Profile: E. Antonio Chiocca, MD, PhD

medical_chioccaThis noted young brain surgeon plans to grow clinical and research faculty to distinguish OSU’s new Department of Neurological Surgery as the “best in the Midwest.”

Unlike most of us, the expression “it’s not brain surgery,” does not apply to internationally recognized researcher E. Antonio Chiocca, MD, PhD. As chair of the recently created Department of Neurological Surgery at The Ohio State University, he has been hailed as a leading investigator in the use of gene therapies for brain tumors and other central nervous system disorders. Additionally he’s the Dardinger Family Professor of Neurosurgical Oncology at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

The native of Padua, Italy meets challenges head-on. One of the main focuses of his research is on glioblastoma multiforme, a cancerous tumor which attack the brain. “This type of cancer affects 18,000 Americans a year, and there’s very little effective therapy,” he says. “We’re working with different kinds of research, such as viruses that will turn into drugs and seek out and destroy cancer cells.”

Early (Phase I) clinical trials on humans have shown engineered viruses to be safe in attempts to kill certain types of cancer, including glioblastoma. But much intelligence still needs to be gathered. “The human brain is so much larger than any idealized model system that we use in the laboratory,” he explains. “It’s like going from a Mom-and-Pop corner store to a huge industrial factory.”

He’s also matching wits with gene therapy and stem cell biology. “With cancer, genes have gone awry. So we try to replace good genes back in the brain,” through drugs and other therapies. And while only being used in preliminary research in the laboratory, “stem cells show promise in delivering various therapies.”

When OSU lured Chiocca from his positions as associate professor of neurosurgery at Harvard Medical School and co-director of the peripheral nerve service at Massachusetts General Hospital, he was intrigued. Ohio State offered the opportunity to mold a department and bring in his own research lab and team members. Although “a place like Harvard is great on its own,” he was enticed by a chance to make a real difference at OSU “and contribute to the body of knowledge with the potential of becoming one of the best treatment centers in the world.”

Plus “Ohio State has a long tradition of excellence,” says Chiocca, who came to the U.S. at age 19 to study biological sciences at the University of Texas – El Paso. He received his medical degree from the medical school in Houston as well as his doctorate from the graduate school of biomedical sciences. “A lot of the original grading and classification in addition to the early treatment of brain aneurisms originated at Ohio State.” Previously a division of the Department of Surgery since 1951, Neurological Surgery originally focused on patients with central nervous system abnormalities and injuries; and spine surgery and treatment for brain tumors, trauma, and cerebrovascular disease.

The new department offers even more comprehensive care, and he credits OSU Medical Center leaders and faculty for fostering a strong atmosphere of learning and research. “Dr. Sanfilippo and others have brought a vision of growth.””

His colleagues agree that expansion is a smart move. “We are fortunate to bring a great physician-scientist and energetic young leader like Nino Chiocca to OSU Medical Center,” comments Fred Sanfilippo, MD, PhD, senior vice-president for Health Sciences and dean of the College of Medicine and Public Health. “He will strengthen our missions in the growing subspecialty of neurological surgery, along with our emphasis on interdisciplinary collaborations.”

The department, which currently has three tenure-track faculty in addition to clinical faculty, is expected to grow quickly, with enhanced educational and clinical training opportunities for students and residents, and a “positive influence on disciplines ranging from anesthesiology to rehabilitation,” adds Sanfilippo. They work closely with the Dardinger Neuro-Oncology Center, which Chiocca co-chairs with Herbert Newton, MD, director of the Division of Neuro-Oncology. Opened in late 2004, the Esther L. Dardinger Neuro-Oncology Center came about as a result of funding specificall earmarked to expand research and treatment for patients with brain and other cancers affecting the central nervous systems

“The resulting multidisciplinary research will increase partnership opportunities with industry to convert research discoveries into new therapeutics and technology.”

For patients, this translates into extended services for what’s already being used: the minimally invasive gamma knife, which focuses on tumors and vascular malformations of the brain; and the blood-brain barrier disruption treatment, a procedure enhancing delivery of chemotherapy to tumor sites. “We’re the only ones in central Ohio who use the gamma knife,” observes Chiocca. Other services in-place, such as the Ohio Spine Center, which provides managed treatment of back pain, and the Spinal Cord Injury Program, a multi-year National Institutes of Health project, will be joined by increasingly sophisticated research and treatments for trauma, spine surgery and movement and vascular disorders. The Dardinger Center focuses on both clinical work and research.

Chiocca brings his own acumen to the brain trust. Among other things, he specializes in the removal of peripheral nerve tumors (including schwannomas and neurofibromas). These benign, encapsulated growths can cause lifelong pain and disability. Although “many doctors don’t believe they can be taken out safely,” he has successfully excised approximately 80 of these tumors from patients. He’s also performed nerve grafting operations for traumatized or otherwise injured motor nerves and has used peripheral nerve stimulation to alleviate neuropathic pain.

Still in his 40s and married, with three children under the age of 6, Chiocca has a lot on his mind. On any given day, he will see patients, do clinical research, work with neurosurgery residents, and consult with medical and other organizations about various work-related issues. As principal investigator on over a dozen research projects, many of which are funded by the National Institutes of Health, he also probes into new treatments for brain tumors and other therapies. His results are evident in more than 100 published articles and book chapters and six patents (with two others pending). And, at any moment, his beeper can go off, indicating an urgent patient-care situation requiring an immediate decision.

Yet he’s found the time to become acquainted with Columbus and Ohio State. “”This area is like a hidden jewel,” he observes. “There’s a lot to do, as with a big city, yet it’s small enough to get around easily.” Another contrast: “At Harvard, everyone turned out for rowing championships, but no one showed up for football. At Ohio State, it’s the exact opposite.” (Point of reference: Ohio State does have talented men’s and women’s rowing teams that win awards in Big Ten championships.)

Chiocca finds his chosen field to be exciting and, so to speak, a perpetual cranium teaser. “The brain represents one of the last frontiers in our knowledge and has a lot of redundant pathways,” he reflects. “If one part is damaged, plasticity ensues and other brain areas learn to take over, depending upon where in the brain damage has taken place.” And unlike other parts of the body, where the physiology is well-known, “We’re just starting in the brain with tools and techniques like imaging, stem cell biology, and genetic knowledge.

“My hope is to help make Ohio State the best place in the Midwest for research,” he continues. “We want to create a department that provides top-notch care and contributes to — or maybe even finds — a cure for brain cancer.”