Ian F. Pollack, MD

A. Leland Albright Professor
Vice Chair, Academic Affairs
Chief, Pediatric Neurosurgery
Co-Director, Neurosurgical Oncology


Ian Pollack

Contact

412-692-5881

Biography

Ian Pollack, MD, is co-director of the Brain Tumor Program at the University of Pittsburgh Cancer Institute, chief of Pediatric Neurosurgery at Children’s Hospital of Pittsburgh of UPMC, and A. Leland Albright Professor of Neurosurgery at the University of Pittsburgh School of Medicine.

Prior to joining the faculty of the Department of Neurological Surgery at the University of Pittsburgh in 1992, he was awarded the 1991 Van Wagenen Traveling Fellowship, which afforded him a year of subspecialty training in the Department of Neurosurgery at the Hospital for Sick Children in Toronto, the Neuro-Oncology Laboratory of the University of Lausanne in Switzerland, and the Laboratory of Tumor Biology of the University of Uppsala in Sweden.

Dr. Pollack graduated magna cum laude from Emory University in 1980, where he earned a BS degree in chemistry. He received his medical degree from the Johns Hopkins University School of Medicine in 1984, then completed a surgical internship and neurosurgical residency at the University of Pittsburgh School of Medicine. He also was a research fellow in neuropathology and neurobiology during some of that time.

Pollack has published more than 320 papers in refereed journals, numerous book chapters and invited papers, and has edited two books on childhood brain tumors. He is co-editor of the book Principles and Practice of Pediatric Neurosurgery and an accompanying atlas Operative Techniques In Pediatric Neurosurgery.

He is currently a principal investigator on numerous NIH grants focusing on novel therapies for brain tumors and evaluating molecular markers of tumor prognosis.

Dr. Pollack was named vice chairman of academic affairs for the department in July of 2008. He has co-chaired the National Cancer Institute brain malignancy steering committee since 2010.

Specialized Areas of Interest

Pediatric neurosurgery; pediatric neuro-oncology; craniofacial surgery; congenital spinal abnormalities; brain tumor clinical trials.

Board Certifications

American Board of Neurological Surgery
American Board of Pediatric Neurosurgery

Hospital Privileges

Children’s Hospital of Pittsburgh of UPMC
Magee-Womens Hospital of UPMC
UPMC Presbyterian

Professional Organization Membership

Academy of Neurological Surgeons
Alpha Omega Alpha
American Association for the Advancement of Science
American Association for Cancer Research
American Association of Neurological Surgeons (AANS)
American College of Surgeons
American Society of Pediatric Neurosurgeons
American Society for Clinical Investigation
Association of American Physicians 
Children’s Oncology Group
Congress of Neurological Surgeons (CNS)
Johns Hopkins Medical and Surgical Society
Joint Section on Tumors (AANS/CNS)
Pennsylvania Neurosurgical Society
Phi Beta Kappa
Society of Neurological Surgeons
Society for Neuro-Oncology
Society of Surgical Oncology

Education & Training

BS, Chemistry, Emory University, Magna cum Laude, 1980
MD, Johns Hopkins University School of Medicine, 1984
Residency, University of Pittsburgh, 1991
Fellowship, University of Pittsburgh, 1990
Fellowship, Hospital for Sick Children, 1991
Fellowship, University of Lausanne, 1991
Fellowship, University of Uppsala, 1992

Honors & Awards

Castle Connolly’s America’s Top Doctors, 2002-15
Who’s Who in America (Marquis), 2005-15
Who’s Who in the World (Marquis), 2008-15
Castle Connolly’s America’s Top Cancer Doctors, 2005-15
Van Wagenen Lecturer, 2014 AANS Meeting
Winn Prize, Society of Neurological Surgeons, 2015

Selected Publications

Jane EP, Premkumar DR, Cavaleri JM, Sutera PA, Rajasekar T, Pollack I. Dinaciclib, a CDK inhibitor promotes proteasomal degradation of Mcl-1 and enhances ABT-737 mediated cell death in malignant human glioma cell lines. J Pharmacol Exp Ther [Epub ahead of print], 2015.

Jakacki RI, Burger P, Kocak M, Boyett J, Goldwein J, Mehta M, Packer RJ, Tarbell N, Pollack IF. Outcome and prognostic factors for children with supratentorial primitive neuroectodermal tumors (SPNET) treated with carboplatin during craniospinal radiotherapy: A report from the Children’s Oncology Group. Pediatr Blood Cancer 62:776-783, 2015.

Pollack IF, Jakacki RI, Butterfield LH, Hamilton RL, Panigrahy A, Potter DM, Connelly AK, Dibridge SA, Whiteside TL, Okada H. Antigen-specific immune responses and clinical outcome after vaccination with glioma-associated antigen peptides and Polyinosinic-polycytidylic acid stabilized by lysine and carboxymethylcellulose in children with newly diagnosed malignant brainstem and nonbrainstem gliomas. J Clin Oncol 32:2050-2058, 2014. 

