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Francesco Soria, Andrea I Beleni, David D'Andrea, Irene Resch, Kilian M Gust, Paolo Gontero, Shahrokh F Shariat
OBJECTIVES: A small subset of patients treated with immune checkpoint inhibitors manifest atypical patterns of response, the so-called pseudoprogression (PP) and hyperprogression (HP). Their prevalence in urothelial (UC) and renal cancer (RCC) remains, to date, mostly uninvestigated. Therefore, we aimed to provide a summary of the current knowledge about PP and HP during immune checkpoint inhibitor therapy in UC and RCC patients. METHODS AND MATERIALS: A systematic medline/pubmed© literature search was performed...
March 16, 2018: World Journal of Urology
Martha Nowosielski, Patrick Y Wen
The identification of more effective therapies for brain tumors has been limited in part by the lack of reliable criteria for determining response and progression. Since its introduction in 1990, the MacDonald criteria have been used in neuro-oncology clinical trials to determine response, but they fail to address issues such as pseudoprogression, pseudoresponse, and nonenhancing tumor progression that have arisen with more recent therapies. The Response Assessment in Neuro-Oncology (RANO) working group, a multidisciplinary international group consisting of neuro-oncologists, medical oncologists, neuroradiologists, neurosurgeons, radiation oncologists, and neuropsychologists, was formed to improve response assessment and clinical trial endpoints in neuro-oncology...
February 2018: Seminars in Neurology
Nghi C Nguyen, Melissa K Yee, Abuzar M Tuchayi, John M Kirkwood, Hussein Tawbi, James M Mountz
Introduction: This pilot study aimed at exploring the utility of the proliferation tracer F-18 fluorothymidine (FLT) and positron-emission tomography (PET)/magnetic resonance imaging (MRI) (FLT-PET/MRI) for early treatment monitoring in patients with melanoma brain metastasis (MBM) who undergo targeted therapy or immunotherapy. Material and Methods: Patients with newly diagnosed MBM underwent baseline and follow-up FLT-PET/MRI scans at 3-4 weeks of targeted therapy or immunotherapy...
2018: Frontiers in Oncology
Jonathan D Breshears, Joseph Chang, Annette M Molinaro, Penny K Sneed, Michael W McDermott, Aaron Tward, Philip V Theodosopoulos
BACKGROUND: The optimal observation interval after the radiosurgical treatment of a sporadic vestibular schwannoma, prior to salvage intervention, is unknown. OBJECTIVE: To determine an optimal postradiosurgical treatment interval for differentiating between pseudoprogression and true tumor growth by analyzing serial volumetric data. METHODS: This single-institution retrospective study included all sporadic vestibular schwannomas treated with Gamma Knife radiosurgery (Eketa AB, Stockholm, Sweden; 12-13 Gy) from 2002 to 2014...
March 5, 2018: Neurosurgery
Hari Nandu, Patrick Y Wen, Raymond Y Huang
Imaging plays several key roles in managing brain tumors, including diagnosis, prognosis, and treatment response assessment. Ongoing challenges remain as new therapies emerge and there are urgent needs to find accurate and clinically feasible methods to noninvasively evaluate brain tumors before and after treatment. This review aims to provide an overview of several advanced imaging modalities including magnetic resonance imaging and positron emission tomography (PET), including advances in new PET agents, and summarize several key areas of their applications, including improving the accuracy of diagnosis and addressing the challenging clinical problems such as evaluation of pseudoprogression and anti-angiogenic therapy, and rising challenges of imaging with immunotherapy...
2018: Therapeutic Advances in Neurological Disorders
Mario Muto, Giulia Frauenfelder, Rossana Senese, Fabio Zeccolini, Emiliano Schena, Francesco Giurazza, Rolf Jager
INTRODUCTION: Distinction between treatment-related changes and tumour recurrence in patients who have received radiation treatment for brain metastases can be difficult on conventional MRI. In this study, we investigated the ability of dynamic susceptibility contrast (DSC) perfusion in differentiating necrotic changes from pathological angiogenesis and compared measurements of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and K2, using a dedicated software...
