Jörg Dietrich, MD, PhD, has a passionate interest in the physiological processes that underlie the natural world — whether it is based on plant physiology or stem cell biology. The AAN Clinical Research Fellow hopes to translate these basic concepts into better treatments and improved management of patients with brain cancer.
His AAN-award winning proposal aims to identify biomarkers in patients with malignant gliomas to select patients for specific therapies, and to predict and monitor treatment response.
After attending medical school at the University of Giessen in Germany, Dr. Dietrich received his PhD and completed his neurology residency at the University of Regensburg in Germany in 2000. He then came to the US for a postdoctoral training in cancer and stem cell biology with Professor Mark Noble in Rochester, NY, and subsequently in 2005 for a neurology residency at Partners Neurology in Boston. He completed a neuro-oncology fellowship at MGH/Dana-Farber Cancer Center in 2009, and he is currently an assistant professor in neurology at Harvard Medical School and a research fellow at the Center for Regenerative Medicine at MGH.
Dr. Dietrich spoke with Neurology Today about his research and why his work as a physician-scientist frames his outlook on the world around him.
WHAT WAS YOUR RESEARCH QUESTION?
The main research question for this proposal is: How can we identify novel biomarkers in patients who are treated for malignant brain tumors? We have preliminary data that a brain cancer patient's blood and bone marrow may show a distinct signature in response to a growing tumor and to a specific treatment. We are trying to identify which cellular markers or circulating blood cells will give us this new and novel information about how a patient responds to treatment. Novel biomarkers would also help us to identify the window when the treatment starts to fail. Imaging is currently the only way of monitoring treatment response and patients typically undergo repeat brain imaging every eight weeks. But it's an expensive way of monitoring a patient and treatment response.
WHAT MAKES YOUR RESEARCH UNIQUE?
The second part of our study is not only to identify these markers and validate them, but also to learn more about how the human body reacts systemically to a growing tumor. We want to find out what host or patient defense mechanisms are triggered by cancer.
Most cancer studies done in recent decades purely focused on the cancer itself, what the cancer cells do and how they behave in culture; however, very little is known about the unique and specific response mechanisms that originate from our own body. That refers to [responses in] the immune system, and to the bone marrow, and includes both cellular and soluble factors that modulate how cancer cells invade into healthy tissues. And this is a big concern, especially when it comes to the brain.
HOW DID YOU CHOOSE THIS SPECIFIC PROBLEM?
I have studied stem cell biology or stem cell niches in the adult brain and during development, and learned that factors from the blood stream and bone marrow interact in a very distinct fashion with stem cell niches in the brain. Generally, all tissue repair mechanisms are not to be understood as local processes, but rather as a process involving systemic factors and various organ systems, such as the bone marrow and the brain. We are interested in identifying the global mechanisms that link the bone marrow and the brain, which is of relevance for normal brain physiology and for the manifestation of neurological diseases.
HOW FAR ALONG ARE YOU IN THE RESEARCH RIGHT NOW?
So far we have worked with cell culture systems and mouse model systems, but it is time to bring these novel concepts into the clinical setting. We have gained some preliminary experiences and data from brain cancer patients. This is why we have decided to move forward with this pilot study as a proof of principle and also to see how much we can learn from real patient data.
DO YOU HAVE A PARTICULAR MENTOR WHO HAS INFLUENCED YOU?
Mark Noble, PhD, in Rochester, NY, has influenced me during my entire research career. He taught me to always look at the “big picture” in science and research, and to identify the fundamental processes and the “prime modulators” that are underlying normal physiology and disease. Currently, I have two excellent mentors, Dr. Tracy Batchelor who is my clinical mentor in the division of Neuro-oncology, and Dr. David Scadden who is my scientific mentor in the Center for Regenerative Medicine at Massachusetts General Hospital. My mentors have taught me to always identify and focus on the most relevant and most critical experiments in order to answer a certain research question, so that a basic science concept can be readily moved to the clinical setting.
CAN YOU TELL US ABOUT YOUR INTERESTS AND PURSUITS OUTSIDE OF YOUR RESEARCH?
I have always had a deep admiration for any physiological processes that surround us in nature. What are the principles that rule all natural processes and the world? This is something that fascinates me beyond just the scope of medicine. Besides medicine and science I enjoy traveling, photography, music and playing the piano.
AAN Clinical Research Training Fellowships are funded by the AAN, the AAN Foundation, and the AAN Foundation Corporate Roundtable, and provide $55,000 per year for two years, plus $10,000 per year for tuition to support formal education in clinical research methodology at the fellow's institution or elsewhere. Fourteen fellowships were awarded for 2011, and more than 70 training fellowships have been awarded through the program since its inception in 1996. For more information about the program, visit http://bit.ly/egrG8L.