Rimas V. Lukas1, Jin Ye Yeo2
1Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; 2CCO Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. CCO Editorial Office, AME Publishing Company. Email: editor@thecco.net
Expert introduction
Prof. Rimas V. Lukas (Figure 1) is the Associate Chief of the Neuro-Oncology Division at the Lou & Jean Malnati Brain Tumor Institute of Northwestern University. He is interested in the care of patients with primary brain tumors and spinal cord tumors as well as central nervous system (CNS) metastases. Specifically, he enjoys focusing his efforts on translating the discoveries of his basic science colleagues into clinical trials with the goal of improving patient outcomes. Additionally, he has a strong interest in medical education in the U.S. and internationally and conducts research in neuroscience medical education.
Figure 1 Prof. Rimas V. Lukas
Interview
CCO: What drove you into the field of neuro-oncology, and subsequently focus your research on glioblastoma and brain tumors?
Prof. Lukas: In neuro-oncology, there are clear unmet needs. My hope is that over the course of my career, I can play at least a small role in moving the field forward.
CCO: Could you provide a brief overview of the recent publications in the treatment for glioblastoma? Are there any findings that stood out to you?
Prof. Lukas: Most of these publications have been in collaboration with basic science or other clinical science colleagues and center on the confluence of the immune system’s interactions with the tumor. They range from preclinical studies to early-phase clinical studies, with Arrieta, et al. (1) as one example. In all of these, my role is that of a single member of a large multi-faceted team. The hope is that this work helps push the field forward and provide meaningful benefits to patients and a clearer understanding of the pathophysiology of disease and how we can best overcome it.
CCO: Your work also focuses on translating basic science discoveries into clinical trials for brain and spinal cord tumors. Could you share some of the most promising discoveries you have helped bring into clinical settings, and what impact they have had on patient outcomes?
Prof. Lukas: I am very lucky to work at the Lou & Jean Malnati Brain Tumor Institute where we have a culture of very close collaboration between our basic science colleagues and clinical researchers such as myself. All of our neuro-oncologists are clinical trialists with an interest in bringing the most promising basic science ideas into the clinic. There are a number of concepts which I would highlight as being of particular interest. One is the addition of well tolerated agents to standard temozolomide chemotherapy. These agents include acetazolamide, mycophenolate mofetil, and triapine. Another concept is the use of intracranial ultrasound for blood-brain barrier disruption to facilitate the ingress of therapeutic agents that otherwise may not reach adequate concentrations. The third concept centers on a variety of approaches to create an immunologically “hot” tumor microenvironment. This can involve the use of oncolytic viruses, gene therapy for pro-inflammatory cytokines, or direct manipulation of the cGAS-STING pathway.
CCO: You have been involved in numerous clinical trials. Can you discuss a recent or ongoing trial that excites you the most, and what potential it holds for changing the current standard of care for glioblastoma and other CNS malignancies?
Prof. Lukas: There is no single trial nor a single approach which stands out as superior to all others. The diversity of perspective and the diversity of approaches will hopefully facilitate a higher likelihood of success with respect to moving the field forward. This is analogous to the old adage of “don’t put all of your eggs in one basket”.
CCO: You also have a strong interest in medical education. What are some areas in neuroscience education that you believe need more attention?
Prof. Lukas: There may be value in earlier exposure to clinical neuroscience subspecialties. Many of these subspecialties conduct the bulk of their work in the outpatient clinic. Current medical training structures include a strong emphasis on inpatient care, which is important. However, the structure has the potential to impede early exposure to neuroscience subspecialties, including neuro-oncology, which have a predominantly an outpatient footprint.
CCO: What do you see as the next big breakthrough in the treatment of CNS tumors, and how is your current research paving the way for this development?
Prof. Lukas: The recent advances in targeted therapy for isocitrate dehydrogenase (IDH) mutant diffuse gliomas are actively changing the landscape of how we think about managing patients with these tumors. This has the potential for a meaningful impact on patients and their families. In addition, it will likely prove invigorating for the field, stimulating the asking of numerous important questions. These include which patient population(s) will benefit most from this approach, how does this mesh with well-established therapeutic approaches including multi-modality treatment with radiation and chemotherapy as well as clinical and radiographic surveillance without active treatment. Our group as well as many others are exploring IDH inhibition in combination with other novel therapeutics.
CCO: How has your experience been as an Editorial Board Member of CCO?
Prof. Lukas: My experience as an editor of a special issue focused on glioblastoma was very enjoyable. I had structured the issue into two equal components. The first focused on a range of key concepts in contemporary thinking on glioblastoma. The second provided country-specific thoughts on management. To my knowledge, this was the first such publication. Working with editorial team behind the scenes was an efficient process and one without any major hurdles.
CCO: As an Editorial Board Member, what are your expectations for CCO?
Prof. Lukas: I have been pleased to see a large number of special issues and articles from a variety of respected contributors to the field of neuro-oncology published by CCO. My hope is that this trend continues and that CCO remains a good venue for highlighting key areas of interest in the field.
Reference
- Arrieta VA, Gould A, Kim KS, et al. Ultrasound-mediated delivery of doxorubicin to the brain results in immune modulation and improved responses to PD-1 blockade in gliomas. Nat Commun 2024;15(1):4698.