Brian Na Joins the Neuro-Oncology Team at the UCSF Brain Tumor Center

Brian Na, MD, PhD earned his medical degree from Drexel University and completed his residency in pediatrics at UH Rainbow Babies & Children’s Hospital in Cleveland, OH. He then finished both a fellowship in pediatric oncology and a PhD in Molecular and Medical Pharmacology at UCLA. His clinical practice focuses on treating patients with neurofibromatosis (NF), a rare genetic condition that causes tumors to develop along nerves throughout the body, and schwannomatosis, a nervous system disorder characterized by painful and tingling noncancerous tumors. He also sees adult patients with brain tumors like ependymoma and medulloblastoma – which are more commonly seen in children.

Building a Multidisciplinary Adult Neurofibromatosis Clinic

We already have a very robust pediatric NF program at UCSF led by Dr. Alyssa Reddy, but patients with NF and those with schwannomatosis live through their childhood and into adulthood. There’s a real need to able to provide comprehensive NF care across the lifespan here in Northern California.

My main impetus for pursuing an adult neuro-oncology fellowship, which was very unusual for a pediatrician, was because of the NF patients I was seeing who were already adults and really couldn’t transition their care and the adolescent young adult patients with brain and spinal cord tumors who did not fit into traditional pediatric or adult categories.

Working with neurosurgeon Dr. Line Jacques, I’m now spearheading the adult NF program and creating a multidisciplinary service line with radiologists, pathologists, neurosurgeons, ENT surgeons, and everyone else who might be involved in the care for these patients. 

Long-Term Survivorship for Pediatric Patients

A lot of caring for patients with NF is anticipatory guidance as we like to say in pediatrics – surveillance and letting our patients know the treatment options for different tumor manifestations that can happen as they get older. There’s not really a standard of care, so it’s really a conversation between us and a family or a patient. It ends up being about a lot about symptom management and really trying to find what patients want for themselves. One drug might be a good option but may have some side effects that could intrude on quality of life. With the explosion of new therapies, we don’t know yet what the effects may be as they get older. 

And with NF, where you have this chronic condition across the lifespan, you really do need a holistic approach to care that involves family members and partners. 

Treatment Advances for NF

For our NF patients, the MEK inhibitors are a class of medications that have been really promising. There’s also been a huge push to develop immunotherapies in the brain tumor space and really in many other tumor contexts. Finally, we know that NF is a genetic condition, and although it’s very early in the development pipeline, another promising approach would be gene therapy. If we were able to fix the genetic issue causing the NF, then that would be a cure. We’re still very far from that, but there’s been a big push within our NF community for that type of treatment modality.

The Best Part of Being at UCSF

What really attracted me to UCSF was the fact that we have such a robust pediatric and adult brain tumor program. Not many programs are like that in the country. We have the Brain Tumor SPORE, which really is only given to programs with a track record of interdisciplinary research between clinicians and scientists. Then, Dr. Kevin Shannon, a renowned UCSF physician-scientist in NF1, co-leads an NF SPORE with Indiana University – called the DHART SPORE. 

We also have the clinical trials infrastructure in place to bring the latest treatments to our patients. We have a lot of clinical trials for children with NF1 mutations though the Pediatric Neuro-Oncology Consortium, and now, with our acceptance into the NF Clinical Trials Consortium, we can start bringing more innovative and needed clinical trials to the Bay Area.