Clinical Focus

• Cancer> Neuro Oncology
• Brain / Central Nervous System Tumors
• Brain / Central Nervous System Tumors - Neuro Oncology
• Brain / Central Nervous System Tumors - Neurosurgery
• Neurological Surgery

Administrative Appointments

• Robert C. and Jeannette Powell Professor in the Neurosciences, Stanford (2008 - present)
• Director, Stanford Neurogenetics Program (2010 - present)
• Director, Stanford Neuromolecular Innovation Program (2009 - present)
• Editorial Board, World Neurosurgery (2010 - present)
• Co-Director, Stanford Cyberknife Program, Stanford (2003 - present)

Honors and Awards

• Robert C. and Jeannette Powell Professor in the Neurosciences, Stanford University (2008-)

Professional Education

Graduate & Fellowship Program Affiliations

• Neurosurgery

Internet Links

• Stanford Neuromolecular Innovation Program

Current Research Interests

The Stanford Neurogenetic Innovation Program (SNIP) brings together clinical experts with the goal of developing new technologies to improve the diagnosis and treatment of patients affected by neurological conditions. Dr. Steven D. Chang, M.D., Professor of Neurosurgery, is leading SNIP’s research efforts, which can be divided into three broad categories: (1) Neural Stem Cells, (2) New Blood Vessel Growth and Response to Radiosurgery, and (3) Nanotechnology and Microfluidic Biochips

1. Neural Stem Cells
SNIP researchers recently found that the ability of stem cells in the brain to regenerate themselves and produce new nerves is a process guided by signals from neighboring cells, in particular the cells that make up our blood vessels. SNIP researchers have succeeded in isolating stem cells from brain tumor tissue. It is possible that errors in the programming of these tumor stem cells may result in abnormal growth of tissue and the development of brain tumors. Similar to neural stem cells, these tumor stem cells are located around the blood vessels that feed the tumor. SNIP researchers are currently studying the stem cells present in brain tumors and vascular malformations to determine what changes occurred in these cells to cause them to produce or promote disease. With this knowledge, it may soon be possible to discover new therapies for affected patients, prevent recurrent tumor growth, identify genetic risk factors, and develop preventative therapies to protect against development of disease.

2. New Blood Vessel Growth and Response to Radiosurgery
Understanding the process by which new blood vessels grow in the brain is important for research on (1) stroke recovery, 2) Blood vascular malformations that are characterized by overgrowth or dysfunction of vascular elements, e.g. arteriovenous malformations, and (3) brain tumors, which grow on the basis of new blood vessel formation to feed the tumor. SNIP researchers have recently found that circulating cells, previously thought only to have functions in our immune system, are recruited to areas of new blood vessel growth in the brain. SNIP researchers hope to develop new therapies that travel through the bloodstream to affect this process in order to directly treat vascular malformations and brain tumors. SNIP researchers are examining genetic variation in key genes responsible for vascular health and response to radiation injury to explain patient variations in response to radiosurgery.

SNIP researchers are also leading efforts in biomarker discovery, a process that focuses on the isolation of circulating factors in the bloodstream of patients that may relate to specific characteristics of their tumor or vascular malformation. These biomarkers are being obtained on all patients undergoing neurosurgery for removal of their tumor or vascular malformation. Differences in biomarkers are being related to characteristics of the specimen obtained from surgery to determine whether these noninvasive measurements can reveal information specific to radiation susceptibility. Dr. Chang hopes to one day offer his patients a simple blood test that he can use to determine whether a particular patient will benefit from neurosurgery versus radiosurgery, i.e. the goal of practicing personalized medicine.

3. Nanotechnology and Microfluidic Biochips
Microfluidic systems can perform conventional chemical and molecular processes on a biochip, allowing for sample metering, mixing, reactions and detection—processes that usually require a laboratory full of equipment to be integrated and miniaturized onto chips no larger than the size of a standard glass slide. SNIP researchers are now focusing on prototyping new biochips to directly isolate specific cell populations and biomarkers using nanotechnology in order to develop tools that can enable SNIP clinicians to improve the diagnostics and treatment options available to patients affected by neurological conditions.

Clinical Trials

• Cyberknife Radiosurgery and Quality of Life Recruiting
• Minimally Invasive Surgery Plus rt-PA for ICH Evacuation (MISTIE) Recruiting
• PI/II of Temozolomide & Hypofractionated Radiotherapy in Tx of Supratentorial Glioblastoma Multiform Recruiting
• Phase I Vorinostat Concurrent with Stereotactic Radiosurgery (SRS) in Brain Metastases from Non-Small Cell Lung Cancer Recruiting
• Phase I/II Study of Fractionated Stereotactic Radiosurgery to Treat Large Brain Metastases Recruiting

Publications

• Stereotactic radiosurgery for central neurocytoma: a quantitative systematic review. Park HK, Chang SD. J Neurooncol. 2012
• Successful repair of a gunshot wound to the head with retained bullet in the torcular herophili. Pricola KL, Zou H, Chang SD. World Neurosurg. 2011 Sep-Oct; 76 (3-4): 362.e1-4
• Ectopic acromegaly due to a pancreatic neuroendocrine tumor producing growth hormone-releasing hormone. Weiss DE, Vogel H, Lopes MB, Chang SD, Katznelson L. Endocr Pract. 2011 Jan-Feb; 17 (1): 79-84
• Clinical Neuroproteomics and Biomarkers: From Basic Research to Clinical Decision-making. Shoemaker LD, Achrol AS, Sethu P, Steinberg GK, Chang SD. Neurosurgery. 2011
• CyberKnife stereotactic radiosurgery for recurrent, metastatic, and residual hemangiopericytomas. Veeravagu A, Jiang B, Patil CG, Lee M, Soltys SG, Gibbs IC, Chang SD. J Hematol Oncol. 2011: 4 26