Ater JL, Zhou T, Holmes E, Mazewski CM, Booth TN, Freyer DR, Lazarus KH, Packer RJ, Prados M, Sposto R,Vezina G, Wisoff JH, Pollack IF. Randomized study of two chemotherapy regimens for treatment of low grade glioma in young children: A Children’s Oncology Group Study. J Clin Oncol 30:2641-2647, 2012.

Pollack IF, Hamilton RL, Sobol RW, Nikiforova MN, Lyons-Weiler MA, LaFramboise WA, Burger PC, Brat DJ, Rosenblum MK, Holmes EJ, Zhou T, Jakacki RI. IDH1 mutations are common in malignant gliomas arising in adolescents: A report from the Children’s Oncology Group. Child’s Nerv Syst 27:87-94, 2011.

Jane EP, Premkumar D, Pollack IF. Bortezomib sensitizes malignant human glioma cells to TRAIL mediated by inhibition of the NF-ĸB signaling pathway. Molecular Cancer Ther 10:198-208, 2011.

Pollack IF, Stewart CF, Kocak M, Young-Poussaint T, Bronsicer A, Banerjee A, Douglas J, Kun LE, Boyett JM, Geyer JR. A phase II study of gefitinib and irradiation in children with newly diagnosed brain stem gliomas: A report from the Pediatric Brain Tumor Consortium. Neuro-Oncology 13:290-297, 2011.

Thaker NG, McDonald PR, Zhang F, Shun TY, Lewen MD, Pollack IF, Lazo JS. Identification of survival genes in human glioblastoma cells using siRNA screening. Molec Pharm 76:1246-1255, 2009.

Pollack IF, Hamilton RL, Sobol RW, Burnham J, Yates AJ, Holmes EJ, Zhou T, Finlay JL. O6-methylguanine-DNA methyltransferase expression strongly correlates with outcome in childhood malignant gliomas: Results from the CCG-945 cohort. J Clin Oncol 24:3431-3437, 2006.

Pollack IF, Finkelstein SD, Woods J, Burnham J, Holmes EJ, Hamilton RL, Yates AJ, Boyett JM, Finlay JL, Sposto R. Expression of p53 and prognosis in malignant gliomas in children. N Engl J Med 346:420-427, 2002.

A complete list of Dr. Pollack's publications can be reviewed through the National Library of Medicine's publication database.

Research Activities

1) Molecular Markers of Prognosis in Gliomas

Malignant astrocytomas are among the most common and deadly brain tumors of childhood. Most affected children die within several years of diagnosis, despite current treatments; however, 20 to 30% respond favorably to therapy and are cured. The basis for these diverse outcomes has been enigmatic, even taking into account clinical and histological factors. Our previous studies demonstrated a striking association between outcome and several molecular features in large multi-institutional cohorts, including MGMT expression status, independent of clinical or histological factors; identified significant differences between molecular features of childhood and adult gliomas; and generated a sizeable resource of tumor tissue for further analyses. Our ongoing studies are examining tumors derived from children enrolled on the most recent Children’s Oncology Group high-grade glioma studies, to define the genetic alterations that characterize pediatric malignant gliomas, as a basis for prioritizing novel targets for prognostic and therapeutic stratification. We hypothesize that categorization of these tumors by their genomic alterations and drug resistance phenotype will improve accuracy of diagnostic and prognostic assessments, and provide insights into novel therapeutic targets. To test these hypotheses, we have initiated studies with the following aims: 1) Assess the frequency, composition, and prognostic relevance of alterations in Akt and MAPK pathway activation in pediatric malignant gliomas; 2) Determine whether O6-methylguanine-DNA methyltransferase (MGMT) overexpression and promoter methylation are associated with progression-free survival, independent of alkylator therapy; 3) Define, on a genome-wide basis, the spectrum and prognostic relevance of genomic alterations in pediatric malignant gliomas, using high-density SNP microarray-based profiling. Relevant markers will be evaluated in the context of conventional prognostic factors, such as histology, to determine their utility for biologically classifying childhood malignant gliomas. Taken together, these studies will incorporate a unique resource of childhood malignant brain tumor samples to provide new insights into the molecular categorization of pediatric high-grade gliomas. This work will establish a foundation for risk-adapted stratification and treatment planning, and the design of future therapeutic strategies for children with these tumors.

