$205 million gift from Lee Kun-hee and family enables researchers to find a breakthrough in pediatric brain cancer
Prof. Kim Seung-ki, a neurosurgeon at Seoul National University Hospital (SNUH), and his team discovered a shared biological component among pediatric patients with medulloblastoma, a cancerous tumor that typically occurs in the cerebellum — the organ that controls balance located near the stem of the brain.
The discovery was realized thanks to a $205 million donation from the families of Samsung chairman Lee Kun-hee, paving a path for pediatric patients with brain tumors.
Korea sees some 20 to 30 patients with medulloblastoma yearly. In the United States, around 0.5 in 100,000 patients are diagnosed with the tumor, according to Kim.
Medulloblastoma has a high likelihood of metastasis — when cancer or tumor spreads — through cerebrospinal fluid, which travels between the spine and brain.
Kim said pediatric patients see a sharp decline in their five-year survival rate once the tumor spreads to other organs, dropping from over 80 percent to around 60 percent.
Kim said around one-third of the patients have metastasis when they are diagnosed. He noted that treatment for high-risk patients with metastasis is challenging despite technological developments in surgery methods and chemotherapy.
“Early and precise diagnosis, which also predicts the possibility of metastasis, would enable doctors to take different approaches and treatments, which could improve medical outcomes,” Kim said.
Kim said an MRI and analysis of cerebrospinal fluid, the current means of detecting the spread of the tumor and cancer, are not accurate enough to detect micrometastasis — when a small portion of cancer cells spread to other organs but are too few to be observed.
“I don’t want to miss a single child,” Prof. Kim said.
Between 2016 and 2019, Kim and his research team analyzed the entire protein component from 35 pediatric patients’ cerebrospinal fluid, including 21 patients who received surgeries at SNUH to treat their medulloblastoma.
The other 14 subjects had hydrocephalus without brain tumors. Hydrocephalus is a medical symptom where patients experience an excessive accumulation of cerebrospinal fluid in their brain.
The research found around 1,100 protein compounds detected per patient on average. Patients with medulloblastoma showed a high concentration of a specific protein called transketolase, which metabolizes glucose and creates essential compounds for cell growth.
The research team said patients with medulloblastoma had a high number of extracellular vesicles containing transketolase. Extracellular vesicles are nano-sized pockets clustered in cells that transmit biological information between cells.
According to the team’s findings, the more extracellular vesicles the patient had, the more severe the metastasis became.
“The transketolase protein could be utilized as an important biomarker—a biological indicator explaining one’s medical state—in determining metastasis progress,” Kim said.
“Our team might be able to develop a precise and simple test kit that could detect the degree of metastasis and diagnose the disease using a patient’s cerebrospinal fluid.”
“Research into adult cancer with a high number of patients receives considerable funding, whereas for pediatric tumors, it is the opposite,” Kim said, adding that their research has been excluded from funding opportunities—except for Samsung Chairman Lee’s donation.
The research was a joint effort with fellow neurology Prof. Kim Joo-Whan as well as Prof. Han Do-hyun, who specializes in transdisciplinary medicine at SNUH.
“If it weren’t for the ‘Lee Kun-hee Project,’ we could not have started the research,” Kim said. “Thanks to the donation, we have done as much research as we wanted.”
Families of the late Samsung Chairman Lee donated the fund to Seoul National University Hospital with an aspiration to support the treatment and research of childhood cancer and rare diseases.