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CNS Oncology

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https://www.readbyqxmd.com/read/28399638/tumor-treating-fields-plus-chemotherapy-versus-chemotherapy-alone-for-glioblastoma-at-first-recurrence-a-post-hoc-analysis-of-the-ef-14-trial
#1
Santosh Kesari, Zvi Ram
BACKGROUND: This post hoc analysis of the EF-14 trial (NCT00916409) of tumor-treating fields (TTFields) plus temozolomide versus temozolomide alone in newly diagnosed glioblastoma compared the efficacy of TTFields plus chemotherapy (physician's choice) versus chemotherapy alone after first recurrence. METHODS: Patients on TTFields plus temozolomide continued TTFields plus second-line chemotherapy after first recurrence. Some patients on temozolomide alone crossed over after approval of TTFields for recurrent GBM...
April 12, 2017: CNS Oncology
https://www.readbyqxmd.com/read/28530445/gamma-knife-treatment-of-recurrent-cns-metastases-of-pancreatic-origin-a-case-report-and-review-of-the-literature
#2
Subha Perni, Tony J Wang, Jerry Lesser, Christopher Mandigo, Steven R Isaacson, David P Horowitz
Brain metastases (BM) of pancreatic origin are extremely rare. We review the literature around BM of pancreatic origin and describe a 38-year-old woman who developed BM 10 months after pancreaticoduodenectomy for treatment of pancreatic adenocarcinoma. She underwent resection and fractionated stereotactic radiotherapy followed by re-resection and Gamma Knife radiosurgery (GKRS) when the lesion recurred. She then developed two new BM, and was treated with GKRS. The patient is alive without progression 38 months after her most recent GKRS...
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425773/prognostic-value-of-pre-and-post-treatment-health-related-quality-of-life-in-predicting-survival-of-patients-with-brain-metastases
#3
Erin Wong, Leigha Rowbottom, May Tsao, Liying Zhang, Rachel McDonald, Cyril Danjoux, Elizabeth Barnes, Stephanie Chan, Edward Chow
AIM: The present study aimed to determine the prognostic survival value of pretreatment health-related quality of life (HRQOL) and changes in HRQOL following whole-brain radiation treatment in patients with brain metastases. METHODS: Patients who were treated with whole-brain radiation treatment and completed HRQOL questionnaires were included. Univariate and multivariate Cox proportional hazard models of overall survival (OS) were conducted for overall HRQOL and domain scores...
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425771/review-of-stereotactic-radiosurgery-for-intradural-spine-tumors
#4
Taylor E Purvis, C Rory Goodwin, Daniel Lubelski, Ilya Laufer, Daniel M Sciubba
Stereotactic radiosurgery (SRS) has become an increasingly popular treatment modality for spinal tumors due to its noninvasive and targeted approach. Whether SRS has the promise of relieving pretreatment symptoms and providing local tumor control for patients with intradural spine tumors is still debated. This review explores the current literature on SRS treatment for both metastatic and benign intradural tumors, with a focus on differential use for intramedullary and intradural extramedullary neoplasms. Although mortality rates from underlying malignant disease remain high, SRS may benefit patients with spinal metastatic lesions...
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425764/braf-v600e-mutant-papillary-craniopharyngioma-dramatically-responds-to-combination-braf-and-mek-inhibitors
#5
Ashley Roque, Yazmin Odia
We present a patient with BRAF-V600E mutant papillary craniopharyngioma successfully treated with combination BRAF (dabrafenib 150 mg twice daily) and MEK (trametinib 2 mg daily) inhibitors after her unresectable tumor proved refractory to radiation. Serial brain MRIs and PET revealed marked tumor reduction with gradual neurological improvement and permanent panhypopituitarism.
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425763/our-panel-of-experts-highlights-the-most-important-research-articles-across-the-spectrum-of-topics-relevant-to-the-field-of-cns-oncology
#6
Larry Junck, Maura Massimino
Expert panel: Larry Junck, University of Michigan Health System, MI, USA; Maura Massimino, Fondazione Istituto di Ricovero & Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy.
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425761/adult-pilocytic-astrocytoma-of-conus-medullaris-clinical-considerations-and-review-of-the-literature
#7
José Pedro Lavrador, Edson Oliveira, José Pimentel, Sérgio Livraghi
Astrocytomas are responsible for 30% of all primitive intramedullary tumors with cervicothoracic predominance. However, only about one hundred cases of intramedullary pilocytic astrocytomas were described. The authors described the case of a 69 year-old patient presenting with a broad-base gait, bilateral pain and dysesthesia of inferior limbs with a diagnosis of an intra-axial cystic lesion centered to the conus medullaris, diagnosed as pilocytic astrocytoma of conus medullaris (PACM) after surgery. To the best of our knowledge, only two previous reports concerning PACM were made...
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425756/cns-hemangioblastomatosis-in-a-patient-without-von-hippel-lindau-disease
#8
Arie Franco, Peter Pytel, Rimas V Lukas, Rupa Chennamaneni, John M Collins
We report on a case of disseminated CNS hemangioblastoma, also referred to as hemangioblastomatosis, involving the supratentorial compartment and the entire spine. The patient presented with new onset headache, gait difficulties and memory deficits many years following resection of a hemangioblastoma from the cerebellum. The patient's family history was negative for von Hippel-Lindau (VHL) disease, and his personal history was negative for any additional VHL-defining lesions. Imaging revealed extensive dural caking and nodularity both supratentorially and in the spine, along with scattered parenchymal tumors showing a more typical appearance for hemangioblastoma...