2) Molecularly Targeted Therapies for Malignant Gliomas

The limited response of malignant gliomas to conventional therapy reflects resistance to undergoing apoptosis in response to DNA damage or mitogen depletion, resulting from tumor suppressor gene mutations and aberrant activation of growth factor signaling. However, our previous studies indicated that despite the limitation in apoptotic triggering, effector pathways of apoptosis may remain intact and can be activated by inhibiting growth factor-mediated signaling or stimulating death receptor pathways. These studies also demonstrated that although a subset of gliomas were responsive to modulation of individual signaling pathways, many showed incomplete growth inhibition, reflecting activation of parallel pathways or intrinsic resistance mechanisms. This led us to examine the efficacy of combinatorial strategies for signaling inhibition, using agents targeting distinct pathways. Based on our findings, we hypothesized that therapeutic approaches that block rationally selected combinations of growth signaling pathways or that enhance apoptosis signaling will provide a novel strategy for inducing glioma cytotoxicity. To test this hypothesis, we are examining the effects on glioma growth and viability of inhibiting combinations of parallel pathways that transmit proliferative signals from aberrantly activated upstream receptors. These studies incorporate a panel of cell lines with defined genetic alterations to assess whether genotypic features influence efficacy, and establish biological surrogates of response. Second, we are determining whether signaling mediators that promote caspase expression can enhance apoptosis induction, and evaluating biological factors that predict efficacy. Third, we are examining whether signaling modulation can enhance efficacy of radiotherapy and conventional chemotherapy in all, or a genotypically defined subset of, gliomas. These studies will provide a foundation for the translation of signal transduction inhibition as a therapeutic approach for gliomas, and indicate ways in which these strategies can be used to enhance efficacy of other therapies.

3) Vaccine Therapy for Pediatric Gliomas

Diffuse brainstem gliomas, other malignant astrocytomas, and recurrent low-grade gliomas and ependymoma carry a poor prognosis, and new therapies are needed. Having gained experience with immunotherapy for adult gliomas, we extended these insights to childhood gliomas, based on our observations regarding their profiles of glioma-associated antigen (GAA) expression. We initiated a pilot trial of subcutaneous vaccinations with peptides for GAA epitopes emulsified in Montanide-ISA-51 given every three weeks for eight courses along with intramuscular injections of poly-ICLC in HLA-A2+ children with newly diagnosed brainstem gliomas (BSG), high-grade gliomas (HGG), or recurrent gliomas. GAAs were EphA2, IL13Rα2, and survivin. Over 50 children have been treated to date in various pilot study cohorts. The primary objectives of this study were to assess immunologic response and safety, given that this was the first such trial in the pediatric age group. Principal toxicities have included local injection site reactions and low grade fevers and flu-like symptoms in almost all patients, referable to the poly-ICLC, which have been generally mild and controlled with acetaminophen or ibuprofen. To date, there have been seven cases of at least possible immunologically-mediated pseudoprogression, and analysis of advanced imaging features that correlate with this finding have been accepted for publication. Results in the initial pilot cohort of brainstem and high-grade gliomas were also published this year. Objective radiological responses have been observed in each of the cohorts, with a particularly high rate in the recurrent low-grade glioma stratum, and approximately 65% of children have demonstrated an immune response against at least one of the vaccine antigens based on ELISPOT analysis. 

More extensive analyses of efficacy in a multi-institutional context are planned within the Pediatric Brain Tumor Consortium. NIH funding has also been obtained for a study of this vaccine strategy in children with recurrent ependymomas, which is in progress.

Media Appearances

Immunotherapy
Fall 2014
UPMC Cancer Center 2014 Annual Report

Glioma: Pilot Trial Shows Peptide Vaccine Active in Pediatric Patients
May 25, 2012
Oncology Times

First-of-its-kind Study of Peptide Vaccine by Pittsburgh Researchers Shows Evidence of Immunological Response in Children with Gliomas
April 4, 2012
HealthCanal.com

Study Suggests Vaccine May Help Kids With Brain Cancer
April 3, 2012
U.S. News and World Report Health Day

Study Suggests Vaccine May Help Kids With Brain Cancer
April 3, 2012
Health.com

Study Suggests Vaccine May Help Kids With Brain Cancer
April 3, 2012
MSN Health

Peptide vaccine shows evidence of immunological, clinical activity in children with gliomas
April 3, 2012
MedicalExpress.com

Brain Tumor Vaccine for Children
April 2, 2012
WTAJ-TV (Johnstown)

Teen Has New Lease On Life After Brain Tumor Removal 
July 22, 2009
WTAE TV-4 (Pittsburgh) Evening News

Study finds clue to deadly childhood brain cancers
February 7, 2002
Pittsburgh Post-Gazette

UPMC On Topic Videos

Brain Care Institute: Expertise
Dr. Pollack talks about managing many of the unusual types of brain tumors.

Brain Care Institute: A Top-Notch Institution
Dr. Pollack talks about the advantages afforded by working at Children's Hospital of Pittsburgh.

Brain Care Institute: A Rewarding Experience
Dr. Pollack talks about the experiences that give him a great sense of satisfaction in his work.