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CNS Oncology

Nicholas F Brown, Thomas Carter, Paul Mulholland
Pleomorphic xanthoastrocytoma (PXA) is a rare brain tumor. Anaplastic features are found in 20-30% of cases of PXA and are associated with poor outcomes. Typical treatment is with gross total resection, followed by radiation therapy and cytotoxic chemotherapy at relapse. BRAFV600 mutations have been identified in 38-60% of patients with PXA. Several case reports and small case series have identified clinical benefit with BRAF inhibition in patients with BRAFV600-mutated PXA. We report the second published case of successful treatment with the BRAF inhibitor dabrafenib in a female patient with relapsed anaplastic PXA with a BRAFV600 mutation, and the first published case of dabrafinib treatment following intolerance to vemurafenib...
October 26, 2016: CNS Oncology
John Trusheim, Erin Dunbar, James Battiste, Fabio Iwamoto, Nimish Mohile, Denise Damek, Daniela A Bota, Jennifer Connelly
Tumor treating fields (TTFields) are an integral treatment modality in the management of glioblastoma and extend overall survival when combined with maintenance temozolomide in newly diagnosed patients. Complexities exist regarding correct selection of imaging sequences with which to perform TTFields treatment planning. Guidelines are warranted first, to facilitate treatment planning standardization across medical disciplines and institutions, to ensure optimal TTFields delivery to the tumor and peritumoral brain zone while maximizing patient safety, and also to mitigate the risk of premature cessation of a potentially beneficial treatment...
September 15, 2016: CNS Oncology
Varun R Kshettry, Khaled Elshazly, James J Evans
Tuberculum sella and planum sphenoidale meningiomas pose a management challenge given their intimate relationship to surrounding critical neurovascular structures. The development and advancement of expanded endoscopic transnasal surgery has provided a good surgical option that in well-selected cases, may provide several advantages over a transcranial route. These include early devascularization, complete dura and bone removal, elimination of brain retraction and enhanced visualization of the optic apparatus perforating vessels...
October 2016: CNS Oncology
Larry Junck, Maura Massimino
No abstract text is available yet for this article.
October 2016: CNS Oncology
Marc C Chamberlain
ASCO 2016, 29 May-2 June 2016, Chicago, IL, USA The largest annual clinical oncology conference the American Society of Clinical Oncology is held in the USA and gives researchers and other key opinion leaders the opportunity to present new cancer clinical trials and research data. The CNS tumors section of the American Society of Clinical Oncology 2016 covered various aspects of neuro-oncology including metastatic CNS diseases and primary brain tumors, presented via posters, oral talks and over 100 abstracts...
October 2016: CNS Oncology
Denis Migliorini, Sara Fertani, Pierre-Yves Dietrich
The standard management of a single brain metastasis is usually maximal resection when feasible followed by radiotherapy. In case of multiple lesions, several options have to be considered depending on the natural behavior of the primary tumor, the localization of brain lesions, their functional impact and related symptoms. In case of life-threatening brain metastasis, debulking surgery is often proposed first, with the risk of major bleeding and postponing the initiation of other treatments. This approach is now challenged by the rapid tumor shrinkage that could be observed with novel targeted therapies...
October 2016: CNS Oncology
Lennox Byer, Cassie Kline, Sabine Mueller
Brain tumors are the most common solid tumor in childhood, yet outcomes vary dramatically. High-grade gliomas have dismal outcomes with poor survival. By contrast, low-grade gliomas, have high survival rates, but children suffer from morbidity of tumor burden and therapy-associated side effects. In this article, we discuss how current trial designs often miss the opportunity to include end points beyond tumor response and thus fail to offer complete assessments of therapeutic approaches. Quality of life, neurocognitive function and neurofunctional deficits need to be considered when assessing overall success of a therapy...
October 2016: CNS Oncology
Ray R Zhang, Kyle I Swanson, Lance T Hall, Jamey P Weichert, John S Kuo
The following is a special report on alkylphosphocholine analogs as targeted imaging and therapy agents for cancer, and their potential role in diagnosis and treatment in glioblastoma and brain metastases. These novel cancer-targeting agents display impressive tumor avidity with low background in the normal brain, and multimodal diagnostic imaging and therapy capabilities. The use of these agents may significantly improve diagnosis, treatment and post-treatment follow-up in patients with brain malignancies.
October 2016: CNS Oncology
Soumya M Turaga, Justin D Lathia
Glioblastoma (GBM) is the most aggressive malignant primary brain tumor in adults with a high recurrence and mortality rate. GBM tumors contain a high degree of cellular heterogeneity, with cells exhibiting stem-like properties (cancer stem cells; CSCs) that are highly efficient at tumor initiation and are resistant to conventional therapies. CSCs interact with their tumor microenvironment by a large group of diverse cell adhesion molecules (CAMs) that participate in intercellular, intracellular and cell-extracellular matrix interactions...