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28425754/immunotherapy-and-targeted-therapy-in-brain-metastases-emerging-options-in-precision-medicine
#9
Tyler Lazaro, Priscilla K Brastianos
Brain metastases (BM) continue to represent an unmet clinical need in oncology. Immunotherapy and targeted therapy hold great promise in the treatment of BM. Emerging data are confirming the activity of these agents in patients with BM. Genomic studies have confirmed that clinically actionable mutations are present in BM and they can be used in clinical studies to link targeted therapies with their genetic targets. Furthermore, as molecular signatures associated with sensitivity and resistance to immunotherapies are developed, we will better be able to select BM patients who will most benefit from these therapies...
April 2017: CNS Oncology
https://www.readbyqxmd.com/read/28303729/case-of-glioblastoma-patient-treated-with-tumor-treating-fields-therapy-at-recurrence-degenerating-to-sarcoma
#10
Pejman Majd, Daniel E O'Connell, Ronald C Kim, Daniela A Bota, Jose A Carrillo
Optune(®) treatment is a US FDA-approved treatment for glioblastoma (GBM) that employs alternating electric fields. Tumor treating field (TTF) therapy can exert its effects on GBM via cell cycle mitosis disruption and cytokinesis. We describe a patient with recurrent GBM who had disease progression following standard surgical treatment and concomitant chemoradiotherapy, and was found to have sarcomatous transformation after initiation of TTF therapy with bevacizumab. Upon tumor progression, repeat surgical resection revealed transformation into a GFAP-negative, reticulin-positive sarcoma with rhabdomyoid features...
March 17, 2017: CNS Oncology
https://www.readbyqxmd.com/read/28001091/treatment-options-for-recurrent-high-grade-gliomas
#11
REVIEW
Harjus S Birk, Seunggu J Han, Nicholas A Butowski
High-grade gliomas are aggressive brain tumors encompassing Grade III and IV classifications. Of these, glioblastoma (GB) is the most malignant with a high rate of recurrence after initial resection. Although standard treatment does exist for newly diagnosed GBs, therapeutic strategies for recurrent GB are less solidified. However, mounting evidence describes the role of re-resection, bevacizumab, chemotherapy, targeted molecular therapies, immunotherapeutic approaches and radiotherapy in recurrent GB management...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/28001090/recent-technological-advances-in-pediatric-brain-tumor-surgery
#12
REVIEW
Bassel Zebian, Francesco Vergani, José Pedro Lavrador, Soumya Mukherjee, William John Kitchen, Vita Stagno, Christos Chamilos, Benedetta Pettorini, Conor Mallucci
X-rays and ventriculograms were the first imaging modalities used to localize intracranial lesions including brain tumors as far back as the 1880s. Subsequent advances in preoperative radiological localization included computed tomography (CT; 1971) and MRI (1977). Since then, other imaging modalities have been developed for clinical application although none as pivotal as CT and MRI. Intraoperative technological advances include the microscope, which has allowed precise surgery under magnification and improved lighting, and the endoscope, which has improved the treatment of hydrocephalus and allowed biopsy and complete resection of intraventricular, pituitary and pineal region tumors through a minimally invasive approach...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/28001089/the-role-of-the-immune-system-in-neurofibromatosis-type-1-associated-nervous-system-tumors
#13
REVIEW
Souvik Karmakar, Karlyne M Reilly
With the recent development of new anticancer therapies targeting the immune system, it is important to understand which immune cell types and cytokines play critical roles in suppressing or promoting tumorigenesis. The role of mast cells in promoting neurofibroma growth in neurofibromatosis type 1 (NF1) patients was hypothesized decades ago. More recent experiments in mouse models have demonstrated the causal role of mast cells in neurofibroma development and of microglia in optic pathway glioma development...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/28001088/glioblastoma-in-the-elderly-treatment-patterns-and-survival
#14
Jean-Aine Pretanvil, Isaac Q Salinas, David E Piccioni
AIM: The optimal treatment for elderly glioblastoma patients is unclear. We conducted a retrospective review of the California Cancer Registry to examine treatment patterns and survival by age. METHODS: We identified 2670 adult patients from the California Cancer Registry with glioblastoma. We compared the extent of resection, treatment type and modality. RESULTS: Elderly patients had the greatest overall survival (OS) with combined surgery, radiation and chemotherapy...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/27918194/first-report-of-tumor-treating-fields-use-in-combination-with-bevacizumab-in-a-pediatric-patient-a-case-report
#15
Daniel O'Connell, Violet Shen, William Loudon, Daniela A Bota
We report the first case of a pediatric patient with glioblastoma (GBM; WHO grade IV astrocytoma) successfully treated with tumor treating fields (TTF). The patient was diagnosed with GBM when 13 years of age and progressed through surgical resection, radiotherapy and chemotherapy. Discrete tumor growth visualized on MRI with stable neurological examination was monitored for 6 months with subsequent stable disease observed radiographically and clinically for 7 months while adherent to Optune(®) (TTF). TTF thereby played a role in forestalling recurrent GBM growth in this young woman for 7 months without significant adverse effects...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/27781490/dabrafenib-in-brafv600-mutated-anaplastic-pleomorphic-xanthoastrocytoma
#16
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...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/27628854/a-state-of-the-art-review-and-guidelines-for-tumor-treating-fields-treatment-planning-and-patient-follow-up-in-glioblastoma
#17
REVIEW
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...
January 2017: CNS Oncology
https://www.readbyqxmd.com/read/27671322/endoscopic-transnasal-surgery-for-planum-and-tuberculum-sella-meningiomas-decision-making-technique-and-outcomes
#18
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
https://www.readbyqxmd.com/read/27616612/neuro-oncology-a-selected-review-of-asco-2016-abstracts
#19
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
https://www.readbyqxmd.com/read/27616484/upfront-targeted-therapy-for-symptomatic-melanoma-brain-metastases-paradigm-changing
#20
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
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