Recent studies suggest that cells in the bone marrow-endothelial precursor cells (EPCs)-can
provide a blood supply to cancerous tumors.
The purpose of this study is to collect brain tumor and blood samples to look for these EPCs
in the samples and analyze the growth signals that may help blood vessels to grow in tumors.
Researchers will study the following in the samples: 1) the number of blood vessels in the
tumor; 2) the levels of growth factors in the tumor and blood; 3) the levels of circulating
EPCs in the blood; and 4) the changes in the genes and proteins in the blood and tumor that
influence growth factor levels.
Participants will be 18 years of age or older and have evidence of a brain tumor that
requires surgery. From this surgery they will donate blood and tumor samples. Participants
will have follow-up visits 4 to 8 weeks after surgery, then at 3-month intervals for
two-and-one-half years, then at 6-month intervals thereafter. At these visits, participants
will undergo a physical exam, a brain scan, and blood work.
Angiogenesis, or the development of new blood vessels, appears to be one of the keys to
tumor survival. Areas of new blood vessel growth, or neovascularization, such as with
trauma or tissue ischemia, appear to release factors that stimulate production of
endothelial cells from progenitor stem cells located in the bone marrow. Endothelial cells
for the inside lining of blood vessels are important in the formation of viable and
functional blood vessel conduits. Recent work suggests that tumors-including primary brain
tumors-secrete many of the same stimulatory growth factors as normally incite endothelial
cells to be produced and turned out into the circulation. Initial evidence suggests that
these circulating endothelial progenitor cells (EPCs) play a role in the impressive
neovascularization seen with tumors. In this study, we wish to investigate the interaction
of gliomas and EPCs to elucidate a potential role for EPCs in tumor formation, response to
therapy, progression, and overall survival, as well, to identify potential new targets for
anti-tumor and/or anti-angiogenic therapies using genomic and proteomic techniques.
Patients suspected of having, or with prior biopsy proof of, a WHO grade II-IV central
nervous system (CNS) glial tumor(s) seen in the Surgical Neurology Branch, NINDS, will be
considered for entry into this study. Tissue samples of tumor resected as part of standard
care will be collected at surgery and preserved for research. Blood samples will also be
collected. Blood will also be collected from anonymous normal volunteers who donate blood
at the NIH Blood Bank; these anonymous donors will serve as controls.
1. Radiographic evidence of a primary glial neoplasm of the CNS (WHO grade II-IV) or any
patient with a known primary neoplasm of the CNS.
2. Medically indicated (diagnostic and/or therapeutic) tumor resection.
3. Informed consent from patient, age 18 or older to 75 years of age.
4. No racial or ethnic group or gender is excluded.
1. Inability to provide informed consent prior to surgery.
2. Medical conditions that cannot be corrected prior to surgery that would be standard
contraindications for neurosurgery.
3. Pregnant Women: Women of child-bearing age will be tested before surgery for