Doctor of Philosophy, Case Western Reserve University, 2016, Pathology
Brain cancer is a devastating disease and a dreaded diagnosis for patients. Cancer within the brain, more than any other organ in the body, more than skin or colon or breast, is a difficult diagnosis to treat and live with because the brain is not just a part of the person, it is the person. Memories, personality, emotions, intelligence, speech and movement all originate in the brain. Therefore, when cancer, or the treatments used to fight the cancer, affect the brain by disrupting or damaging an area of the brain that controls these functions, it not only changes the body of the person, but changes the person. It is a particularly cruel disease. Glioblastoma is the most common and aggressive form of malignant brain cancer, which we currently have no way to effectively treat. The majority of patients die within 16 months of receiving a diagnosis, many times following aggressive surgery, radiation and chemotherapy, and then a sequelae of declining physical and cognitive function.
Effective therapies are urgently needed for these patients. Many studies have identified potential therapeutic targets through in vitro screens or genomic sequencing, but this has not led to effective clinical therapies. Here we present a novel method of identifying potential drug targets in glioblastoma using advanced RNA interference screening in an in vivo orthotopic microenvironment. Using this system, we discover that screening within a functional microenvironment reveals novel targets that have been missed by traditional in silico or in vitro screening. We also demonstrate that our targets identified in vivo are more clinically relevant than targets we were able to identify in vitro using the same system. We focused our screening on epigenetic modifier genes, as many of these enzymes are sensitive to microenvironmental conditions and are potentially druggable. Within epigenetic modifier genes, we revealed that factors involved in transcription pause-release and elongation ar (open full item for complete abstract)
Committee: Jeremy Rich MD, MHSc, MBA (Advisor); Paul Tesar PhD (Advisor); Alan Levine PhD (Committee Chair); Peter Scacheri PhD (Committee Member); Bruce Trapp PhD (Committee Member); Steven Rosenfeld MD, PhD (Committee Member); Mark Jackson PhD (Committee Co-Chair); Clive Hamlin PhD (Committee Member)
Subjects: Biology; Biomedical Research; Cellular Biology; Genetics; Medicine; Molecular Biology; Neurology; Pathology