Alyne Ellis (Host): May is Brain Tumor Awareness Month, something Dr. Analiz Rodriguez deals with every day at the University of Arkansas for Medical Sciences. She's here to tell us more about the brain tumor bank at UAMS and what it can mean for future treatments. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I'm Alyne Ellis. Let's begin Dr. Rodriguez with what is a brain tumor bank?

Analiz Rodriguez, MD, PhD (Guest): A lot of people aren't familiar with it. And I think it's probably by the way it's named, but what I tell people it's real reason it's called a bank in my mind is potentially because similar to how a bank stores your money, this is a way to store specimens or tissue from surgery. And you can have various "banks" but the one that we developed here, in my laboratory is specifically for brain tumors and that's because I study brain tumors.

Host: Can you give me an example of what that means and how you use the bank?

Dr. Rodriguez: What that means, just a little bit of background. I am a neurosurgeon and a scientist, and so I get to really be on both sides of the coin. And what that means is typically when you do a brain surgery, some of the goals of surgery, obviously first and foremost are to make sure that you have a diagnosis. And what that means is that we send tissue to another doctor that looks at the tissue and tells us what type of tumor it is. Interestingly, sometimes tumors, you know, they're various sizes. After that, is completed basically you can have some leftover tissue, that otherwise may be discarded. And so what we have developed, is a system where tissue that might otherwise get discarded, gets taken to the research laboratory. And there, it can be stored for future use as well as we can actually grow cells or miniature tumors from the sample. And then we're able to use that information for discoveries.

Host: So, what made you all decide to start one at UAMS and also how common is it for a hospital to have one?

Dr. Rodriguez: So I think, it's relatively common at large centers, that do translational research, which means that you're doing research where you're actually using the information from the person's body to inform the type of research you do. I came to UAMS in 2017. I have specialized training in brain tumors in regards to clinically, I did an extra year of training for brain tumors, but also I have a PhD. So, I also do research and I have another degree for research. And so when I came, one of the reasons I came to Arkansas was to help develop a brain tumor research program. And my boss is, Dr. J. D. Day. One of the things that we talked about was the need for a quote unquote "brain tumor bank." And this is something that Dr. Day has envisioned. And then, when I came, it was pretty much, one of my first tasks to help build this repository of tumor specimens so that we can research what happens for some of the most aggressive tumors in the body. And also in the future, start thinking about developing new therapies.

Host: So walk us through how you populate the bank.

Dr. Rodriguez: Sure. So it actually requires a lot of people, like anything else. So, typically what happens is someone comes in for various reasons, they find out that they have a brain tumor and most brain tumors you can have surgery for and so once we talk to the person about doing surgery, we ask if they are interested in donating tissue for research.

I was a little bit surprised about how many people are very much open to this. And so, we just happen to have really amazing patients who are very altruistic and are very much happy to help others. And if it doesn't necessarily help them, it may help other people. So, then once they say that they're interested, we actually have a specialized research nurse who comes and talks to them about donating in more detail. And they have to give us permission. And then on the day of surgery, we work with the pathology doctor to verify that we gave them enough tissue to make a diagnosis and they have everything they need. And then, the surgeon, which is, sometimes, it's me, sometimes it's another surgeon. We typically save some tissue for the research lab and someone actually come and gets it from the operating room. Our nurses have trained in a way to keep it all sterile and then someone comes and picks it up and then it gets taken to the research lab. And then in the research lab, it gets stored and then we do a lot of different tests in order to grow the tumors outside of the body.

Host: So, I understand you just published a paper about brain tumor biobanking protocol at UAMS and can you tell us more about that?

Dr. Rodriguez: What's kind of interesting and I wrote this paper from the perspective of a surgeon; basically the reason that this type of research is needed is because we routinely do two different things. We ask all of our brain tumor patients, are you interested in donating for research? We also ask them about getting genetic sequencing for their brain tumor. And I tell my patients, your tumor is like a fingerprint. Yes, you have a certain type of tumor, but just like your fingerprint, your tumor likely has unique features. And the reason this is important is because we're transitioning to a one size fit all type of treatment to really saying, hey, let's understand not only that genetic fingerprint of your tumor, how it grows in the lab, let's figure out what drugs might work specifically for you. Let's grow your tumor in the lab and test drugs and see, hey is it effective and so in order to do that, that's why this brain tumor bank is essential for that type of research.

And so in this paper, we talk about that process and the team that is required to do this level of research. But the other thing is we talk about our experience in Arkansas, because we are currently the only place that has a brain tumor bank. And in our first year, which was 2019, we enrolled over a hundred patients. So, that means over a hundred people donated. And that to me is amazing. And then furthermore, they came from all different parts of Arkansas, which as a rural state, I think that's really important because there are healthcare disparities for people depending on where they may live. And we're capturing people from all over the state, in order to really understand if for example, does your environment affect certain things? And all of this will in the future, just continue to build and help more and more people.

Host: And just out of curiosity, have you been able to help anybody so far who's still alive from dealing with this brain tumor.

Dr. Rodriguez: Yes, we have. So, what is interesting, a lot of people ask me about what motivates me. And I talked a little bit about how we have both the brain tumor bank and we do the genetic sequencing. We use that information together. And I have a family member that I had a call, the person that passed away had a very unique tumor and we published about their case and their family member remember distinctly asked me, how come this didn't help them when they were alive. And like, I'm happy it's going to help other people, but how could it have helped them? And so I remember those words, so that's really has motivated me to think about well, how can it help you now, not just in the future. So, along those lines, we recently, we have another publication that is under review right now, where we were able to, using the genetic fingerprint of a person's tumor, we were able to predict what therapy might work for them. And then once we identified a drug that might work for them, we were able to grow their tumor cells in the lab and test that drug.

And then we compared that other patients and we were able to find that, yes, our algorithm of how your genetics might predict which drugs respond, seems to work, because we were able to say, this person responded, the other person does not, and then grow cells from different patients and show that that actually happened in the dish, meaning outside of the body. And then thankfully, just recently we were able to get approval to use that drug in the patient, God willing that actually works for their tumor.

Host: Well, that's just really so helpful. Thank you so much. Is there anything else you'd like to add?

Dr. Rodriguez: I just wanted to add that, May is Brain Tumor Awareness Month, and we just hope to continue doing research that will benefit Arkansans and I also just wanted this thank the most important people in all of this. Yes, it's a big team of people at UAMS, but the most important people are the patients. And I'm so grateful that they say most of the time, almost all people say yes, and they do it just out of hope that they can help someone else. And I always think that is such a gift that even though it may not help them, they're willing to donate to help others.

Host: Well, thank you so much Doctor for your time and your insight today.

Dr. Rodriguez: Thank you.

Host: Dr. Analiz Rodriguez is a Neurosurgeon and Scientist and the Director of Neurosurgical Oncology at the University of Arkansas for Medical Sciences. For more information, visit uamshealth.com. If you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics that may interest you. This is UAMS Health Talk from the University of Arkansas for Medical Sciences. I'm Alyne Ellis. Thanks for listening.