March 5, 2018: La Radiologia Medica
Surabhi Ranjan, Martha Quezado, Nancy Garren, Lisa Boris, Christine Siegel, Osorio Lopes Abath Neto, Brett J Theeler, Deric M Park, Edjah Nduom, Kareem A Zaghloul, Mark R Gilbert, Jing Wu
BACKGROUND: Immune checkpoint inhibitors (ICPIs) are being investigated in clinical trials for patients with glioblastoma. While these therapies hold great promise, management of the patients receiving such treatment can be complicated due to the challenges in recognizing immune-related adverse events caused by checkpoint inhibitor treatment. Brain imaging changes that are the consequence of an inflammatory response may be misinterpreted as disease progression leading to inappropriate premature cessation of treatment...
March 1, 2018: BMC Cancer
Nathan Nordmann, Molly Hubbard, Tyler Nordmann, Paul W Sperduto, H Brent Clark, Matthew A Hunt
Learning objectives To evaluate radiation-induced changes in patients with brain metastasis secondary to malignant melanoma who received treatment with Gamma Knife radiosurgery (GKRS) and programmed cell death 1 (PD-1) receptor antagonists. Introduction  Stereotactic radiosurgery and chemotherapeutics are used together for treatment of metastatic melanoma and have been linked to delayed radiation-induced vasculitic leukoencephalopathy (DRIVL). There have been reports of more intense interactions with new immunotherapeutics targeting PD-1 receptors, but their interactions have not been well described and may result in an accelerated response to GKRS...
December 13, 2017: Curēus
Gloria C Chiang, Ilhami Kovanlikaya, Changho Choi, Rohan Ramakrishna, Rajiv Magge, Dikoma C Shungu
Advances in metabolic imaging techniques have allowed for more precise characterization of gliomas, particularly as it relates to tumor recurrence or pseudoprogression. Furthermore, the emerging field of radiogenomics where radiographic features are systemically correlated with molecular markers has the potential to achieve the holy grail of neuro-oncologic neuro-radiology, namely molecular diagnosis without requiring tissue specimens. In this section, we will review the utility of metabolic imaging and discuss the current state of the art related to the radiogenomics of glioblastoma...
2018: Frontiers in Neurology
Jenny H Lee, Georgina V Long, Alexander M Menzies, Serigne Lo, Alexander Guminski, Kataraina Whitbourne, Michelle Peranec, Richard Scolyer, Richard F Kefford, Helen Rizos, Matteo S Carlino
Importance: Longitudinal circulating tumor DNA (ctDNA) has been shown to predict response and survival in patients with metastatic melanoma treated with anti-programmed cell death 1 (PD-1) antibodies. Pseudoprogression, defined as radiologic finding of disease progression prior to response, has been a challenge to clinicians. Objective: To establish whether ctDNA at baseline and up to week 12 of treatment can differentiate between the radiologic findings of pseudoprogression and true progression in patients with metastatic melanoma...
February 8, 2018: JAMA Oncology
Nacer Abrouk, Bryan Oronsky, Scott Caroen, Shoucheng Ning, Susan Knox, Donna Peehl
Responses to immuno-oncology agents are often subject to misinterpretation as apparent tumor growth due to immune infiltration leads to the appearance of progressive disease and can result in the discontinuation of effective therapeutic agents. Better statistical strategies to determine experimental outcomes are needed to distinguish between true and pseudoprogression. We applied time-to-event statistical analyses methods that account for study design features and capture the longitudinal and panoramic aspects of pseudoprogression to test superiority of a combination of RRx-001, a novel tumor-associated macrophage polarizing agent in Phase 2, and an anti-PD-L1 antibody in a myeloma preclinical model, comparing to traditional, mean-based mixed effects modeling approaches that did not show statistical significance...
February 5, 2018: Cancer Chemotherapy and Pharmacology
Patrick Grierson, Danielle Crites, Marianna B Ruzinova, Motoyo Yano, Kian-Huat Lim
There are few effective therapies for unresectable or metastatic hepatocellular carcinoma. Recent data have demonstrated efficacy of immune checkpoint blockade in this difficult to treat disease; however, clinical experience is limited. We report a case of hepatocellular carcinoma displaying pseudoprogression followed by a late response with novel magnetic resonance imaging features following treatment with the anti-programmed cell death protein 1 agent pembrolizumab. (Hepatology Communications 2018;2:148-151)...
