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Brain metastases guidelines

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https://www.readbyqxmd.com/read/29329006/ongoing-unmet-needs-in-treating-estrogen-receptor-positive-her2-negative-metastatic-breast-cancer
#1
REVIEW
Gül A Başaran, Chris Twelves, Véronique Diéras, Javier Cortés, Ahmad Awada
Estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2 negative (HER2-) advanced or metastatic breast cancer (MBC) is the most common MBC subtype and currently remains incurable, with a median overall survival of 24.8 months (95% confidence interval, 21.3-30.3). Common sites of metastases are bone, viscera, and brain, causing significant symptoms that negatively affect patient functioning, quality of life (QoL), and work productivity. Guidelines state that endocrine therapy (ET) is preferable to chemotherapy as first-line treatment for patients with ER+ MBC, regardless of limited visceral metastases, unless rapid tumor response is required or ET resistance is suspected...
December 6, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29304360/clinical-trial-design-for-local-therapies-for-brain-metastases-a-guideline-by-the-response-assessment-in-neuro-oncology-brain-metastases-working-group
#2
REVIEW
Brian M Alexander, Paul D Brown, Manmeet S Ahluwalia, Hidefumi Aoyama, Brigitta G Baumert, Susan M Chang, Laurie E Gaspar, Steven N Kalkanis, David R Macdonald, Minesh P Mehta, Riccardo Soffietti, John H Suh, Martin J van den Bent, Michael A Vogelbaum, Jeffrey S Wefel, Eudocia Q Lee, Patrick Y Wen
The goals of therapeutic and biomarker development form the foundation of clinical trial design, and change considerably from early-phase to late-phase trials. From these goals, decisions on specific clinical trial design elements, such as endpoint selection and statistical approaches, are formed. Whereas early-phase trials might focus on finding a therapeutic signal to make decisions on further development, late-phase trials focus on the confirmation of therapeutic impact by considering clinically meaningful endpoints...
January 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29304358/clinical-trial-design-for-systemic-agents-in-patients-with-brain-metastases-from-solid-tumours-a-guideline-by-the-response-assessment-in-neuro-oncology-brain-metastases-working-group
#3
REVIEW
D Ross Camidge, Eudocia Q Lee, Nancy U Lin, Kim Margolin, Manmeet S Ahluwalia, Martin Bendszus, Susan M Chang, Janet Dancey, Elisabeth G E de Vries, Gordon J Harris, F Stephen Hodi, Andrew B Lassman, David R Macdonald, David M Peereboom, David Schiff, Ricardo Soffietti, Martin J van den Bent, Jeffrey S Wefel, Patrick Y Wen
Patients with active CNS disease are often excluded from clinical trials, and data regarding the CNS efficacy of systemic agents are usually obtained late in the drug development process or not at all. In this guideline from the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) working group, we provide detailed recommendations on when patients with brain metastases from solid tumours should be included or excluded in clinical trials of systemic agents. We also discuss the limitations of retrospective studies in determining the CNS efficacy of systemic drugs...
January 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29208355/usage-of-prophylactic-cranial-irradiation-in-elderly-patients-with-small-cell-lung-cancer
#4
Ronald A M Damhuis, Suresh Senan, Jose S Belderbos
BACKGROUND: Prophylactic cranial irradiation (PCI) reduces the risk of overt brain metastases in patients with small-cell lung cancer (SCLC) and is currently recommended in guidelines for both limited and extensive disease. Given the concerns about the greater frequency of neurologic side effects in elderly patients, we studied the association among age, PCI usage, and survival for SCLC patients in the Netherlands. PATIENTS AND METHODS: Data from the Netherlands Cancer Registry for patients diagnosed with SCLC from 2009 to 2013 were queried...
