Massachusetts General Hospital

Establishment and operation of the Brian D. Silber Spine Tumor Clinic at MGH

Expansion of MGH’s Pediatric Neurosurgery service to include special expertise in the management of spinal cord tumors in children

Rapid expansion of specialized, image-guided photon therapy for spinal tumors

Purchase of an AGFA Imaging Center for viewing spinal images and a Digitimer Cortical Stimulator for monitoring during spinal surgery

Completion of a clinical study on the long-term outcome of spinal cord tumor patients treated by radiation, “Long-Term Outcomes of Patients With Spinal Cord Gliomas Treated by Modern Conformal Radiation Techniques”

Establishment of a named laboratory in memory of Brian D. Silber at MGH

Research on spinal cord tumor diagnosis and immunotherapy by Drs. William Curry, Ganesh Shankar, and Bryan Choi, Department of Neurosurgery, MGH (2018-present).  For research summaries, see the 2024 Research Updates below and see the June 2022 Research Update and April 2021 Research Update.

• 2024 Research Update on Tumor Diagnosis from Dr. Ganesh Shankar:
  • We have identified specific changes (mutations) in DNA as markers for certain types of brain and spinal cord tumors.
  • Over the past three years, we developed a method for identifying these mutations in cerebrospinal fluid, thereby eliminating the need for an invasive brain or spinal cord biopsy. This ultrarapid test has a turnaround time of 80 minutes.
  • This method has been implemented in the MGH Pathology Lab and is consistently ordered by clinicians at MGH and around the US!
  • The results of this test have helped facilitate the diagnosis and treatment of patients with brain and spinal cord tumors, in some cases without ever requiring surgery.

• 2024 Research Update on Immunotherapy from Dr. Bryan Choi:
  • We have identified multiple genes associated with tumor progression across a subset of cancers known as IDH-mutant tumors.
  • Understanding these genes may allow us to target brain and spinal cancers more optimally with immune therapy, a rapidly growing area of cancer therapy.
  • Our findings support the notion that intervention may be more effective at earlier stages, prior to transformation to higher-grade tumors.

Research on spinal cord astrocytoma genomics by Dr. Ganesh Shankar, Clinical Fellow in Neurosurgery, MGH (2014-2017)

January 2016 publication of research led by Dr. Ganesh Shankar, “BRAF Alteration Status and the Histone H3F3A Gene K27M Mutation Segregate Spinal Cord Astrocytoma Histology.”  These findings will hopefully lead to more precise diagnoses and effective, targeted treatments for spinal cord astrocytoma patients.

Research on spinal tumors in the laboratory of Dr. Scott Plotkin, Director, Neurofibromatosis Clinic, MGH (2009-2011).  “The best feeling in the world/Study improves hearing in NF2 patients.”

Research on astrocytomas in the laboratory of Dr. Arnab Chakravarti, Director, Molecular and Cellular Radiation Neuro-Oncology Laboratory, MGH (2002-2009).  Sample publications: “A STAT3 Gene Expression Signature in Gliomas is Associated with a Poor Prognosis” & “The Prognostic Significance of Phophatidylinositol 3-Kinase Pathway Activation in Human Gliomas”

Eighteen Brian D. Silber Lectureships have been held in the historic Ether Dome at MGH. Each year a clinician or researcher in the field of spinal tumors is invited to MGH to present his/her work and meet with MGH faculty. The Lectureship is a valuable way for faculty members at MGH to collaborate, learn, and share their work with other experts in the field of spinal tumors and cancer.

The Silber Lectures have featured Drs. Fred Epstein, Darell Bigner, Michael C. V. Jensen, Roy Patchell, J. Gregory Cairncross, Mark Bilsky, Antonino Raco, Paul McCormick, Kenneth Aldape, Peter Gerszten, Donald M. McDonald, Laurence Rhines, George Jallo, Viviane Tabar, Claudio Tatsui, Lawrence Borges, Chetan Bettegowda, and C. Rory Goodwin (see below).

The First Brian D. Silber Spine Oncology Symposium, a 2-day educational exchange featuring faculty lectures and laboratory work on advanced surgical techniques for spinal tumors, was held at MGH in April 2014.

