Publications by authors named "David D Eisenstat"

The p53 tumor suppressor protein plays a crucial role in detecting and eliminating various oncogenic threats by promoting processes such as cell cycle arrest, DNA repair, senescence, and apoptosis. UBE4B is essential for negatively regulating p53 during normal conditions and following DNA damage. In previous studies, we demonstrated that UBE4B targets phosphorylated p53 for degradation in response to DNA damage.

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p53, often referred to as the "guardian of the genome," is a critical regulator of cellular responses to stress. p53 plays a dual role in tumor suppression and immune regulation. In addition to its well-known functions of maintaining genomic stability and inducing apoptosis, p53 orchestrates a complex interaction between innate and adaptive immune responses.

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Gliomas account for nearly 30% of all primary central nervous system (CNS) tumors in children and adolescents and young adults (AYA), contributing to significant morbidity and mortality. The updated molecular classification of gliomas defines molecularly diverse subtypes with a spectrum of tumors associated with age-distinct incidence. In adults, gliomas are characterized by the presence or absence of mutations in isocitrate dehydrogenase (), with mutated (mIDH) gliomas providing favorable outcomes and avenues for targeted therapy with the emergence of mIDH inhibitors.

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Pediatric high-grade gliomas (pHGGs) are the most aggressive brain tumors in children, necessitating innovative therapies to improve outcomes. Unlike adult gliomas, recent research reveals that childhood gliomas have distinct biological features, requiring specific treatment strategies. Here, we focused on deciphering unique genetic dependencies specific to childhood gliomas.

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Article Synopsis
  • Diffuse hemispheric gliomas, specifically H3G34R/V-mutant, are aggressive brain tumors with no current targeted therapies and come from neural precursor cells.
  • Researchers found that these tumors display developmental patterns similar to healthy brain interneurons and identified key genes that these tumor cells depend on, especially CDK6.
  • Targeting CDK6 with inhibitors showed promising results in reducing tumor growth and improving survival in experimental models, with one patient showing a significant response to treatment.
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Pediatric high-grade gliomas (pHGG) are malignant and usually fatal central nervous system (CNS) WHO Grade 4 tumors. The majority of pHGG consist of diffuse midline gliomas (DMG), H3.3 or H3.

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  • Recent research indicates that precision medicine is effective in developing new treatment options for childhood cancers, specifically for high-risk patients with a low expected cure rate.
  • In a study involving 384 patients, 67% received recommendations for precision-guided treatment (PGT), leading to a 36% objective response rate and better 2-year progression-free survival compared to standard treatments.
  • The most significant benefits from PGT were observed in cases targeting specific genetic markers and when treatment started before disease progression.
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The collection of biological specimens is necessary to support basic and translational research. However, the complexity of biobanking introduces numerous ethical issues, particularly regarding informed consent. To evaluate the acceptability and perceived benefits of an educational video facilitating the consent process for the Children's Cancer Centre Biobank.

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  • The Australian and New Zealand Children's Haematology and Oncology Group (ANZCHOG) aims to provide access to cutting-edge clinical trials for all pediatric cancers, particularly focusing on diffuse intrinsic pontine gliomas (DIPGs), which have a very low survival rate of less than 10% at two years.
  • Despite advances in research, DIPG remains a challenging cancer without a cure, necessitating new therapeutic approaches in surgery, imaging, and treatment methods.
  • It is recommended that all DIPG cases be reviewed by a team of specialists, with radiation therapy as the standard treatment, and that patients are considered for clinical trials and innovative treatments based on individual
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  • Diffuse midline glioma (DMG), particularly DIPG, is a fatal brain tumor with no effective treatments, but recent studies identified PIK3CA and MTOR as promising targets for therapy.
  • The research demonstrates that combining the PI3K/Akt/mTOR inhibitor paxalisib with the antihyperglycemic drug metformin and the PKC inhibitor enzastaurin can enhance treatment efficacy and prolong survival in animal models.
  • Advanced techniques like spatial transcriptomics and ATAC-Seq were used to evaluate the effects on tumor biology, revealing significant changes that could support a clinically relevant combination therapy for DIPG.
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Background: Modern oncological therapies together with chemotherapy and radiotherapy have broadened the agents that can cause cardiac sequelae, which can manifest for pediatric oncology patients while on active treatment. Recommendations for high-risk patients who should be monitored in a pediatric cardio-oncology clinic have previously been developed by expert Delphi consensus by our group. In 2022 we opened our first multidisciplinary pediatric cardio-oncology clinic adhering to these recommendations in surveillance and management.

