An NCI-designated Comprehensive Cancer Center
By Michael Easterling | August 20, 2019
rahul jandial headshot 256 x 256 Rahul Jandial, M.D., Ph.D.
Rahul Jandial, M.D., Ph.D., associate professor in City of Hope’s Division of Neurosurgery, Department of Surgery, has received the “Breakthrough” award and a $1.35 million grant from the Department of Defense Breast Cancer Research Program to support his laboratory research into leptomeningeal disease (LMD).
 
Also known as carcinomatous meningitis, the disease is characterized by the spreading of tumor cells to the lining of the brain and spinal cord. Despite its discovery nearly 150 years ago, it remains the most ominous diagnosis a patient can receive — yet with the fewest treatment options.
 
The brain and spinal cord float in clear liquid called cerebrospinal fluid, which supplies nutrients and serves to create a buoyant environment for the delicate organ. Notably, not all Stage 4 diagnoses have the same prognosis. “The spread of cancer to this unique fluid space is associated with the worst prognosis, often only months, and excludes patients from other medicines and clinical trials,” Jandial said.
 
Jandial explained that his research team’s early findings show that one of the three main cell types in the brain (oligodendrocyte precursor cells, or OPCs) may create an environment that is less hospitable to cancer cell invasion, essentially thwarting their sinister mission. Based on these clinical observations, Jandial will be investigating the cancer biology driving the development of LMD, as well as the OPC-derived signals that prevent it. He and his team are seeking new approaches to transform care and deliver a next generation of treatment that could lead to healing.
 
“We want to identify what allows breast cancers to invade the most protected space in the human body — the central nervous system — and figure out how to stop it in its tracks,” said Jandial, who is on a neurosurgical team for delivering CAR T cells into the cerebrospinal fluid of patients who have HER2-positive breast cancer that has spread to the brain. “If we learn about our enemy — learn why some breast cancers metastasize and other don’t — we can then uncover its biological Achille’s heel. This is the first step to inventing medicine.” 
 
“My team is committed personally — and City of Hope is committed institutionally — to help improve the length and quality of life for women with breast cancer,” he continued. “And through this funded research, we may discover a fundamental flaw in metastatic breast cancer that may be also exploited for other types of brain metastasis.”

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