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Lisa DeAngelis leptomeningeal

Alissa Thomas, Marc Rosenblum, Sasan Karimi, Lisa M DeAngelis, Antonio Omuro, Thomas J Kaley
Interpretation of MRI abnormalities in patients with malignant gliomas (MG) treated with bevacizumab is challenging. Recent reports describe quantitative analyses of diffusion-weighted imaging abnormalities not available in standard clinical settings, to differentiate tumor recurrence from treatment necrosis. We retrospectively reviewed bevacizumab treated MG patients who underwent surgery or autopsy to correlate radiographic recurrence patterns with pathologic findings. 32 patients with MG (26 glioblastoma, three anaplastic astrocytoma and three anaplastic oligodendroglioma) were identified...
January 2018: CNS Oncology
Xuling Lin, Martin Fleisher, Marc Rosenblum, Oscar Lin, Adrienne Boire, Samuel Briggs, Yevgeniya Bensman, Brenda Hurtado, Larisa Shagabayeva, Lisa M DeAngelis, Katherine S Panageas, Antonio Omuro, Elena I Pentsova
Background: Diagnosis of leptomeningeal metastasis (LM) remains challenging due to low sensitivity of CSF cytology and infrequent unequivocal MRI findings. In a previous pilot study, we showed that rare cell capture technology (RCCT) could be used to detect circulating tumor cells (CTC) in the CSF of patients with LM from epithelial tumors. To establish the diagnostic accuracy of CSF-CTC in the diagnosis of LM, we applied this technique in a distinct, larger cohort of patients. Methods: In this institutional review board-approved prospective study, patients with epithelial tumors and clinical suspicion of LM underwent CSF-CTC evaluation and standard MRI and CSF cytology examination...
September 1, 2017: Neuro-oncology
Macarena I de la Fuente, Lisa M DeAngelis
OBJECTIVES: To assess the impact of ventriculoperitoneal (VPS) in patients with glioma. METHODS: Retrospective review of patients with grade II-IV glioma who had VPS placement from January 1995 to November 2012. RESULTS: We identified 62 patients. At time of VPS, 41 had gait disturbance, 40 cognitive impairment and 16 urinary incontinence; 10 had the classic triad. Thirty-eight (61%) improved after VPS. Median overall survival from VPS was 7 months for all patients, but 11 months for those who improved and 2 months for non-responders...
January 2014: Annals of Clinical and Translational Neurology
Jennie W Taylor, Eoin P Flanagan, Brian P O'Neill, Tali Siegal, Antonio Omuro, Lisa Deangelis, Joachim Baehring, Ryo Nishikawa, Fernando Pinto, Marc Chamberlain, Khe Hoang-Xuan, Alberto Gonzalez-Aguilar, Tracy Batchelor, Jean-Yves Blay, Agnieszka Korfel, Rebecca A Betensky, Maria-Beatriz S Lopes, David Schiff
OBJECTIVE: To evaluate clinical presentation, optimal diagnostic evaluation and treatment, and outcome in primary leptomeningeal lymphoma, a rare form of primary CNS lymphoma without parenchymal or systemic involvement. METHODS: The International Primary CNS Lymphoma Collaborative Group, a multidisciplinary group of physicians with a particular interest in primary CNS lymphoma, retrospectively identified cases of lymphoma isolated to the leptomeninges as diagnosed by CSF cytology, flow cytometry, or biopsy, without systemic or parenchymal brain/spinal cord lymphoma or immunodeficiency...
November 5, 2013: Neurology
Lakshmi Nayak, Martin Fleisher, Rita Gonzalez-Espinoza, Oscar Lin, Katherine Panageas, Anne Reiner, Chhui-Mei Liu, Lisa M Deangelis, Antonio Omuro
OBJECTIVE: To evaluate the utility of rare cell capture technology (RCCT) in the diagnosis of leptomeningeal metastasis (LM) from solid tumors through identification of circulating tumor cells (CTCs) in the CSF. METHODS: In this pilot study, CSF samples from 60 patients were analyzed. The main patient cohort consisted of 51 patients with solid tumors undergoing lumbar puncture for clinical suspicion of LM. Those patients underwent initial MRI evaluation and had CSF analyzed through conventional cytology and for the presence of CTCs using RCCT, based on immunomagnetic platform enrichment utilizing anti-epithelial cell adhesion molecule antibody-covered magnetic nanoparticles...