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  • DNA methylation array profiling shows promise in classifying pediatric CNS tumors, serving as a useful complement to traditional histopathology.
  • The AIM BRAIN diagnostic trial tested this technique across 11 cancer centers with 269 patient samples, achieving high classification rates (66.4% and 79.2% for two classifier versions).
  • Results demonstrated excellent test reproducibility (99% concordance with another study) and highlighted the technique's ability to provide significant diagnostic insights, enhancing overall CNS tumor diagnosis.
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Background: (formerly known as fused supratentorial ependymoma (fus ST-EPN) has been recognized as a novel entity in the 2016 WHO classification of CNS tumors and further defined in the recent 2021 edition. fus ST-EPN was reported to portend poorer prognosis when compared to its counterpart, ST-EPN in some previously published series. The aim of this study was to determine the treatment outcome of molecularly confirmed and conventionally treated fus ST-EPN patients treated in multiple institutions.

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  • Diffuse midline gliomas (DMG), particularly diffuse intrinsic pontine gliomas (DIPG), are highly lethal childhood cancers, with palliative radiotherapy offering limited survival benefits of 9-11 months.
  • ONC201, a drug that targets certain pathways in cancer cells, has shown potential effectiveness against DMG, but further research is needed to understand how different genetic mutations affect its response.
  • Studies indicate that DIPGs with PIK3CA mutations are more sensitive to ONC201, while those with TP53 mutations are resistant; combining ONC201 with the drug paxalisib can enhance treatment effectiveness by overcoming metabolic adaptations linked to these mutations.
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Background: Diffuse intrinsic pontine glioma (DIPG) and other diffuse midline gliomas (DMG) of the thalamus and spinal cord are rare but devastating high-grade glial tumors of childhood with no curative treatment. Despite aggressive treatment attempts the prognosis has remained poor. Chimeric antigen receptor (CAR) T cell therapy has been identified as a promising new approach in the treatment of DMG tumors; however, additional targets are urgently required given known tumor heterogeneity and the prospect of antigen escape of this cancer.

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Diffuse midline gliomas (DMG), including diffuse intrinsic pontine gliomas (DIPGs), are the most lethal of childhood cancers. Palliative radiotherapy is the only established treatment, with median patient survival of 9-11 months. ONC201 is a DRD2 antagonist and ClpP agonist that has shown preclinical and emerging clinical efficacy in DMG.

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The mitogen-activated protein kinase (MAPK) pathway signaling pathway is one of the most commonly mutated pathways in human cancers. In particular, BRAF alterations result in constitutive activation of the rapidly accelerating fibrosarcoma-extracellular signal-regulated kinase-MAPK significant pathway, leading to cellular proliferation, survival, and dedifferentiation. The role of BRAF mutations in oncogenesis and tumorigenesis has spurred the development of targeted agents, which have been successful in treating many adult cancers.

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Glioblastoma (GBM) is the most common and aggressive malignant primary brain tumor in adults. The standard treatment achieves a median overall survival for GBM patients of only 15 months. Hence, novel therapies based on an increased understanding of the mechanistic underpinnings of GBM are desperately needed.

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The tumor suppressor p53 plays a critical role in cancer pathogenesis, and regulation of p53 expression is essential for maintaining normal cell growth. UBE4B is an E3/E4 ubiquitin ligase involved in a negative-feedback loop with p53. UBE4B is required for Hdm2-mediated p53 polyubiquitination and degradation.

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