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Postmortem brain donations vs premortem surgical resections for glioblastoma research: viewing the matter as a whole
Cassandra P Griffin1,2,3,4, Christine L Paul1,3,4,5,6, Kimberley L Alexander7,8,9
1School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
Abstract:
There have been limited improvements in diagnosis, treatment, and outcomes of primary brain cancers, including glioblastoma, over the past 10 years. This is largely attributable to persistent deficits in understanding brain tumor biology and pathogenesis due to a lack of high-quality biological research specimens. Traditional, premortem, surgical biopsy samples do not allow full characterization of the spatial and temporal heterogeneity of glioblastoma, nor capture end-stage disease to allow full evaluation of the evolutionary and mutational processes that lead to treatment resistance and recurrence. Furthermore, the necessity of ensuring sufficient viable tissue is available for histopathological diagnosis, while minimizing surgically induced functional deficit, leaves minimal tissue for research purposes and results in formalin fixation of most surgical specimens. Postmortem brain donation programs are rapidly gaining support due to their unique ability to address the limitations associated with surgical tissue sampling. Collecting, processing, and preserving tissue samples intended solely for research provides both a spatial and temporal view of tumor heterogeneity as well as the opportunity to fully characterize end-stage disease from histological and molecular standpoints. This review explores the limitations of traditional sample collection and the opportunities afforded by postmortem brain donations for future neurobiological cancer research.
Insights
Limited progress in brain cancer treatment stems from poor understanding of tumor biology, hindered by inadequate research samples. Postmortem brain donation offers a solution for comprehensive glioblastoma research.
Area of Science:
- Neuroscience
- Oncology
- Pathology
Background:
- Primary brain cancers like glioblastoma have seen minimal treatment and diagnostic advances in the last decade.
- Understanding glioblastoma biology and pathogenesis is hampered by a scarcity of high-quality research specimens.
- Surgical biopsy samples are insufficient for studying tumor heterogeneity and end-stage disease evolution.
Purpose of the Study:
- To review the limitations of traditional surgical tissue sampling for brain tumor research.
- To explore the opportunities presented by postmortem brain donation for advancing neurobiological cancer research.
- To highlight the potential of postmortem samples for characterizing tumor heterogeneity and treatment resistance.
Main Methods:
- Review of existing literature on brain tumor research methodologies.
- Analysis of the constraints imposed by surgical biopsy sample collection.
- Examination of the advantages of postmortem brain donation programs for research.
Main Results:
- Surgical biopsies provide limited tissue, often formalin-fixed, hindering comprehensive molecular and spatial analysis.
- Postmortem brain donation enables collection of research-dedicated samples, preserving tissue integrity.
- Postmortem samples allow for detailed study of tumor heterogeneity, end-stage disease, and treatment resistance mechanisms.
Conclusions:
- Postmortem brain donation is crucial for overcoming limitations in current brain tumor research.
- This approach facilitates a deeper understanding of glioblastoma evolution and recurrence.
- Enhanced research through postmortem samples promises to improve future diagnosis and treatment of brain cancers.
