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Moving Forward in Childhood and Adult Brain Tumor Epidemiology

BTEC group photo
Location DKFZ, Communication Center, Heidelberg
Phone Contact ++49 (0)6221 42 2383 (Dr. B. Schlehofer)

Short Report

The 10th annual meeting of the BTEC was successfully held in DKFZ during two days in April 2008. More than 50 researchers from the United States (U.S.), Europe, Canada, and Israel working in the field of brain tumor epidemiology attended the meeting.

Under the meeting's banner "Moving Forward in Childhood and Adult Brain Tumor Epidemiology", different topics were presented and discussed by the fifty-three (53) conference participants:

The annual BTEC meetings are held to bring together scientists from around the world in order to communicate the latest knowledge in the field of brain tumor epidemiology. This forum provides the opportunity for a high quality exchange of study results, discussions of methodological issues and future research in brain tumor epidemiology. Its atmosphere promotes collaborations in which joint projects can be planned, discussed and executed among members of the Consortium. In addition, the meetings include educational lectures to improve the knowledge of the participants, especially that of new members.

Prof Dr. Otmar Wiestler, the Scientific Director of the German Cancer Research Centre, opened the 10th annual BTEC Meeting with an enthusiastic welcome to the conference participants. This was followed by Mr. Denis. Strangman, the Chair of the International Brain Tumor Alliance (IBTA), who informed the group about the ongoing activities of the international community of brain tumor patients and their families. The IBTA addresses issues of treatment and quality of life for patients globally.

The first scientific session of the meeting was moderated by Joellen Schildkraut and included four lectures on meningioma risk factors. Mrs. Siegal Sadetzki, Ramat-Gan, Israel, informed the participants on the status of ionizing radiation and meningioma risk. She gave an historical overview, and presented the recent results from the follow-up of the tinea capitis cohort study performed in Israel. This study includes more than 10,000 irradiated persons and non-irradiated controls and > 5,000 sibling controls. In addition, results from other ionizing radiation studies (e.g. atomic bomb survivors) were presented especially focusing on meningioma development. The association between ionizing radiation and genetic markers for radio sensitivity were discussed as well as the interaction between ionizing radiation and hormones or environmental influences. Jack Siemiatycki, Canada, presented methods for occupational exposure assessment of different levels of measurements. The problem of correct exposure assessment in retrospective epidemiological studies and the advantage and limitations of available job exposure matrices (JEM) were critically discussed. There was a suggestion to include experts (e.g. occupational hygienists) on the research team of these studies. Preetha Rajaraman, U.S., gave an overview on the current status of occupational risk factors for meningioma development. Lead, pesticides, and chlorinated solvents were discussed, as well as electromagnetic fields (EMF). However, the results of the studies are not conclusive, and further research is warranted. Elisabeth Claus, U.S., reported on the association between hormones and meningiomas. Larger and more recent cohort studies have provided hints for an increased risk of meningioma for hormone replacement therapy (HRT) users, while oral contraception (OC) was not associated with this tumor. There is a pending U.S. request for a new, multi-center epidemiological study for further studies, especially for the association between the expression of hormonal receptors (progesterone receptors, PR, or estrogen receptors, ER), genetic polymorphisms and meningioma development and grading. European and Israeli researchers have been invited to participate.

This session ended with an extensive pathological overview of different subtypes of meningioma given by Andreas von Deimling, Germany. New findings including genetic mutations of the NF1 and NF2 gene in meningioma subtypes and possible interaction with ionizing radiation were presented, demonstrating that NF1 mutations do not play a predominant role in radiation-induced meningioma. The association between meningioma progression and genes was also discussed.

The second session, held on the following day, was moderated by Ching Lau, U.S., and focused on risk factors for childhood brain tumors. In her interesting presentation Maria Feychting, Sweden, explained the sources of exposure for low- and high frequency electromagnetic fields (EMF), the issue of exposure assessment and exposure misclassification. She also presented the results of various studies concerning EMF and childhood brain tumors. Lisbeth Samsø Schmidt, Denmark, gave a comprehensive overview of the descriptive epidemiology of central nervous system tumors (CNS) in children based on the data given by the WHO and the Danish Tumor Registry. The association between CNS tumor development and genetic predisposition (genetic syndromes and familial aggregation) were shown. Environmental risk factors were presented with emphasis on pre-maternal risk factors (e.g. medication during pregnancy, paternal smoking and occupations). Sufficient information is still lacking on the etiology of the majority of childhood brain tumors and, as a consequence, the need and the possibility for conducting further studies were discussed.

