Patients diagnosed with glioblastoma survive for an average of 15 months.

What’s needed is a better way of identifying those hidden cancer cells and predicting where the tumor might grow next. Jennifer Munson believes she and her research team at the Fralin Biomedical Research Institute at VTC have developed a tool to do just that.

Their method, described recently in npj Biomedical Innovations, combines magnetic resonance imaging, Munson’s in-depth knowledge of how fluid moves through human tissues, and an algorithm Munson’s team developed to identify and predict where the cancer might reappear.

“If you can’t find the tumor cells, you can’t kill the tumor cells, whether that’s by cutting them out, hitting them with radiation therapy, or getting drugs to them,” said Munson, professor and director of the FBRI Cancer Research Center — Roanoke. “This is a method that now we believe can allow us to find those tumor cells.”

Currently, doctors plan surgeries to remove glioblastoma tumors based on radiological scans, but that only provides a view of the area just outside the cancer’s edge. During surgery, fluorescent dyes highlight cancer cells, but the dyes don’t penetrate deeply and the cells have to be visible to the eye.

“Those methods are not going to see a cell that has migrated or invaded further into the tissue, which is something that we think we can do with this method,” said Munson, who also holds an appointment in Virginia Tech’s Department of Biomedical Engineering and Mechanics.

Munson’s research focuses primarily on interstitial fluid flow — the movement of fluid through the spaces between cells in tissues. The flow behaves differently in different diseases.

In studying glioblastoma, Munson’s lab found that faster flows predict where tumor cells are invading. More random motion of the fluid, or diffusion, however, correlates with less invasion by the cancer cells.

But a new metric Munson’s team developed proved to be the best predictor. The fluid flow around the tumor establishes pathways, like streams merging into rivers, which the cancer cells follow to migrate into the surrounding tissue.

“This could tell a surgeon where there’s going to be a higher chance of there being more tumor cells, so they might be a little more aggressive, if it’s safe to the patient to go after a more invasive region,” Munson said.

Munson’s findings underpin the work of a new spinoff company, Cairina, which aims to improve cancer treatment through a more personalized approach to surgery and cancer therapies.

“Cairina is trying to take this to the next level,” Munson said. “Our goal is to supply surgeons and radiation oncologists with probability maps or hotspot maps, where we would predict more cancer cell invasion to support more aggressive therapeutic application, and also to identify where there may be less invasion, to help spare tissue from unnecessary treatment.”

This research was funded by grants from the National Cancer Institute, the Red Gates Foundation, the American Cancer Society, and the National Institute of Neurological Disorders and Stroke.

Budianto Hakim from the National Research and Innovation Agency of Indonesia (BRIN) and Professor Adam Brumm from the Australian Research Centre for Human Evolution at Griffith University led the research published recently in Nature.

A field team led by Hakim excavated a total of seven stone artefacts from the sedimentary layers of a sandstone outcrop in a modern corn field at the southern Sulawesi location.

In the Early Pleistocene, this would have been the site of hominin tool-making and other activities such as hunting, in the vicinity of a river channel.

The Calio artefacts consist of small, sharp-edged fragments of stones (flakes) that the early human tool-makers struck from larger pebbles that had most likely been obtained from nearby riverbeds.

The Griffith-led team used palaeomagnetic dating of the sandstone itself and direct-dating of an excavated pig fossil, to confirm an age of at least 1.04 million years for the artifacts.

Previously, Professor Brumm’s team had revealed evidence for hominin occupation in this archipelago, known as Wallacea, from at least 1.02 million years ago, based on the presence of stone tools at Wolo Sege on the island of Flores, and by around 194 thousand years ago at Talepu on Sulawesi.

The island of Luzon in the Philippines, to the north of Wallacea, had also yielded evidence of hominins from around 700,000 years ago.

“This discovery adds to our understanding of the movement of extinct humans across the Wallace Line, a transitional zone beyond which unique and often quite peculiar animal species evolved in isolation,” Professor Brumm said.

