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CNS Oncology

Charles Cobbs, Edward McClay, J Paul Duic, L Burt Nabors, Donna Morgan Murray, Santosh Kesari
AIM: Evaluation of the Nativis Voyager® device in patients with recurrent glioblastoma (rGBM). MATERIALS & METHODS: Voyager is a noninvasive, nonthermal, nonionizing and portable investigational device which delivers ultra-low radio frequency energy (ulRFE® ) that uses a magnetic field to penetrate tissues to alter specific biologic functions within cells. Patients with rGBM were treated with Voyager alone (V) or Voyager in combination with standard of care (V + SoC)...
December 14, 2018: CNS Oncology
Paul MacMahon, Collin M Labak, Sarah E Martin-Bach, Ahmad Issawi, Kiran Velpula, Andrew J Tsung
BACKGROUND: Transformation to glioblastoma following recurrent epidermoid cyst resection has not been reported. Chronic inflammation can underlie malignant transformation of epidermoid cysts. Astrogliosis following repeated resections may have induced the rare transformation to glioblastoma. CLINICAL PRESENTATION: A patient presenting with left lower extremity weakness was found to harbor a parietal mass lesion. Histopathology demonstrated an epidermoid cyst. Following multiple re-resections, an intra-axial mass was discovered within the operative bed, confirmed as glioblastoma...
December 13, 2018: CNS Oncology
Enrique Orrego, Carlos A Castaneda, Miluska Castillo, Luis A Bernabe, Sandro Casavilca, Arnab Chakravarti, Wei Meng, Pamela Garcia-Corrochano, Maria R Villa-Robles, Rocio Zevallos, Omar Mejia, Pedro Deza, Carolina Belmar-Lopez, Luis Ojeda
AIM: Evaluation of features related to infiltrating immune cell level in glioblastoma. METHODS: Tumor-infiltrating lymphocytes (TILs) through H&E staining, and TILs (CD3, CD4, CD8 and CD20) and macrophage (CD68 and CD163) levels through immunohistochemistry were evaluated through digital analysis. RESULTS: CD68 (9.1%), CD163 (2.2%), CD3 (1.6%) and CD8 (1.6%) had the highest density. Higher CD4+ was associated with unmethylated MGMT (p = 0...
October 9, 2018: CNS Oncology
Christian Brogna, José Pedro Lavrador, Sabina Patel, Eduardo C Ribas, Miren Aizpurua, Francesco Vergani, Keyoumours Ashkan, Ranjeev Bhangoo
Sylvian fissure meningiomas (SFMs) represent a rare subgroup of nondural-based tumors arising from the meningothelial cells within the arachnoid of the Sylvian fissure. SFMs are more frequent in young males, usually manifest with seizures and display the same radiological features of meningiomas in other locations. Although the absence of dural attachment makes these tumors suitable for a complete resection, their anatomical relationships with the middle cerebral artery branches have impaired its achievement in half of them...
October 2, 2018: CNS Oncology
Lisa Modelevsky, Richard Tizon, Samantha N Reiss, Marcel Smith, Rachel Garonce, Thomas Kaley
AIM: To establish the safety and feasibility of rapidly infusing rituximab over 90 min in patients with primary CNS lymphoma (PCNSL). PATIENTS & METHODS: We retrospectively reviewed all patients with PCNSL who received rapid rituximab infusions (RRI) from January 2016 to January 2017. Primary end point was incidence of infusion reactions. RESULTS & CONCLUSION: 11 patients received a total of 44 RRIs. Rituximab was dosed at 500 or 750 mg/m2 ...
July 1, 2018: CNS Oncology
Daniela A Bota, Jinah Chung, Manisha Dandekar, Jose A Carrillo, Xiao-Tang Kong, Beverly D Fu, Frank Pk Hsu, Axel H Schönthal, Florence M Hofman, Thomas C Chen, Raphael Zidovetzki, Chrystel Pretto, Ankie Strik, Virgil Ejc Schijns, Apostolos Stathopoulos
AIM: ERC1671 is an allogeneic/autologous therapeutic glioblastoma (GBM) vaccine - composed of whole, inactivated tumor cells mixed with tumor cell lysates derived from the patient and three GBM donors. METHODS: In this double-blinded, randomized, Phase II study bevacizumab-naive patients with recurrent GBM were randomized to receive either ERC1671 in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF) (Leukine®  or sargramostim) and cyclophosphamide plus bevacizumab, or placebo plus bevacizumab...
