In February, McMaster University received a rare gift.
It was a brain and spinal cord belonging to a glioblastoma (GBM) patient which the university took special measures to obtain. The “unprecedented” donation could hold the key to unlocking secrets of the lethal disease, say researchers at the Sheila Singh Brain Tumour Lab.
“I’m not aware of anybody who has been able to remove a GBM patient’s entire brain and spinal cord and profile the entire tumour,” said Dr. Sheila Singh, professor in surgery and biochemistry.
Glioblastoma is a deadly cancer that affects the brain and spinal cord. While it’s rarer than other cancers such as breast and lung, glioblastoma is the most common adult tumour originating in the brain — also known as a primary brain tumour.
Glioblastoma grows into the brain tissue, sprouting tendrils that invade the entire organ. That’s why it’s impossible to fully remove the cancer through surgery alone. Other treatments such as radiation and chemotherapy often follow.
The disease affects about four in 100,000 Canadians, according to the Brain Tumour Registry of Canada. A patient’s median survivorship is about 15 or 16 months from the date of diagnosis, Singh said. The five-year survival rate for the disease barely changed in the last 30 years — moving from four per cent to seven — according to a recent study from the United States.
Singh had obtained samples of the patient’s tumour during two prior surgeries, plus a blood sample. Now that her lab has brain tissues from the time of the patient’s death, for the first time, Singh will be able to get a comprehensive picture of how the tumour evolves.
“We’re trying to develop a better understanding of the evolution of tumours through time and space,” Singh said. “If you make all your decisions based on the primary tumour, it’s almost like the horse is out of the barn already because the tumour evolves and changes in the patient, and by the time it recurs or comes back after treatment, now it’s a completely different tumour.”
But even though the family had themselves offered the donation, the logistics weren’t easy.
For one, Singh’s team wouldn’t have more than 24 hours to retrieve the brain after the patient’s death because they needed to recover live cells. The goal was to be able to grow the cells in a dish and send them to different labs.
There were also bureaucratic hurdles. A pathologist could only perform an autopsy on a patient who dies in hospital, while Singh’s patient was in hospice.
That’s where Dr. Bruce Wainman’s team came in. His lab in McMaster’s education program in anatomy was shut down in the pandemic because there was little in-person teaching and it was hard to get staff in the hospital.
But they made an exception for this patient.
“We saw that as an opportunity to facilitate almost this heroic altruism that that family showed,” Wainman said. “We just made it our mission.”
He rounded up a team and made sure they met all the COVID-19 and legal restrictions. They had to be ready to act as soon as the patient died.
When the time came, a bequeathal co-ordinator arranged for the patient’s body to be transported from Guelph to McMaster.
Two prosectors prepared the body. Then Singh’s team of neurosurgeons harvested the brain for tissues. Her lab was waiting with ice to transport the specimens and remove cells from the tissue.
The process took 12 hours in all, Singh said.
“This was the fastest retrieval of cells we have ever accomplished from someone’s brain,” she said.
“Within two hours of her death, we had already gotten the cells into a condition to grow them.”
The operation has already shown promise. Singh’s team divided the brain into 10 sections which then grew 10 reproducible samples.
“Believe it or not, all of them are different,” Singh said.
The next step involves profiling the tumour and publishing an atlas of their findings.
Singh says the donation is a gift that keeps on giving.
After others got wind of the donation, up to 10 patients and families have reached out wishing to make a similar gift.
The response has sped up Singh’s and Wainman’s plans to discuss new protocols to facilitate these types of donations.
An anonymous donor has also offered a “generous donation” to Singh’s lab, said a spokesperson for McMaster’s Faculty of Health Sciences. That would help support the research Singh said costs hundreds of thousands, if not millions of dollars.
The patient’s widower is also establishing a legacy scholarship to McMaster’s cancer research centre to support a student studying brain cancer every year.
“This is so wonderful because we’re covering so many bases, so many things that are important in research,” Singh said.