Retinoblastoma Center of Excellence    

  A Research Story    

Accepting the challenge of discovering new and better treatments for retinoblastoma, the multi-disciplinary Retinoblastoma Center is a collaborative effort . With a strong “bench to bedside” approach, it  incorporates experts from Children’s Memorial Hospital, Children’s Memorial Research Center and the Feinberg School of Medicine working together as a tightly knit team. The founding members of the group include Drs Nikia Laurie, Marilyn Mets, Paul Bryar, Joanna Weinstein and Bento Soares.  
 
The  research process begins when a patient with retinoblastoma comes to Children's Memorial Hospital (CMH) for a diagnosis. There they encounter Dr Marilyn Mets who examines the patient and makes the diagnosis based on an ophthalmological examination, and an MRI, B-scan ultrasonography or CT. Since currently there is no safe method for taking a biopsy of a retinal tumor, at our institution, the CMH standard of care is to have two ophthalmologists agree on the diagnosis. Dr Mets has two levels of concern for the patient: first to save the patient’s life and second to save as much of their vision as possible.   

Dr. Joanna Weinstein of the Hematology/Oncology division is called upon to discuss various treatment options with the patient. In advanced cases, enucleation is often the most appropriate option and in these cases the tissue samples are sent to Dr Bryar for classification. In less advanced cases, efforts to save the eye and vision are made. Current treatments include chemotherapy, laser or radiotherapy, but these have significant side effects that are either acute or latent. Clinical research has resulted in recently developed therapies, such as administering chemotherapy directly into an ophthalmic artery, and takes a collaborative effort between ophthalmology, interventional neuro-radiology and oncology.   

Dr Paul Bryar, one of only a handful of ophthalmic pathologists in the U.S., assesses the tumor specimen when available. Examining the tissue to identify the presence of certain high risk features, he communicates his findings to the clinical team so they can modify the treatment plan as needed. Acting as a bridge between the clinical and basic scientists, he provides tissue to the Cancer Biology and Epigenomics laboratory for extraction and analysis of RNA and DNA.  

Working at the “bench” at Children’s Memorial Research Center is Dr Nikia Laurie, who along with Dr Bento Soares, Director of the Cancer Biology and Epigenomics Program, conducts microRNA profiling of the tumor samples from Dr. Bryar, endeavoring to discover the reasons why some genes and microRNAs are overexpressed and others underexpressed. MicroRNA profiling of the tumors may shed light on why some tumors are more likely to spread or become more invasive. These profiles will help to clarify the mystery of the disease and develop additional therapies. Additionally, since the behavior of microRNAs affects a wide range of cancers, discoveries regarding their effects should be germane to other cancers, both adult and pediatric.