April 23, 2013: Neurology
Patrick G Morris, Anne S Reiner, Olga Rosenvald Szenberg, Jennifer L Clarke, Katherine S Panageas, Hector R Perez, Mark G Kris, Timothy A Chan, Lisa M DeAngelis, Antonio M Omuro
INTRODUCTION: Leptomeningeal metastasis (LM), or leptomeningeal carcinomatosis, is a devastating complication of non-small cell lung cancer (NSCLC), and the optimal therapeutic approach remains challenging. A retrospective review was carried out to assess the impact of whole brain radiotherapy (WBRT), intrathecal therapy (IT), and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) on outcomes. METHODS: Patients with newly diagnosed LM from NSCLC from January 2002 to December 2009 were identified through institutional databases and medical records reviewed...
February 2012: Journal of Thoracic Oncology
Meltem Ekenel, Adilia M Hormigo, Scott Peak, Lisa M Deangelis, Lauren E Abrey
Central nervous system (CNS) metastases from breast cancer carry a poor prognosis. Systemic chemotherapy is often ineffective due to the impermeability of the blood-brain barrier (BBB) and inherent chemoresistance of CNS metastases. There are limited data supporting the use of capecitabine in this setting. Medical records of seven patients with brain metastases from breast cancer who received capecitabine treatment at Memorial Sloan-Kettering Cancer Center from 1994-2006 were reviewed. Treatment outcomes were analyzed retrospectively in those patients...
November 2007: Journal of Neuro-oncology
Antonio M P Omuro, Enrico C Lallana, Mark H Bilsky, Lisa M DeAngelis
The authors reviewed 37 patients with leptomeningeal metastasis (LM) who required a ventriculoperitoneal shunt (VP shunt) for management of intracranial hypertension. Improvement was seen in 27 (77%) patients; subdural hematoma developed in one and shunt malfunction in three. Median overall survival was 2 months (range 2 days to 3.6 years) after VP shunt placement, but there was no procedure-related mortality. The prognosis of LM remained poor, but VP shunt can be an effective palliative tool when required.
May 10, 2005: Neurology
Lisa M DeAngelis, Dina Boutros
Leptomeningeal metastasis is a common complication of cancer. Often the diagnosis can be difficult, but early diagnosis and aggressive treatment can prevent irreversible neurologic deficits. Diagnosis is usually established by the demonstration of malignant cells in the cerebrospinal fluid (CSF) or by the presence of enhancing tumor nodules on cranial or spinal MRI. Treatment may require focal radiotherapy to symptomatic sites accompanied by chemotherapy. Intra-CSF chemotherapy requires normal CSF flow dynamics and is typically limited to the use of methotrexate, cytarabine or thiotepa...
2005: Cancer Investigation
Lisa M Deangelis, Adília Hormigo
Primary central nervous system lymphoma (PCNSL) is a rare neoplasm that has captured popular attention because of its rising incidence and marked chemosensitivity. It is a non-Hodgkins B-cell lymphoma (NHL) that appears confined to the central nervous system (CNS) at presentation but may be multifocal within the brain or involve the leptomeninges or eyes at diagnosis. Like systemic lymphoma, it is highly sensitive to corticosteroids, and administration of steroids should be withheld until the diagnosis has been confirmed histologically...
October 2004: Seminars in Oncology
Alexis Demopoulos, Lisa M DeAngelis
PURPOSE OF REVIEW: As treatment of the leukemias improves, patients are surviving longer. Recognizing and rapidly treating metastatic complications or avoiding neurotoxic therapies improves outcome, reduces morbidity and mortality, and limits long-term sequelae. RECENT FINDINGS: Neurologic dysfunction may result from leukemic infiltration of the nervous system or as a consequence of chemotherapy or prophylactic craniospinal irradiation. The present review summarizes common problems in the neurologic complications of leukemia and discusses recent advancements in their diagnosis and treatment...
December 2002: Current Opinion in Neurology
Raja B Khan, Weiji Shi, Howard T Thaler, Lisa M DeAngelis, Lauren E Abrey
Systemic high-dose methotrexate (HD-MTX) is the most effective chemotherapeutic agent in the treatment of primary central nervous system lymphoma (PCNSL). Leptomeningeal involvement is common and intrathecal methotrexate (IT-MTX) is frequently used in combination with HD-MTX, but its benefits are not established. Using a case-controlled retrospective study, matching patients treated with HD-MTX with or without IT-MTX, we found no difference in survival, disease control, or neurotoxicity.
June 2002: Journal of Neuro-oncology
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