November 21, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29204521/factors-influencing-the-utilization-of-prophylactic-cranial-irradiation-in-patients-with-limited-stage-small-cell-lung-cancer
#5
Benjamin H Lok, Jennifer Ma, Amanda Foster, Carmen A Perez, Weiji Shi, Zhigang Zhang, Bob T Li, Charles M Rudin, Andreas Rimner, Abraham J Wu
Purpose: Brain metastases are common in patients with limited-stage small cell lung cancer (LS-SCLC) due to the inability of most chemotherapeutics to penetrate the blood-brain barrier. Prophylactic cranial irradiation (PCI) is therefore recommended for use in patients with a good response to concurrent chemoradiotherapy. However, PCI is not always delivered; therefore, we investigated the reasons for PCI omission in patients who underwent therapy with curative intent. Methods and materials: We retrospectively reviewed all patients with LS-SCLC who were treated with curative intent at our institution...
October 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29170039/-delineation-of-the-surgical-bed-of-operated-brain-metastases-treated-with-adjuvant-stereotactic-irradiation-a-review
#6
A Keller, G Noël, D Antoni
Stereotactic radiotherapy of the surgical bed of brain metastases is a technique that comes supplant indications of adjuvant whole brain radiotherapy after surgery. After a growing number of retrospective studies, a phase III trial has been presented and validated this indication. However, several criteria such as the dose, the fractionation, the use of a margin and definition of volumes remain to be defined. Our study consisted in making a literature review in order to provide a guideline of delineation of surgical beds of brain metastases, as well as the different modalities of their implementation process...
November 20, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/29157748/consensus-contouring-guidelines-for-postoperative-completely-resected-cavity-stereotactic-radiosurgery-for-brain-metastases
#7
Hany Soliman, Mark Ruschin, Lilyana Angelov, Paul D Brown, Veronica L S Chiang, John P Kirkpatrick, Simon S Lo, Anita Mahajan, Kevin S Oh, Jason P Sheehan, Scott G Soltys, Arjun Sahgal
PURPOSE: To propose contouring guidelines based on consensus contours generated by 10 international experts for cavity stereotactic radiosurgery (SRS), an emerging treatment option after surgical resection of brain metastases. No guidelines for contouring the surgical cavity volume have been previously reported. METHODS AND MATERIALS: Ten postoperative completely resected cases with varying clinical scenarios and locations within the brain were selected. For each case, 10 experts independently contoured the surgical cavity clinical target volume (CTV)...
October 4, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29126142/stereotactic-radiosurgery-in-the-management-of-limited-1-4-brain-metasteses-systematic-review-and-international-stereotactic-radiosurgery-society-practice-guideline
#8
Samuel T Chao, Antonio De Salles, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martinez, Ian Paddick, Jean Régis, Samuel Ryu, Ben J Slotman, Arjun Sahgal
BACKGROUND: Guidelines regarding stereotactic radiosurgery (SRS) for brain metastases are missing recently published evidence. OBJECTIVE: To conduct a systematic review and provide an objective summary of publications regarding SRS in managing patients with 1 to 4 brain metastases. METHODS: Using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted using PubMed and Medline up to November 2016...
November 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28975433/discrepancies-between-biomarkers-of-primary-breast-cancer-and-subsequent-brain-metastases-an-international-multicenter-study
#9
O Kaidar-Person, I Meattini, P Jain, P Bult, N Simone, I Kindts, R Steffens, C Weltens, P Navarria, Y Belkacemi, J Lopez-Guerra, L Livi, B G Baumert, B Vieites, D Limon, N Kurman, K Ko, J B Yu, V Chiang, P Poortmans, T Zagar
PURPOSE: Discordances between the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), expression between primary breast tumors and their subsequent brain metastases (BM) were investigated in breast cancer patients. METHODS: We collected retrospective data from 11 institutions in 8 countries in a predefined-standardized format. Receptor status (positive or negative) was determined according to institutional guidelines (immunohistochemically and/or fluorescence in situ hybridization)...