October 2016: CNS Oncology
Laura E Donovan, Ashley V Arnal, Shih-Hsiu Wang, Yazmin Odia
Pituitary adenomas are the commonest intracranial tumor, but metastases are rare (0.2% yearly incidence) and portend poor prognosis. CAPecitabine and TEMozolomide improved outcomes for neuroendocrine tumors. However, no chemotherapy is approved for refractory pituitary carcinomas. Next-generation sequencing revealed an actionable mTOR pathway STK11 mutation in a woman with adrenocorticotropic hormone-secreting pituitary carcinoma refractory to six resections, radiation and CAPecitabine and TEMozolomide. Given efficacy in preclinical pancreatic cancer models with STK11 mutations, she received radiation and everolimus leading to clinical improvement and stability on MRI and PET for >6 months...
October 2016: CNS Oncology
Dina Randazzo, Katherine B Peters
All cancer patients experience distress from the diagnosis, the effects of the disease or the treatment. Clinically significant distress decreases overall quality of life and the recognition of distress with prompt intervention is essential. The National Comprehensive Cancer Network distress thermometer (NCCN-DT) is a validated measuring tool that has been utilized in the primary brain tumor population to detect psychologic distress thereby provoking a referral process to the appropriate support system. Brain tumor patients commonly reported emotional and physical distress encompassing: fatigue, fears, memory and concentration and worry...
October 2016: CNS Oncology
(no author information available yet)
No abstract text is available yet for this article.
July 2016: CNS Oncology
Sten Myrehaug, Hany Soliman, Chia-Lin Tseng, Mark Ruschin, David Larson, Arjun Sahgal
No abstract text is available yet for this article.
July 2016: CNS Oncology
Larry Junck, Maura Massimino
No abstract text is available yet for this article.
July 2016: CNS Oncology
Adrian G Murphy, Stuart A Grossman
We describe a 62-year-old of Egyptian origin who presented with sudden, severe and symptomatic anemia requiring hospitalization shortly after beginning concurrent radiation and temozolomide for his newly diagnosed glioblastoma. He had also recently been started on steroids, anticonvulsants and Pneumocystis jirovecii prophylaxis. He was ultimately diagnosed with G6PD deficiency with an acute hemolytic anemia precipitated by dapsone. Screening for G6PD deficiency should be considered in high-risk patient populations where P...
July 2016: CNS Oncology
Sean A Grimm, Marc C Chamberlain
Anaplastic astrocytoma (AA) is a diffusely infiltrating, malignant, astrocytic, primary brain tumor. AA is currently defined by histology although future classification schemes will include molecular alterations. AA can be separated into subgroups, which share similar molecular profiles, age at diagnosis and median survival, based on 1p/19q co-deletion status and IDH mutation status. AA with co-deletion of chromosomes 1p and 19q and IDH mutation have the best prognosis. AA with IDH mutation and no 1p/19q co-deletion have intermediate prognosis and AA with wild-type IDH have the worst prognosis and share many molecular alterations with glioblastoma...
July 2016: CNS Oncology
Sheila Mansouri, Romina Nejad, Merve Karabork, Can Ekinci, Ihsan Solaroglu, Kenneth D Aldape, Gelareh Zadeh
Tumors of the CNS are composed of a complex mixture of neoplastic cells, in addition to vascular, inflammatory and stromal components. Similar to most other tumors, brain tumors contain a heterogeneous population of cells that are found at different stages of differentiation. The cancer stem cell hypothesis suggests that all tumors are composed of subpopulation of cells with stem-like properties, which are capable of self-renewal, display resistance to therapy and lead to tumor recurrence. One of the most important transcription factors that regulate cancer stem cell properties is SOX2...
July 2016: CNS Oncology
Marc C Chamberlain
20th Annual Meeting of the Society for Neuro-Oncology, San Antonio, TX, USA, 18-22 November 2015 The Society for Neuro-Oncology is the largest neuro-oncology meeting in the USA that meets annually and provides a multiday venue that showcases new brain cancer clinical trial results and basic research primarily pertaining to gliomas. The Society for Neuro-Oncology 2015 meeting comprising one education day, 2 days of premeetings and 3 days of presentation, over 200 oral presentations and 900 abstracts provides an overview of contemporary neuro-oncology that includes metastatic disease of the central nervous system as well as primary brain tumors...
July 2016: CNS Oncology
Maurizio Lucchesi, Anna M Buccoliero, Silvia Scoccianti, Milena Guidi, Silvia Farina, Carla Fonte, Claudio Favre, Lorenzo Genitori, Iacopo Sardi
Malignant meningioma has a bad prognosis. Surgery and radiotherapy are the most effective therapeutic options, without an established role for chemotherapy. We report a case of 2-year-old male child with diagnosis of postoperative relapse of a malignant meningioma. Considering the rapid progression, the young age and the lack of effective therapeutic alternatives, the patient underwent multidisciplinary anticancer treatment with a protocol made for soft tissue sarcomas (EpSSG NRSSTS 2005 protocol), with positive outcome...
July 2016: CNS Oncology
Tiffany R Hodges, Sherise D Ferguson, Amy B Heimberger
Immunotherapy for glioblastoma (GBM) provides a unique opportunity for targeted therapies for each patient, addressing individual variability in genes, tumor biomarkers and clinical profile. As immunotherapy has the potential to specifically target tumor cells with minimal risk to normal tissue, several immunotherapeutic strategies are currently being evaluated in clinical trials in GBM. With the Precision Medicine Initiative being announced in the President's State of the Union Address in 2016, GBM immunotherapy provides a useful platform for changing the landscape in treating patients with difficult disease...
July 2016: CNS Oncology
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