February 2018: Hepatology Communications
M Kerkhof, I Ganeff, R G J Wiggenraad, G J Lycklama À Nijeholt, S Hammer, M J B Taphoorn, L Dirven, M J Vos
To assess the applicability of perfusion-weighted (PWI) magnetic resonance (MR) imaging in clinical practice, as well as to evaluate the changes in PWI in brain metastases before and after stereotactic radiotherapy (SRT), and to correlate these changes to tumor status on conventional MR imaging. Serial MR images at baseline and at least 3 and 6 months after SRT were retrospectively evaluated. Size of metastases and the relative cerebral blood volume (rCBV), assessed with subjective visual inspection in the contrast enhanced area, were evaluated at each time point...
February 1, 2018: Journal of Neuro-oncology
Chong Hyun Suh, Ho Sung Kim, Seung Chai Jung, Choong Gon Choi, Sang Joon Kim
OBJECTIVE: To evaluate the value of multiparametric MRI for determination of early treatment response following concurrent chemoradiotherapy in patients with newly diagnosed glioblastoma. METHODS: A computerized search of Ovid-MEDLINE and EMBASE up to 1 October 2017 was performed to find studies on the diagnostic performance of multiparametric MRI for differentiating true progression from pseudoprogression. The beginning search date was not specified. Pooled estimates of sensitivity and specificity were obtained using hierarchical logistic regression modeling...
January 26, 2018: European Radiology
Martin H Cherk, Grace Kong, Rodney J Hicks, Michael S Hofman
BACKGROUND: To evaluate the effects of long-acting somatostatin analogue (SSA) therapy on68 Ga-DOTA-octreotate (GaTate) uptake at physiological and metastatic sites in neuroendocrine tumour (NET) patients. METHODS: Twenty-one patients who underwent GaTate PET/CT before and after commencement of SSA therapy were reviewed. Maximum standardized uptake values (SUVmax) were measured in normal organs. Changes in uptake of 49 metastatic lesions in 12 patients with stable disease were also compared...
January 24, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
M Akiyama
No abstract text is available yet for this article.
December 2017: British Journal of Dermatology
Gil Awada, Jean Klastersky
PURPOSE OF REVIEW: The therapeutic armamentarium for advanced non-small-cell lung cancer has evolved considerably over the past years. Immune checkpoint inhibitors targeting programmed cell death-1 such as pembrolizumab and nivolumab or programmed cell death ligand 1 such as atezolizumab, durvalumab and avelumab have shown favorable efficacy results in this patient population in the first-line and second-line setting. These immunotherapies are associated with a distinct toxicity profile based on autoimmune organ toxicity which is a new challenge for supportive care during treatment with these drugs...
January 4, 2018: Current Opinion in Oncology
Š Houdek, T Büchler, E Kindlová
BACKGROUND: Immunotherapy is a relatively new and developing modality in oncological treatment, which may significantly improve treatment results for some patients with malignant tumors. With the increasing number of clinical trials, the demand for a suitable tool to assess and compare treatment responses is growing. Currently, the most common response assessment system for solid tumors is RECIST (response Evaluation Criteria in Solid Tumors) version 1.1. However, in immuno-oncology, a small percentage of patients manifest a new response pattern termed pseudoprogression, in which, after the initial increase in tumor burden or after the discovery of new lesions, a response or at least a prolonged stabilization of the disease can occur...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
P D Delgado-López, E Riñones-Mena, E M Corrales-García
The assessment of response to therapy in glioblastoma remains a challenge, because the surrogate measures of survival are subject to radiographic misinterpretation. A solid and reliable definition of progression is needed for both clinical decision-making and for evaluating response within the clinical trials. Historically, assessment criteria have used radiologic and clinical features aimed to correctly classify patients into progressive or non-progressive disease. The widely used RANO criteria are a valuable tool in disease evaluation, both in the clinical setting and in the clinical trials...
December 7, 2017: Clinical & Translational Oncology
Jörg Dietrich, Sebastian F Winter, Joshua P Klein
No abstract text is available yet for this article.
October 2017: Seminars in Neurology
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