“It’s a significant piece of the puzzle, but the Calio site has yet to yield any hominin fossils; so while we now know there were tool-makers on Sulawesi a million years ago, their identity remains a mystery.”

The original discovery of Homo floresiensis (the ‘hobbit’) and subsequent 700,000-year-old fossils of a similar small-bodied hominin on Flores, also led by Professor Brumm’s team, suggested that it could have been Homo erectus that breached the formidable marine barrier between mainland Southeast Asia to inhabit this small Wallacean island, and, over hundreds of thousands of years, underwent island dwarfism.

Professor Brumm said his team’s recent find on Sulawesi has led him to wonder what might have happened to Homo erectus on an island more than 12 times the size of Flores?

“Sulawesi is a wild card – it’s like a mini-continent in itself,” he said.

“If hominins were cut off on this huge and ecologically rich island for a million years, would they have undergone the same evolutionary changes as the Flores hobbits? Or would something totally different have happened?”

The study ‘Hominins on Sulawesi during the Early Pleistocene’ has been published in Nature.

A new study has revealed that most Australian women of reproductive age prescribed GLP-1 receptor agonists — medications increasingly used for weight loss such as Ozempic — are not using effective contraception, despite known risks during pregnancy.

Published in the Medical Journal of Australia, the research analyzed data from over 1.6 million women aged 18 to 49 who attended general practices between 2011 and 2022. Of the 18,010 women who were first prescribed GLP-1 receptor agonists during that time, only 21% had reported using contraception.

Originally developed to manage type 2 diabetes, GLP-1 receptor agonists have gained popularity for their appetite-suppressing and weight-loss effects, with the study finding that most prescriptions are now issued to women without diabetes.

Lead author and pharmacist, Associate Professor Luke Grzeskowiak, says that in 2022 alone, more than 6,000 women began treatment on GLP-1s, and over 90% of those did not have a diabetes diagnosis.

“We’re seeing widespread use of these medications among women of childbearing age, but very little evidence that contraception is being considered as part of routine care,” says Associate Professor Grzeskowiak from the College of Medicine and Public Health.

“These medications can be incredibly helpful, but they’re not risk-free, especially during pregnancy.”

The study found that 2.2% of women became pregnant within six months of starting GLP-1 treatment with pregnancy rates highest among younger women with diabetes, and among women without diabetes in their early thirties.

Women with polycystic ovary syndrome were twice as likely to conceive, suggesting that weight loss may improve fertility, even when unintended.

Importantly, women who were using contraception at the time of prescribing had a significantly lower risk of pregnancy.

A previous review of animal studies from the University of Amsterdam linked GLP-1 exposure during pregnancy to reduced fetal growth and skeletal abnormalities, and while human data is limited, the potential risks remain concerning.

“Whilst the UK advises that women using GLP-1 receptor agonists should avoid pregnancy and use effective contraception, this advice is not being followed consistently in Australian clinical practice,” says Associate Professor Grzeskowiak.

“We need to ensure that reproductive health is part of every conversation when these drugs are prescribed to any women of childbearing age.

“It is also vitally important that we have clearer practice recommendations and guidelines for those prescribing GLP-1s to women to ensure their safe and effective use.

“Our advice is to speak to your GP about the risks and benefits of GLP-1 medicines before taking them, and only take those prescribed by a healthcare professional.”

The authors say that further studies evaluating the impact of these medications on pregnancy and unborn babies are warranted.

Acknowledgements: Luke Grzeskowiak receives salary support from a Channel 7 Children’s Research Foundation Fellowship (CRF-210323). We also acknowledge the contributions of members of the SPHERE Centre of Research Excellence in Women’s Sexual and Reproductive Health in Primary Care (SPHERE 2.0 CRE), which is funded by the National Health and Medical Research Council (APP2024717).