October 3, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28968165/modernizing-clinical-trial-eligibility-criteria-recommendations-of-the-american-society-of-clinical-oncology-friends-of-cancer-research-brain-metastases-working-group
#10
Nancy U Lin, Tatiana Prowell, Antoinette R Tan, Marina Kozak, Oliver Rosen, Laleh Amiri-Kordestani, Julia White, Joohee Sul, Louise Perkins, Katherine Beal, Richard Gaynor, Edward S Kim
Purpose Broadening trial eligibility to improve accrual and access and to better reflect intended-to-treat populations has been recognized as a priority. Historically, patients with brain metastases have been understudied, because of restrictive eligibility across all phases of clinical trials. Methods In 2016, after a literature search and series of teleconferences, a multistakeholder workshop was convened. Our working group focused on developing consensus recommendations regarding the inclusion of patients with brain metastases in clinical trials, as part of a broader effort that encompassed minimum age, HIV status, and organ dysfunction...
November 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28839327/role-of-surgery-in-brain-metastases
#11
Altaf Ali Laghari, Syed Ijlal Ahmed, Muhammad Shahzad Shamim
Brain metastases remain the commonest type of brain tumour, being four times more common than primary brain tumours. Although surgical intervention may be recommended for one of various reasons in the management of these tumours, including but not limited to conformation of diagnosis, relief of mass effect, improvement of neurological status and prolongation of survival, the guidelines for management of brain metastases remain largely subjective and therefore controversial. Herein the authors have attempted to review some of the existing evidence on role of surgery in the management of brain metastases and have presented their selected guidelines for the readers...
August 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28836150/anticoagulation-for-the-treatment-of-venous-thromboembolism-in-patients-with-brain-metastases-a-meta-analysis-and-systematic-review
#12
Bradley D Hunter, Tracy Minichiello, Stephen Bent
The risk benefit decision in providing anticoagulation for patients with brain metastases is amongst the most difficult decisions faced by clinicians. The purpose of our study was to evaluate both the risk of intracerebral hemorrhage (ICH) associated with anticoagulation therapy and the effect of anticoagulation on survival in patients with brain metastases and venous thromboembolism (VTE). A systematic review of the literature was performed via the PubMed, EMBASE, and the Cochrane databases. Our initial search resulted in 1304 unique citations, and 5 studies satisfied all eligibility criteria and were included for analysis...
October 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28835132/two-year-experience-of-multi-disciplinary-team-mdt-outcomes-for-brain-metastases-in-a-tertiary-neuro-oncology-centre
#13
Daniel Loh, Florence Hogg, Penelope Edwards, Jillian MacColl, Christian Brogna, Ranjeev Bhangoo, Keyoumars Ashkan, Francesco Vergani
Brain metastases (BMs) are the most common intracranial tumour in adults and form a significant proportion of the neuro-oncology workload. Their management has progressed significantly in the last few decades but a gold-standard evidence-based management strategy has not been defined to date and several guidelines based on available evidence exist to support clinical decision-making. This paper evaluates the decision-making process of the neuro-oncology multi-disciplinary team (MDT) in a tertiary neuro-oncology centre over a two-year period...
August 24, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28762600/assessing-the-practice-of-palliative-care-doctors-what-driving-advice-do-they-give-patients-with-advanced-disease
#14
Nashringi Weir, Amanda Fischer, Phillip Good
BACKGROUND: There is little research and no clear guidelines for clinicians to follow when instructing patients with advanced disease about driving. AIMS: To investigate current practice in providing advice to patients with advanced disease and identify areas of consensus or variation with the Australian driving guidelines. METHODS: An online survey was distributed to Australian members of the Australian and New Zealand Society of Palliative Medicine (ANZSPM)...
August 1, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28759295/preventing-discontinuation-of-radiation-therapy-predictive-factors-to-improve-patient-selection-for-palliative-treatment
#15
Lindsay L Puckett, Eric Luitweiler, Louis Potters, Sewit Teckie
PURPOSE: Approximately one third of patients with cancer require palliative radiation therapy (PRT), yet no guidelines exist for optimal patient selection. We have observed that many patients who begin PRT do not complete their prescribed treatment. Our study sought to identify factors associated with discontinuation of PRT, assess for a relationship with survival, and inform patient selection. METHODS: We performed an institutional review board-approved retrospective analysis of patients with cancer treated in a multicenter radiation oncology department in 2014...
