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Brain Tumor Program

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The Maine Medical Center (MMC) brain tumor program is a unique collaboration between our Neuroscience and Cancer institutes. The program provides comprehensive neuro oncological services to adults and children with primary brain tumors, metastatic lesions to the central nervous system, and spinal tumors.

Each year, MMC treats hundreds of patients with brain and spinal tumors, including some of the most difficult cases in the state. This is a testament to the experience, expertise, and state-of-the-art technology available here. The program is led by Medical Director Christine Lu-Emerson, M.D., the only board-certified neuro-oncologist in the state of Maine.

Our multidisciplinary team—including experts in neuro-oncology, neurosurgery, radiation oncology, neuroradiology, pathology, neuro-navigation, and palliative care—works together to tailor treatment plans to the individual patient. These plans take into account the needs of each patient and family while providing high quality care close to home, either directly or through close cooperation with the patient’s local oncology team.

  • Maine's most comprehensive, multidisciplinary team of specialists with expertise in tumors of the central nervous system - including brain and spine
  • The state’s only board-certified neuro-oncologist, Christine Lu-Emerson, M.D.
  • Outstanding neurosurgical expertise that is unparalleled in the state
  • A coordinated approach to care that also addresses the patient's and family's psychosocial needs through integration of neuro-navigation and social work in the program
  • Personalized support for neuro-oncology patients and family provided by a specially-trained patient navigator
  • Complete, leading-edge diagnostic and treatment services for adults and children - many of which are not available any place else in Maine
  • Access to novel therapies through MMC's ongoing participation in clinical trials - both nationwide cooperative trials and individual pharmaceutical industry trials

We treat benign and malignant tumors of the central nervous system (brain and spine) including but not limited to:

• Gliomas: grade 2 and 3 astrocytoma, oligodendrogliomas, mixed oligoastrocytomas, and grade 4 glioblastoma/gliosarcoma
• Pleomorphic xanthoastrocytoma, grade 2 and 3
• Pilocytic astrocytoma
• Ependymomas
• Meningiomas/Hemangiopericytoma
• Primary CNS lymphoma
• Metastatic cancer to the brain
• Medulloblastoma
• Chondrosarcoma
• Ganglioglioma and other neuronal tumors

With state-of-the-art technology, our multidisciplinary team has a wealth of diagnostic and treatment resources for patients with brain and spinal tumors:

  • Advanced pre-surgical and intraoperative planning: Our neurosurgeons employ neuro-navigational technology that combines sophisticated imaging techniques and advanced computer software to visualize the brain in three dimensions and determine the precise location of a brain tumor - minimizing risk to surrounding areas of the brain and improving the extent of tumor removal.
  • Stereotactic radio surgery: This procedure allows for precise targeting of brain tumors otherwise unable to be removed with standard operating techniques.
  • Intensity modulated radiation therapy: This technique of radiation treatment allows for higher doses of radiation to the tumor while protecting the surrounding brain tissue.
  • Awake craniotomy with language mapping: This technique can be used in certain cases when a tumor infiltrates brain tissue that affects an essential function such as speech. The patient is fully anesthetized during the opening and closing portions of surgery; after the brain is exposed, the patient is brought into a conscious state and relevant areas of the brain are stimulated to assess for function and pinpoint what tissue can be safely removed.
  • Chemotherapy: A full range of traditional chemotherapeutic agents and targeted molecular therapies are available.
  • Advanced imaging techniques, including MRI perfusion, functional MRI, diffusion weighted imaging, and spectroscopy
  • Embolization: This approach is performed by an interventional neuroradiologist, reduces the blood supply to the cancer, often causing the tumor to shrink and making it easier to treat surgically or with radiation.
  • Optune® Medical Device Prescriptions
  • Neurosurgical innovations including 5’ALA for high grade glioma and LITT therapy
  • Experience with treatment of inoperable of plexiform neurofibromas in NF1 patients
  • Clinical Trials: MMC has the largest center for brain tumor research in Maine. Our team works closely with the MMC Research Institute, and we collaborate with Jackson Laboratories. We have patients enrolling in clinical trials, also called research studies, of new treatments that may improve outcomes for them and teach us more about this cancer. Recent or current studies include:
    • Newly diagnosed GBM: Phase II/III Randomized Trial of Veliparib or Placebo in Combination with Adjuvant Temozolomide in Newly Diagnosed Glioblastoma with MGMT promoter Hypermethylation
    • Recurrent GBM: Randomized Phase II Trial of Concurrent bevacizumab and Re-Irradiation Versus bevacizumab Alone as Treatment for Recurrent Glioblastoma
    • Anaplastic Glioma: Phase III Intergroup Study of Temozolomide alone vs. Radiotherapy and concomitant and adjuvant temozolomide vs. Radiotherapy and adjuvant PCV chemotherapy in patients with 1p/19q co-deleted anaplastic glioma
    • CNS Lymphoma: Phase II Randmonized Trial to Rituximab, Methotrexate, Procarbazine, Vincristine and Cytarabine +/- Low Dose Whole Brain RT for Primary CNS lymphoma
    • A Phase 3, Randomized, Open-Label Study to Evaluate the Efficacy and Safety of Eflornithine with Lomustine Compared to Lomustine Alone in Patients with Anaplastic Astrocytoma That Progress/Recur After Irradiation and Adjuvant Temozolomide Chemotherapy (STELLAR Study)
    • A Phase II/III Randomized Trial of Veliparib or Placebo in Combination with Adjuvant Temozolomide in Newly Diagnosed Glioblastoma with MGMT Promoter Hypermethylation (Alliance A071102)
    • Alliance A071101:  A Phase II Randomized Trial Comparing the Efficacy of Heat Shock Protein-Peptide Complex-96 (HSPPC-96) Vaccine Given with Bevacizumab Versus Bevacizumab Alone in the Treatment of Surgically Resectable Recurrent Glioblastoma Multiforme (GBM)
    • Longitudinal Assessment of Neurocognitive Function in Glioma Patients and Identification of Predictive Biomarkers

We have a robust clinical trial program offering clinical trials for newly diagnosed and recurrent glioblastomas, grade 2 and 3 gliomas, and atypical meningiomas.

Glioblastoma:
• CHEMO ID trial: recurrent glioblastoma

Grade 2 and 3 IDH mutant gliomas
• NRG-BN005: Phase II randomized trial of proton versus photon therapy (IMRT) for cognitive preservation in patients with IDH mutant, low to intermediate grade glioma
• AG-881/INDIGO: Randomized double blind phase III study of vorasidenib (AG-881) versus placebo in patients with residual or recurrent grade II glioma with IDH mutation
• CHEMO ID trial: grade 3 glioma

Meningioma
• NRG-BN003: Phase III trial of observation versus irradiation for a gross totally resected grade II meningioma


Brain Tumor Patient Navigator

Sara Schrock
Email: SCSchrock@mmc.org
Phone: 207-662-1539

What is a patient navigator?

A patient navigator is a nurse or social worker who makes sure that you and your family have all the information you need to make the most informed decisions about your treatment plan. The service is free and provided at many MaineHealth locations.

What services does the patient navigator provide?

As part of your health care team, the patient navigator will:

  • Ease your concerns and answer any questions you may have
  • Explain your different treatment options
  • Discuss any clinical trials that may be available to you
  • Schedule consultations for you and your family with specialists as needed
  • Provide information and literature relative to your specific diagnosis, treatment, and follow-up care

What other support to you offer?

A monthly support group is also available for brain tumor patients. Please contact Sara Schrock at SCSchrock@mmc.org for more information.