Below are summaries of the research projects we support and accelerate:
NF2 3DVolumetric Imaging Research
NF2 BioSolutions is inviting you to participate in a study with the purpose to develop automated 3D volumetric measurements of the NF2 vestibular schwannomas from the patients’ MRIs. This study will be conducted by Yale University.
It is crucial for patients and doctors to know the accurate size and growth rate of the tumors in order to be able to decide the next step to follow, for example, « wait and see », surgery resection, radial surgery, Avastin, etc… The typical measurements that we receive in our MRI reports, are 2 axis dimensions (e.g 1.5cm x 2.1cm ) or inaccurate 3 axes dimensions (e.g 1.5vm x 2cm x 1.3cm), it is not accurate enough and it could make you think that the tumor is stable when it is not, or the opposite.
In order to be able to develop this automated measurement tool, we need to collect a maximum of NF2 patients’ brain MRIs.
Gene Replacement Approach:
Thanks to our 29th March 2019 consortium in Boston, we are collaborating with three top gene therapy labs to explore different gene replacement approaches:
Dr. Meyer Lab at Abigail Wexner Research Institute at Nationwide Children’s Hospital
NF2 BioSolutions signed a contract in July 2019 to partially fund a NF2 
Gene therapy Pilot Pre-Clinical Study at the Abigail Wexner Research Institute at Nationwide Children’s Hospital by Dr. Kathrin Meyer, who is serving as the Principal Investigator.
Dr. Chris Mueller Lab at the University of Massachusetts
Dr. Chris Mueller from UMass attended NF2 BioSolutions’ NF2 Gene Therapy Consortium in Boston on March 29th. Being moved by the impact of NF2, Dr. Mueller decided to run a gene therapy pilot study to identify if his lab’s gene therapy platform could be a good candidate for tackling the NF2 mutation. The advantage of his platform is its ability to silence the mutated gene and then add a healthy one. Dr. Mueller, assisted by Dr. Karin Meijboom, will be financing the development of the gene therapy NF2 vector for the pilot. Once manufactured, it will be tested on NF2 in order to determine efficacy.
NF2 BioSolutions will facilitate the collaboration between the NF2 experts and Mueller’s lab.
On the 7th of August 2019, NF2 BioSolutions and NF North East organized a visit to the lab, where NF2 patients could meet the researchers.
Dr. Karin Meijboom “Our recent visit with the NF2 community was an invaluable experience for the Mueller Lab. Not only was it an opportunity to meet with a remarkable and dedicated group of individuals, but we were also fortunate enough to hear, first-hand, their personal stories about living with NF2. As researchers, it is often far too easy for us to focus on the technical mechanisms of a disease, but this visit gave us something more: the inspiration and energy to find solutions and treatments from the inspiring people living with this condition.”
Therapeutic strategy: Gene replacement
To introduce new copies of the NF2 gene using AAV in order to increase the amount of normal NF2 gene product (Merlin) to a level at which it can execute its tumor suppressor functions in patients. This project involves an international collaboration among several research groups with expertise in either NF2 or gene therapy. The Mueller group will design the project and the gene therapy and do preliminary testing in cells and healthy mice. Other groups that have more expertise in NF2 will treat NF2 mouse models with gene therapy and examine the effects on NF2 pathology.
Dr. Brenner Lab at Massachusetts General Hospital
Dr. Brenner is working on two approaches, an immunotherapy approach, and Suicide Gene Therapy Approach
A. Immunotherapy Approach of Dr. Brenner
NF2 BioSolutions is excited to announce the funding of Dr. Gary Brenner’s lab at Massachusetts General Hospital for the development of immunotherapy for treating NF2. This new approach utilizes a cell-based treatment strategy, meaning that cells or cellular material are injected or implanted into a patient. In this case, preclinical data show that following direct injection of this particular cellular product into NF2 schwannomas, tumor killing occurs by causing:
- Cell death.
- Development of a host anti-tumor adaptive immune response, meaning the patient’s own immune system is turned into a destructive force against the body’s tumors.
- Inhibition of angiogenesis. This means that new blood vessels are prevented from forming.
The goal of this project is to develop a genetically modified version of the cellular product “armed” with genes that enhance tumor cell death and the development of anti-tumor adaptive immunity. We anticipate the FDA Fast Track designation, which will help speed up and facilitate moving the product to the clinic. Upon clinical success for NF2/schwannomas, we expect utility in other benign and NF2-related neoplasms. In addition, Dr. Brenner is continuing his work on the suicide gene therapy approach.
