Dr. Venur specializes in treating patients with primary brain tumors and central nervous system metastases. Dr. Venur is currently employed at the Seattle Cancer Care Alliance and UW Medical Center’s Alvord Brain Tumor Center in Seattle, Washington. Dr. Venur’s research focuses on developing treatment options for CNS metastases and brain tumors, and emphasizes immunotherapy and expanding clinical trial options for CNS and Brain Metastases patient populations.
Primary parenchymal brain tumors are traditionally graded from WHO grade 1 to 4. Recent advances in the genomic characterizations of these malignancies have led to better classification and novel therapeutic targets. Point mutations in IDH gene is a focus of drug development in low grade gliomas. IDH inhibitors are being studied as single agents or in combination with other agents to delay the disease progression of low-grade glioma. Similarly, several novel targeted agents are being studied for the management of high-grade gliomas. Immunotherapy has been an area of intense research in several different malignancies, including high grade and low-grade gliomas. However, initial results with anti-PD1 antibodies have been disappointing in primary brain tumors, except for one study showing modest survival benefit with the use of anti-PD1 therapy prior to resection of recurrent glioblastoma. The PD-1/PD-L1 antibodies are now being studied in combination with other agents. Of late, there has been increased effort to enhance immune response against brain tumors with several vaccine-based approaches. Novel antigen/peptide-based vaccines and personalized vaccines are being developed in primary brain tumors. Another area of intense research has been surgically delivered oncolytic viruses. These viruses lead to cell death and recruit immune response to provide potentially durable responses. Despite these novel agents, drug development in primary brain tumors have been slow and largely disappointing. New clinical trial designs like adaptive Bayesian model based multi-arm trials and basket trials are being run to identify drugs with early signal for efficacy. We will discuss the important novel targeted agents, immunotherapy, vaccine and oncolytic virus-based approaches for gliomas