A Pathway to Predicting Brain Tumours

This neurosurgeon's trailblazing and award-winning work could reshape how brain tumours are detected, classified and treated.

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Neurosurgeon Gelareh Zadeh removes brain tumours in her clinical practice. Her research into their molecular and genomic signatures has the potential to overtake the current global standard of how we classify these cancers for better predictions on how they will behave.

This understanding could lead to more personalized care, in addition to earlier detection of cancer recurrence after treatment, which would be transformational for patient outcomes. For this work, Zadeh has been recognized with a 2023 Canada Gairdner Momentum Award.

Most of the tumours that Zadeh removes come from the skull base, and they are usually benign. But they could become malignant, and there are few treatment options available.

“The majority of my research focuses on the tumours that I remove in my clinical practice,” says Zadeh, professor of surgery at the University of Toronto and neurosurgeon-scientist at Toronto Western Hospital, University Health Network.

“So one of the areas that we really need to advance our understanding of brain tumours is to be able to predict their outcome, their response to treatment, and most importantly longevity and what prevents them from recurrence, and what drives recurrence for an individual patient.”

Meningiomas are the most common type of brain tumour, and Zadeh co-founded the International Consortium on Meningiomas (ICOM) to help researchers gather and share samples and data sets. That led to the largest ever analysis of these data, giving novel insights into how they should be classified.

“So where we’re at in our research is coming up with biomarkers, signatures, and predictive modeling,” adds Zadeh.

“We use genomic information to be able to more accurately diagnose and classify brain tumours, in particular meningiomas, and we’ve identified four new categories of meningiomas that to date have not been examined. And what’s most important is that these four categories provide us with therapeutic options.”

In particular, Zadeh is interested in finding non-invasive biomarkers that can be found in a patient’s blood, allowing healthcare providers to monitor for cancer without invasive procedures like biopsies. Being able to do routine blood testing on cancer survivors would make it easier to find relapses earlier.

She has already identified several such biomarkers that can not only provide a diagnosis, but also categorize cases by responsiveness to treatment options for a wide variety of brain tumours.

Zadeh also uncovered two separate molecular pathways that can transform a benign neuronal tumour into a malignant cancer. The discovery of these important pathways paves the way for future therapies.

“The impact of the Canada Gairdner Momentum Award for me, it shows me, but hopefully others who are interested in this career path, that this level of recognition is possible for the work that we do,” says Zadeh.

“The fact that I’ve been given this award means that the work we are doing does make an impact.”

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Dr. Gelareh Zadeh, MD, PhD, FRCS(C), FAANS, is the Dan Family Chair and Professor of Neurosurgery, University of Toronto. This role makes her the first Canadian Chair of Neurosurgery. She is Head of the Department of Neurosurgery at Toronto Western Hospital and Medical Director for the Krembil Brain Institute at University Health Network. Dr. Zadeh is a Senior Scientist at Princess Margaret Cancer Centre where she runs a translational research program at MacFeeters-Hamilton Neuro-oncology Program and holds the Wilkins Family Brain Tumor Research Chair.

Dr. Zadeh has a dedicated neuro-oncology and skull base practice, which includes a number of multidisciplinary specialized programs including a skull base clinic, brain metastases, pituitary clinic, and neurofibromatosis clinics. In parallel, she has an active research laboratory focusing on integrated multi-platform molecular analysis of brain tumors, together with a focus on understanding molecular response to targeted therapies, such as anti-angiogenesis and metabolic inhibitors.

She had held a number of leadership roles in organized neuro-oncology and neurosurgery societies, nationally and internationally. To highlight a few she has held numerous leadership roles in Society of Neuro-Oncology (SNO): Chair of the International Committee, Scientific Chair of the Annual Scientific Program, Treasurer, Vice President and President, with currently 2022/23 being the immediate Past President of Society. She has served as the Chair of Neuro-oncology Committee and presently the Chair of Women in Neurosurgery at the World Federation of Neurological Surgeons. She is the current Chair of Education Committee of the Tumor Section of AANs. Leveraging her experience in these positions she has found and leads the International Consortium on Meningiomas (ICOM).

She is the Editor-in-Chief of Neuro-Oncology Advances, open-access journal of SNO and European Association of Neuro-Oncology.

Dr. Zadeh is an excellent teacher and educator, having trained a number of neurosurgery residents, graduate students and fellows in a wide range of expertise in neurosurgery and research, majority who have successfully advanced to independent academic practice.

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