Brian D. Silber Lectures:

1. Dr. Fred Epstein, Founding Director, Institute for Neurology and Neurosurgery, Beth Israel Medical Center, New York.  Topic: Intramedullary Spinal Cord Tumors, 2001
2. Dr. Darell Bigner, Edwin L. Jones, Jr. & Lucille Finch Jones Cancer Research Professor, Vice-Chairman for Investigative Pathology, Director pro tempore, Duke Comprehensive Cancer Center.  Topic: New Approaches to Treatment of Malignant Gliomas, 2003
3. Dr. Michael C.V. Jensen, Assistant Professor, Pediatrics, City of Hope National Medical Center and Division of Molecular Medicine, Beckman Research Institute.  Topic: Cellular Scalpels Derived From Genetically-Modified Cytolytic T-Cells for Excising Invasive Tumor Cells of Malignant Glioma, 2004
4. Dr. Roy Patchell, Professor of Neurology, Neurosurgery, and Internal Medicine, University of Kentucky College of Medicine.  Topic: New Developments in the Treatment of Metastatic Epidural Spinal Cord Compression, 2006
5. Dr. J. Gregory Cairncross, Professor and Head of Department of Clinical Neurosciences, University of Calgary.  Topic: Oligodendroglioma: at the Intersection of Science and Medicine, 2007
6. Dr. Mark Bilsky, Director, Multidisciplinary Spine Tumor Team, Memorial Sloan-Kettering Cancer Center.  Topic: Shifting Paradigms in the Management of Metastatic Spine Disease: The Integration of Radiation, Interventional Radiology and Surgery, 2008
7. Dr. Antonino Raco, Chief of Neurosurgery, S.M. Goretti Hospital, Rome.  Topic: Management of Intramedullary Tumors: An Update, 2009
8. Dr. Paul McCormick, Herbert & Linda Gallen Professor of Neurological Surgery, Medical Director, Spine Center, Columbia-Presbyterian Medical Center.  Topic: Anatomic Principles of Intradural Spinal Surgery, 2010
9. Dr. Kenneth Aldape, Professor, Department of Pathology, Neuropathologist, University of Texas MD Anderson Cancer Center. Topic: Molecular Diagnostics of Gliomas, 2011
10. Dr. Peter C. Gerszten, Professor of Neurological Surgery, Director Percutaneous Spine Service, University of Pittsburgh. Topic: Spine Radiosurgery: A Paradigm Shift in Spine Oncology, 2012
11. Dr. Donald M. McDonald, Professor of Anatomy, University of California, San Francisco. Topic: Controlling Escape from Angiogenesis Inhibitors, 2013
12. Dr. Laurence Rhines, Professor of Neurosurgery, University of Texas MD Anderson Cancer Center. Topic: Primary Spinal Tumors: Evaluation and Decision Making, 2014
13. Dr. George Jallo, Clinical Director, Pediatric Neurosurgery, Professor of Neurosurgery, The Johns Hopkins Hospital, Topic: Spinal Cord Tumors: From Operating Room to the Laboratory, 2015
14. Dr. Viviane Tabar, Vice Chair, Research and Education, Theresa Feng Chair in Neurosurgery, Memorial Sloan Kettering Cancer Center, Topic: Modeling Brain Tumors using Human ES Cell Progeny, 2016
15. Dr. Claudio Tatsui, Associate Professor, Dept. of Neurosurgery, University of Texas MD Anderson Cancer Center, Topic: Current Management of Spinal Metastasis, 2017
16. Dr. Lawrence Borges, Director, Neurosurgical Spine Center, Massachusetts General Hospital, Topic: Intradural Spinal Tumors – An MGH Perspective, 2018
17. Dr. Chetan Bettegowda, Professor of Neurosurgery, Johns Hopkins University School of Medicine, Topic: Clinical Implications of our Genomic Understanding of Brain and Spinal Cord Tumors, 2023
18. Dr. C. Rory Goodwin, Director for Spinal Oncology, Surgical Director for the Duke Center for Brain and Spine Metastasis, and Associate Professor at the Duke University Medical Center, Topic: Priming: The Landscape of Spinal Oncology, 2024