July 1, 2018: CNS Oncology
Gregory F Guzauskas, Marc Salzberg, Bruce Cm Wang
AIM: To estimate the mean lifetime survival benefit, an essential component of health economic evaluations in oncology, of adding tumor treating fields (TTFields) to maintenance temozolomide (TMZ) for newly diagnosed glioblastoma patients. METHODS: We integrated EF-14 trial data with glioblastoma epidemiology data. The model provided for an evidence-based approach to estimate lifetime survival for the material number of EF-14 trial patients still alive at 5 years...
July 1, 2018: CNS Oncology
Konstantin Brawanski, Gero Brockhoff, Peter Hau, Arabel Vollmann-Zwerenz, Christian Freyschlag, Annette Lohmeier, Markus J Riemenschneider, Claudius Thomé, Alexander Brawanski, Martin A Proescholdt
AIM: Recently, D,L-methadone has been put forward as adjuvant treatment in glioblastoma (GBM). METHODS: We analyzed the μ-opioid receptor expression in a set of GBM cell lines and investigated the efficacy of D,L-methadone alone and in combination with temozolomide (TMZ). Results & conclusion: Expression of the μ-opioid receptor was similar in the tested cell lines. High concentrations of D,L-methadone induced apoptosis in all cell lines and showed treatment interaction with TMZ...
July 1, 2018: CNS Oncology
Andrea Wasilewski, Nimish Mohile
BACKGROUND: Adult pilocytic astrocytomas are rare and highly vascular tumors. AIM: We hypothesized that they may be uniquely responsive to bevacizumab (BEV). PATIENTS: We present four adult patients with pathologically diagnosed WHO grade I pilocytic astrocytoma who had robust and durable responses to BEV at time of recurrence. Three patients developed radiographic changes on MRI, consistent with progressive disease based on response assessment in neuro-oncology criteria...
July 1, 2018: CNS Oncology
Tine Rosenberg, Charlotte Aaberg-Jessen, Stine Asferg Petterson, Bjarne Winther Kristensen
AIM: To investigate the time profile of hypoxia and stem cell markers in glioblastoma spheroids of known molecular subtype. MATERIALS & METHODS: Patient-derived glioblastoma spheroids were cultured up to 7 days in either 2% or 21% oxygen. Levels of proliferation (Ki-67), hypoxia (HIF-1α, CA9 and VEGF) and stem cell markers (CD133, nestin and musashi-1) were investigated by immunohistochemistry. RESULTS: Hypoxia markers as well as CD133 and partially nestin increased in long-term hypoxia...
April 2018: CNS Oncology
Rimas V Lukas, Ryan T Merrell
Pleomorphic xanthoastrocytomas can be very resistant to treatment if they progress after standard therapy with surgery and radiation. We present the case of a patient with a multiply recurrent pleomorphic xanthoastrocytoma which demonstrated a sustained partial response to a combination regimen of the BRAF inhibitor vemurafenib and tumor treating fields. The regimen proved tolerable and efficacious in this case.
April 2018: CNS Oncology
Zehra Pınar Koç, Pelin Özcan Kara, Ahmet Dağtekin
AIM:  F-18 fluorodeoxyglucose (FDG) PET/CT has several advantages in diagnosis of cancer of unknown primary with reported incremental diagnostic value. In this study, we evaluated the patients who were presented with multiple brain metastasis and unknown primary tumor. MATERIALS & METHODS: 31 patients (17 males, 14 females; mean: 56.1 ± 14.22 years old) with diagnosis of brain metastasis according to histopathology and/or MRI were included into this retrospective study...
April 2018: CNS Oncology
Emily C Merfeld, Sonika Dahiya, Stephanie M Perkins
AIM: To evaluate the use of chemotherapy and radiation, and their outcomes for patients with astroblastoma. PATIENTS & METHODS: This is a retrospective review of patients extracted from the National Cancer Database. We investigated overall survival (OS) using Kaplan-Meier curves. Cox proportional hazards models were used to correlate OS with risk variables and treatments. RESULTS: OS at 5 years was 79.5%. Patients with high-grade tumors were more likely to receive chemotherapy and radiation...
April 2018: CNS Oncology
Vijay M Patil, Nikhil Pande, Arun Chandrasekharan, Chandrakanth M, Raees Tonse, Rahul Krishnatry, Jayant S Goda, Hollis Dsouza, Dilip Harindran Vallathol, Santam Chakraborty, Tejpal Gupta, Rakesh Jalali
AIM: This study was designed with a primary objective to study the rate of agreement in treatment plan and decisions between video follow-up (VF) and conventional clinic follow-up (CF). PATIENTS & METHODS: Adult patients with intermediate- to high-grade glioma on adjuvant temozolomide (TMZ) with facilities for live video call were invited to participate in the study. RESULTS: The concurrence in decision of administering TMZ between VF and CF was 100% (p < 0...
