured during surgery can be saved and shared with the post-op team to guide treatment. “There’s so much data available for the taking that could ultimately result in a more beneficial treatment plan,” said Dr. Ivan.
To build the technology, Dr. Ivan worked with Max Cacchione, Director of Innovation in the Information Technology Department at the University of Miami. “It’s extremely valuable to connect collaborators across the University, because a lot of researchers need help to bring their ideas to life,” said Mr. Cacchione.
Cacchione says this help almost always comes down to programming and software development. He and his team created UMIT Innovate to assist faculty in translating their ideas into actionable projects. Through an Innovate an apprenticeship, the University’s most talented and ambitious students are placed on projects like Dr. Ivan’s Magic Leap grant.
Part of what drives Dr. Ivan’s work is the desire to build on small victories that will make a big impact over time. Historically, studies on GBM that weren’t producing statistically big results were ignored, said Dr. Ivan. If a trial was successful for only five percent of enrolled patients, it was closed. In doing so, scientists and physicians lost opportunities to build on small wins.
“There have been over one thousand trials on GBM,” says Dr. Ivan. “If each one just helped one percent of the patients and we knew which one percent that was, we would’ve made a much bigger difference in the disease by now.”
In October 2022, Dr. Ivan received the Young Investigator Award at the Congress of Neurological Surgeons for his basic research investigating brain cancer cells through the project “Controlling Glioblastoma Invasion In Vivo with CD 97.”
“Dr. Ivan is a world-renowned surgeon and scientist who is pushing the field of brain tumors forward,” says his longtime colleague and associate professor of neurological surgery Ricardo Komotar, M.D. “It is an honor and pleasure to work alongside him.”
Dr. Ivan believes combining efforts is the key to progress for GBM research. “It’s an area of tremendous exploration and science and discovery that makes it exciting. Every week that goes by, you’re hopeful that some new progress that is being made is going to make a difference,” he says.
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