September 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28757800/case-report-recurrent-mucoepidermoid-carcinoma-of-the-tongue-in-adult-female-patient-with-lung-cancer
#16
Arielle Rubin, John Davis, Karim Jreije, Henry Wu, Randy Oppenheimer
There is a steady rise in incidence of malignant salivary gland tumors in the United States, with mucoepidermoid carcinoma (MEC) the most frequent. Although 40% of MECs are found in the parotid gland, these lesions possess the capacity to develop anywhere along the aerodigestive tract. Here, we present a case of recurrent tongue MEC in a young adult female patient with history of lung malignancy and multiple brain metastases. Without a universally accepted management protocol for recurrent MECs, the current clinical practice uses tumor grade, location, and clinical progression to determine both prognosis and goals of care...
2017: Clinical Medicine Insights. Ear, Nose and Throat
https://www.readbyqxmd.com/read/28748331/eligibility-for-phase-3-clinical-trials-of-systemic-therapy-in-real-world-patients-with-metastatic-renal-cell-cancer-managed-in-a-rural-region
#17
Carsten Nieder, Mohsan A Syed, Astrid Dalhaug, Adam Pawinski, Jan Norum
Previous research has identified disparities between urban and rural cancer care, including clinical trial access. Therefore, we addressed three different questions in patients with metastatic renal cell cancer managed according to national guidelines in a rural Norwegian standard practice setting. (1) How many patients would have been eligible for three recent landmark randomized clinical trials? (2) Is survival different between eligible and non-eligible patients receiving first-line systemic therapy? (3) Is survival different between eligible patients and published trial results? We performed a retrospective analysis of 101 consecutive patients (2006-2016)...
September 2017: Medical Oncology
https://www.readbyqxmd.com/read/28391295/diagnosis-and-treatment-of-brain-metastases-from-solid-tumors-guidelines-from-the-european-association-of-neuro-oncology-eano
#18
Riccardo Soffietti, Ufuk Abacioglu, Brigitta Baumert, Stephanie E Combs, Sara Kinhult, Johan M Kros, Christine Marosi, Philippe Metellus, Alexander Radbruch, Salvador S Villa Freixa, Michael Brada, Carmine M Carapella, Matthias Preusser, Emilie Le Rhun, Roberta Rudà, Joerg C Tonn, Damien C Weber, Michael Weller
The management of patients with brain metastases has become a major issue due to the increasing frequency and complexity of the diagnostic and therapeutic approaches. In 2014, the European Association of Neuro-Oncology (EANO) created a multidisciplinary Task Force to draw evidence-based guidelines for patients with brain metastases from solid tumors. Here, we present these guidelines, which provide a consensus review of evidence and recommendations for diagnosis by neuroimaging and neuropathology, staging, prognostic factors, and different treatment options...
February 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28216937/renal-cell-carcinoma-atypical-metastasis-to-inguinal-lymph-nodes
#19
Qamar Saeed Chaudhry, Tanweer Ahmed Naveed Bhatty, Ziauddin Khan, Elsawi Medani Osman
Renal cell carcinoma (RCC) is a common tumor of the urinary tract. It is known to have variable presentations due to the extremely vascular nature of the organ. RCC are known to metastasize to lungs, bone, and brain commonly but atypical metastasis to various sites are reported in literature but as very rare pathology. We report a case of a 60-year-old female who presented with multiple inguinal and axillary lymph node enlargements which on excision biopsy showed metastatic RCC. RCC can present with synchronous metastatic deposits in the various organs...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28178376/treatment-trends-for-patients-with-brain-metastases-does-practice-reflect-the-data
#20
Kiri A Sandler, Narek Shaverdian, Ryan R Cook, Amar U Kishan, Christopher R King, Isaac Yang, Michael L Steinberg, Percy Lee
BACKGROUND: Published guidelines regarding the optimal treatment strategies for brain metastases focus on patients with ≤3 lesions. As delivery techniques for stereotactic radiosurgery (SRS) improve, radiation oncologists are increasingly using it for patients with >3 metastases. In the current study, the authors sought to characterize practice patterns among practitioners to identify areas of controversy. METHODS: A survey of practicing radiation oncologists was distributed via e-mail...
February 8, 2017: Cancer
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