April 2018: CNS Oncology
Shamsudini Hashi, Courtney Rory Goodwin, Ali Karim Ahmed, Daniel M Sciubba
Extranodal lymphoma of the spine is often a late manifestation of systemic disease, and may result in symptoms of pain, neurologic compromise or spinal instability. Symptomatic relief is generally achieved by radiotherapy alone, but is not sufficient in addressing spinal instability. The indications for surgery remain controversial, but may be required for spinal stabilization, or refractory disease. Currently, there is a lack of studies that compare the indications and clinical outcomes of patients receiving surgical and nonsurgical management of spinal extranodal lymphoma...
April 2018: CNS Oncology
Jason T Pham, Ronald C Kim, Anna Nguyen, Daniela Bota, Xiao-Tang Kong, Sumeet Vadera, Frank Hsu, Jose A Carrillo
Meningiomas have been implicated as the most common primary intracranial tumor to contain tumor-to-tumor metastasis. In the following two case reports, we describe cases of adenocarcinoma and breast carcinoma that metastasized into an intracranial meningioma. The first patient was a 64-year-old man presenting to the emergency department with seizures and loss of consciousness. After a left frontal mass resection, pathology reported a heterogeneous mass consisting of a meningioma and a metastatic adenocarcinoma component...
April 2018: CNS Oncology
Kirsty J Martin-McGill, Nisaharan Srikandarajah, Anthony G Marson, Catrin Tudur Smith, Michael D Jenkinson
AIM: We performed a systematic review of the evidence for effectiveness and acceptability of different ketogenic diets (KDs) in the therapeutic management of gliomas. METHODS: The search strategy included searches of seven electronic databases. Data extraction and quality assessment were undertaken independently by two authors. RESULTS: No randomized clinical trials were identified. Six studies (n = 39) met the eligibility criteria for this review - all were case series or reports and therefore at high risk of bias...
April 2018: CNS Oncology
Victor A Levin, Sandra E Ictech, Kenneth R Hess
This review covers the literature between 1989 and 2007 on studies relevant to the neuro-oncology usage of eflornithine (α-difluoromethylornithine), an oral agent that irreversibly inhibits the enzyme ornithine decarboxylase. It covers the use of eflornithine, alone or in combination, to treat high-grade gliomas. In addition, we provide an update on overall survival from The University of Texas MD Anderson Cancer Center Community Clinical Oncology Program and Clinical Trials Data Office that demonstrates a meaningful benefit in overall survival for eflornithine as a single agent and in combination with nitrosourea-based therapies for anaplastic gliomas...
April 2018: CNS Oncology
Kevin O Lillehei, Steven N Kalkanis, Linda M Liau, Dellann Elliott Mydland, Jeffrey Olson, Nina A Paleologos, Timothy Ryken, Tania Johnson, Evan Scullin
Implantation of biodegradable wafers impregnated with carmustine (BCNU) is one of the few chemotherapeutic modalities that have been evaluated in Phase III trials and approved by the US FDA for treatment of newly diagnosed high-grade glioma and recurrent glioblastoma. Enrolling up to 500 patients for 3-year follow-up at over 30 sites, the prospective Vigilant ObservatIon of GlIadeL WAfer ImplaNT (VIGILANT) registry (NCT02684838) will evaluate BCNU wafers for treatment of CNS malignancies in contemporary practice and in the new era of molecular tumor analysis...
April 2018: CNS Oncology
Cheng-Hung Tai, Cheng-Chia Wu, Mark E Hwang, Anurag Saraf, Christopher Grubb, Ashish Jani, Matthew E Lapa, Jacquelyn I S Andrews, Steven R Isaacson, Adam M Sonabend, Sameer A Sheth, Guy M McKhann, Michael B Sisti, Jeffrey N Bruce, Simon K Cheng, Eileen P Connolly, Tony Jc Wang
AIM: The number of breast cancer brain metastases is a prognostic clinical variable in the modified graded prognostic assessment (GPA) Index for breast cancer. PATIENTS & METHODS: We retrospectively gathered data from 127 breast cancer patients who underwent radiation therapy for brain metastasis. Patients were stratified by both breast GPA and modified breast GPA scores, and survival was determined using the Kaplan-Meier curves and Cox proportional hazards model...
January 2018: CNS Oncology
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