Patricia Buffler and Roberta McKean-Cowdin, U.S., presented in more detail, the genetic risk factors for specific subtypes of childhood brain tumors. The molecular genetic characteristics and pathways (also for candidate genes) were explained, as well as the differences to adult brain tumor characteristics. Epigenetic mechanisms, gene variations and gene-environment risk factors for childhood brain tumors were taken into consideration in this presentation. New genetic projects for studies of pediatric gliomas and medulloblastomas in California were presented, and the strength and limitations of these studies were discussed. The presentation of Dora Il'yasova, U.S., focused on the influence of chemical exposures and brain tumors in children, a topic which has been discussed for many years. The influence of the major risk factors: n-nitroso compounds (NOC), tobacco, and pesticides were reviewed critically, taking into account new knowledge on epidemiological and biological evidence. The complexity of the interaction of environmental risk factors and their possible influence on tumor development were impressively shown. The last presentation in this session was given by Peter Kaatsch, Germany, who showed incidence, time trends and regional variations of childhood brain tumors. His informative report was based on data from the German Childhood Cancer Registry and the Automated Childhood Cancer Information System (ACCIS). During the presentation of the structure of these systems and their classification system he stated their strengths and limitations and the possibility of using these systems for the observation of time trends and regional variations.

The afternoon session of the second day was opened with a very informative Educational Lecture: Blood Brain Barrier (BBB), given by Berhard Erdlenbruch, Germany. He taught the group about the molecular composition of the endothelial tight junctions, the various modes for BBB opening and the transport of small compounds, low molecular weight nutrients, vitamins, hormones, etc. across the BBB, and the role of brain vessels for tumor growth. He finished his lecture by announcing a new important area of brain tumor treatment: the improvement of drug delivery into the CNS by BBB-opening. Faith Davis, U.S., moderated an exciting discussion following his lecture.

The Abstract Presentation Session followed and included seven colleagues presenting results from their recent innovative studies. The first four presentations focused on glioma research. Bridget McCarthy, U.S., reported on a collaborative study of the epidemiology of oligodendroglioma. Bob Jenkins, U.S., showed slides of a case-case comparison study of the differential association of chromosome 19 SNP variants with oligodendroglioma. Ping Yang and colleagues, U.S., reported on a large, on-going U.S. case-control study investigating the association between glioma in adults and genetic factors as well as medical history. Gene polymorphisms related to innate immunity and the risk of adult glioma was presented by Alina Brenner and Preetha Rajaraman, both U.S.. Thereafter, Beata Siegmund, Germany, showed her preliminary results from an investigation in the framework of a cohort study on glioma and meningioma and the co-morbidity with autoimmune diseases. Jose Pulido and Brian O'Neil, U.S., reported racial and ethnic differences in primary CNS lymphoma (PCNSL), a study that was established with data from the National Cancer Institute SEER Program. In the last presentation, Adelheid Wöhrer, Austria, presented a novel approach to population-based brain tumor epidemiology within the Austrian Brain Tumor Registry (ABTR). Manuela Orjuela, U.S., presented a poster with the results of her observations concerning weight change during therapy for medulloblastoma in children. Brigitte Schlehofer, Germany moderated the extensive discussions that followed the abstract presentations.

The sessions were closed by the Business Meeting, moderated by Carol Kruchko, U.S. during which candidates for the new executive officers in the U.S. were presented. The election was completed after the meeting by voting per e-mail, in order to give members not present, the opportunity to register their vote.

The evening Conference Dinner provided all participants with the opportunity to discuss again the different presentations and to find partners for joint projects.

The last day started with a critical presentation on Immunology and Brain Tumor Development, given by Judith Schwarzbaum, U.S./Sweden. She showed the preliminary results of the role of glioblastoma stem cell expression and inflammatory-related gene expression in CD133 proliferation. This is a project between the Ohio State University, U.S.; and the Karolinska Institute, Sweden. This lecture was followed by the talk of Joe Wiemels, U.S., who reported on the role of immune system in brain tumor etiology. Besides reviewing other studies, he presented interesting results concerning glioma survival and allergy, IgE levels and SNPs. Margaret Wrensch, U.S., moderated the session. Conflicting results in this field and many open questions lead to an intensive discussion between the audiences.

Melissa Bondy, U.S., presented the Gliogene Program Update, in which some of the meeting participants are actively involved and which has been followed with interest by other BTEC members. For those who are not involved in the Gliogene Program, she gave a comprehensive overview about the histology, the structure and the aims of the Gliogene Consortium and taught the audience how to use the Gliogene Website.

Daniela Seminara, U.S., followed Dr. Bondy's presentation with an update of the National Cancer Institute (NCI), U.S. brain tumor research portfolio. She presented the structure and characteristics of the NCI Epidemiology and Genetics Research Program (EGRP), and, especially, the possibilities of financial support available from the NCI.

Time was allotted during the final part of the meeting for Break-out Sessions for Different Working Groups. During this session new projects and collaborations could be discussed and assessed, thus fulfilling a major goal of the BTEC: to bring experts in epidemiology and etiology from the U.S. and outside the U.S., in particular Europe, with the highest level of scientific expertise in the population science of brain tumors together for opportunities to develop joint projects The positive feedback, including announcements of preliminary collaborations, from the meeting participants confirmed that the aim of the BTEC Heidelberg Meeting had been reached.

The BTEC Heidelberg meeting was made possible with funding from our sponsors.

 

Last Updated: 23 Oct 2009

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