UOSD NEUROSURGERY

Research activity has been oriented either toward translational neuro-oncological projects as well as toward new, innovative, more effective surgical techniques.

The aim of our multi-specialist translational group was to identify new molecular glioma biomarkers useful for better determine the diagnosis, prognosis and/or therapeutic response. To accomplish this goal, we take advantage of an extensive database including retrospective as well prospective case series collected at IRE.

We currently participate to the “Glioma Project” which has been developed by the Neuro-Oncology Unit, to combine the results of Radiomics and molecular analysis of primitive brain tumors and we will contribute to the “CLINGLIO” randomized, double blind, placebo-controlled adjuvant trial in newly diagnosed primary glioblastoma, to assess the efficacy and safety of 2-hydroxyleic acid (2-OHOA) in combination with Radiotherapy and Temozolamide standard of care treatment.

A relevant issue is related to research and identification of circulating biomarkers for detection and prognosis of primary brain tumors. We are evaluating eleven circulating serum microRNAs, previously associated with brain tumors, as potential non-invasive diagnostic biomarkers for glioma patients.

The role of microRNA has been also investigated in brain metastases. In particular, it has been assessed whether aberrant expression of specific microRNAs could contribute to brain metastases. Comparison of primary lung tumors and their matched metastatic brain disseminations identified shared patterns of several microRNAs, including common down-regulation of miR-145-5p, which appeared to play a pivotal role in malignancy progression and in metastasis.

The Neurosurgical Unit has been actively involved in the METAMECH (Master Protocol Mechanobiology Translational Research in Breast Cancer) a multicenter study funded by AIRC, with the primary aim to build a resource of clinical annotated biological samples feeding the consortium laboratories and allowing a mechano-focused “precision research” in breast cancer.

The potential contributes of CSF cytometry analysis for early detection and characterization of tumor cells in the presence of leptomeningeal carcinomatosis and lymphomas, is also under investigation.

Fluorescence-guided resection with 5-ALA, can reliably increase the extent of surgery in primitive brain tumors. Our experience regarding more than 130 patients has been presented in several scientific meetings.

With regard to spinal tumors, vertebral pathological fractures represent one of the most challenging issues. The emerging role and integration of minimally invasive surgery with Radiosurgery, the so called “separation surgery” has been investigated by the Neurosurgical and Radiotherapy Units with the purpose to present a combined protocol of treatment. The results of our innovative mini-invasive approaches have been published in 2018 in Clinical Neurosurgery and 2019 in World Neurosurgery.