B. Schwannoma Suicide Gene Therapy Approach of Dr. Brenner
NF2 BioSolutions is also supporting Dr. Gary Brenner’s lab to move towards a toxicology study for its Suicide gene therapy approach, prior to submitting an IND (investigational new drug) application to the FDA.
Schwannoma background:
Schwannomas are benign tumors composed of Schwann-lineage cells that normally form a protective sheath around nerves in the cranium (skull) and peripheral nervous system. Most people with the schwannoma-associated disease have multiple tumors which generally first appear during adolescence and continue to develop throughout life. These tumors cause pain, sensory/motor dysfunction, and death through compression of peripheral nerves, the spinal cord, and/or the brain stem. Effective chemotherapy is essentially non-existent, but because schwannomas are slow-growing and non-malignant, reduction in volume and slowing of growth can be therapeutic. Although it is the current standard of care, surgery and radiation can lead to significant sensory loss (including deafness in the case of vestibular schwannoma) and motor dysfunction and are not always possible due to the risk of nerve or brain stem damage. The paucity of therapeutic options, and the suffering caused by what limited options do exist, make the treatment of schwannomas a major unmet medical need.
Market size:
Schwannomas are associated with three distinct disease entities – sporadic schwannoma, neurofibromatosis type 2 (NF2), and schwannomatosis. Sporadic vestibular schwannomas are diagnosed in over 6000 individuals per year in the US alone (19 tumors/1,000,000 individuals per year). NF2 and Schwannomatosis have incidences of 1/25,000 and 1/40,000 births, with estimated point prevalences (people currently living with the disorder) of 13,000 and 8,000 respectively in the US.
Gene therapy approach:
The focus of the lab is to address this need by developing a gene therapy that specifically targets schwannomas, which are composed entirely of Schwann-lineage tumor cells. Schwannomas are appropriate targets for gene therapy because they grow slowly, are rarely malignant, and are never metastatic. They can be readily localized and followed over time using MRI. In addition, tumor genomes have been shown to be stable, with little genomic variability among tumor cells. The advantage of gene therapy over surgical resection is that the former uses a minimally invasive procedure (image-guided needle injection) with significantly less potential for nerve damage.
The team designed a gene therapy strategy that uses an adeno-associated (AAV) viral vector that expresses the pro-apoptotic gene ASC (ASC =“apoptosis-associated speck-like protein containing a carboxy-terminal CARD”) under the Schwann-lineage specific promoter, P0. This novel vector is thus termed “AAV-P0-ASC.” AAV vectors have been shown to be safe for use in the human nervous system in gene therapy trials. The delivery of ASC to schwannoma cells is attractive as ASC is both pro-apoptotic and pro-inflammatory. This gene therapy strategy utilizes a single transgene that potentially can: 1) induce apoptotic cell death in the cells in which it is expressed, 2) propagate the death signal to adjacent tumor cells, and 3) initiate innate and adaptive immune responses that control subsequent tumor formation.
Data obtained using a human-NF2 xenograft model (in immune-deficient nude mice) that the team developed to test potential schwannoma therapies indicate that the AAV-P0-ASC vector is very effective in killing schwannoma tumor cells while causing minimal toxicity to underlying neurons and healthy Schwann cells. Notably, the mouse models also demonstrate the resolution of tumor-associated pain. There is minimal risk of toxicity with this approach because the P0 promoter is Schwann cell-specific and is active only in dividing schwannoma cells while remaining relatively inactive in healthy neighboring Schwann cells. Of note, these findings have confirmed the AAV-P0-ASC efficacy signal in a second model, this involving mouse schwannomas developing in immune-competent animals.
This program is ready to move to humans. We believe the researchers have all the data necessary to support moving to human clinical trials. Your support will help us bring this research to those who need it.
This project is based on many years of research from Dr. Brenner:
Regression of Schwannomas Induced by Adeno-Associated Virus-Mediated Delivery of Caspase-1\
Brenner-2018-Schwannoma-gene-therapy-by-AAV-delivery-of-Gasdermin-D
https://www.ncbi.nlm.nih.gov/m/pubmed/30977509/
More papers will be published soon regarding this specific scientific gene therapy approach for schwannomas.