Our laboratory is based on a close partnership between Dr. Ballester and Dr. Esquenazi. We believe that the close integration of neurosurgery and neuropathology allows us to tackle complex problems in neuro-oncology in a unique way.
A main area of research in the laboratory involves the discovery and validation of cerebrospinal fluid (CSF) biomarkers to develop a liquid biopsy assay for diagnosing and monitoring patients with central nervous system (CNS) tumors. Efforts in this area include analysis of circulating tumor DNA (ctDNA), extracellular vesicle micro RNAs (EV-miRNAs), and metabolites. The other main focus of the Ballester-Esquenazi lab is on the relationship between glioma and gut microbiome/metabolites. We are evaluating this through 16S rRNA sequencing and fecal metabolites in both mice and glioma patients. Efforts in the lab are been made to identify this relationship, microbiome signatures that might predict patients outcomes, the relationship between the gut microbiome/metabolites and radiation-induced cognitive deficit, and the enhancement of therapies for glioma patients through gut microbiome manipulation.
Additionally, we are interested in developing novel biomarkers that would allow us to identify the effects of radiation therapy on the brain, and to differentiate these effects from those related to the growth of tumors which can be quite challenging even with the use of advanced brain imaging techniques.
We are also interested in identifying biological differences that determine both tumor and normal tissue response to radiation and integrate these differences into individualized treatment strategies for patients.
Another area of interest involves the development of targeted therapies for the treatment of CNS tumors. In particular, we are interested in targeted therapies for the treatment of diffuse intrinsic pontine gliomas (DIPGs), which are also known as “diffuse midline glioma H3K27M mutant”. In addition, we are interested in developing targeted therapies for IDH1/IDH2 mutant gliomas. Efforts in this area are done in collaboration with Dr. Greg Cuny (medicinal chemist) at University of Houston.