CNS OncologyPub Date : 2018-12-01Epub Date: 2018-10-02DOI: 10.2217/cns-2018-0004
Christian Brogna, José Pedro Lavrador, Sabina Patel, Eduardo C Ribas, Miren Aizpurua, Francesco Vergani, Keyoumours Ashkan, Ranjeev Bhangoo
{"title":"Grade II Sylvian fissure meningiomas without dural attachment: case report and review of the literature.","authors":"Christian Brogna, José Pedro Lavrador, Sabina Patel, Eduardo C Ribas, Miren Aizpurua, Francesco Vergani, Keyoumours Ashkan, Ranjeev Bhangoo","doi":"10.2217/cns-2018-0004","DOIUrl":"10.2217/cns-2018-0004","url":null,"abstract":"<p><p>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. To the best of our knowledge, only five atypical WHO grade II SFMs have been previously described. We provide a literature review of SFMs WHO grades I-II and discuss common characteristics and surgical challenges we found in a similar case.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 4","pages":"CNS20"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36547749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-12-01Epub Date: 2018-10-09DOI: 10.2217/cns-2017-0037
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
{"title":"Distribution of tumor-infiltrating immune cells in glioblastoma.","authors":"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","doi":"10.2217/cns-2017-0037","DOIUrl":"https://doi.org/10.2217/cns-2017-0037","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of features related to infiltrating immune cell level in glioblastoma.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>CD68 (9.1%), CD163 (2.2%), CD3 (1.6%) and CD8 (1.6%) had the highest density. Higher CD4<sup>+</sup> was associated with unmethylated MGMT (p = 0.016). Higher CD8<sup>+</sup> was associated with larger tumoral size (p = 0.027). Higher CD163<sup>+</sup> was associated with higher age (p = 0.044) and recursive partitioning analysis = 4. Women (p < 0.05), total resection (p < 0.05), MGMT-methylation (p < 0.001), radiotherapy (p < 0.001), chemotherapy (p < 0.001) and lower CD4<sup>+</sup> (p < 0.05) were associated with longer overall survival.</p><p><strong>Conclusion: </strong>Macrophages are more frequent than TILs. Some subsets are associated with clinical features.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 4","pages":"CNS21"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/58/cns-07-21.PMC6331699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36557853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-10-01DOI: 10.2217/cns-2019-0017
Ming Y Chong, C. Lorimer, S. Mehta, Ehab Ibrahim, J. Brock, C. Mcbain, P. McLoone, A. Chalmers
{"title":"An audit of the management of elderly patients with glioblastoma in the UK: have recent trial results changed treatment?","authors":"Ming Y Chong, C. Lorimer, S. Mehta, Ehab Ibrahim, J. Brock, C. Mcbain, P. McLoone, A. Chalmers","doi":"10.2217/cns-2019-0017","DOIUrl":"https://doi.org/10.2217/cns-2019-0017","url":null,"abstract":"Aim: We investigated uptake of short-course chemo-radiotherapy and compared outcomes with other treatment schedules in elderly patients with glioblastoma (GBM). Methods: Patients aged 65 or over with a diagnosis of GBM were identified from an 18-month period from three centers in the UK. The primary end point of this study was overall survival from the date of diagnosis. Results: The analysis included 210 patients. Overall median survival was 5.0 months. Approximately 31.9% of patients received combined chemoradiation; multivariate analysis showed that patients who received standard chemoradiation were at a reduced risk of death than those receiving hypofractionated chemoradiation. Discussion: In this retrospective study, patients treated with standard chemoradiation experienced better outcomes than patients receiving hypofractionated chemoradiation. Patient selection likely contributed to these findings.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74189495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-07-01Epub Date: 2018-09-17DOI: 10.2217/cns-2018-0001
Lisa Modelevsky, Richard Tizon, Samantha N Reiss, Marcel Smith, Rachel Garonce, Thomas Kaley
{"title":"Rapid infusion rituximab is well tolerated in patients with primary CNS lymphoma.","authors":"Lisa Modelevsky, Richard Tizon, Samantha N Reiss, Marcel Smith, Rachel Garonce, Thomas Kaley","doi":"10.2217/cns-2018-0001","DOIUrl":"https://doi.org/10.2217/cns-2018-0001","url":null,"abstract":"<p><strong>Aim: </strong>To establish the safety and feasibility of rapidly infusing rituximab over 90 min in patients with primary CNS lymphoma (PCNSL).</p><p><strong>Patients & methods: </strong>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.</p><p><strong>Results & conclusion: </strong>11 patients received a total of 44 RRIs. Rituximab was dosed at 500 or 750 mg/m<sup>2</sup>. Premedication included acetaminophen and diphenhydramine. No infusion reactions occurred during any RRI. Two infusions were administered with steroids for neurologic symptoms at baseline (4.5%). Rapid administration of rituximab was safe and feasible for patients with PCNSL and at the higher doses received.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 3","pages":"CNS19"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36497917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-07-01Epub Date: 2018-08-20DOI: 10.2217/cns-2018-0010
Gregory F Guzauskas, Marc Salzberg, Bruce Cm Wang
{"title":"Estimated lifetime survival benefit of tumor treating fields and temozolomide for newly diagnosed glioblastoma patients.","authors":"Gregory F Guzauskas, Marc Salzberg, Bruce Cm Wang","doi":"10.2217/cns-2018-0010","DOIUrl":"https://doi.org/10.2217/cns-2018-0010","url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results & conclusion: </strong>Patients treated with TTFields and TMZ had an incremental mean lifetime survival of 1.8 years (TTFields/TMZ: 4.2 vs TMZ alone: 2.4). Patients alive at year 2 after starting TTFields had a 20.7% probability of surviving to year 10. The results presented here provide the required incremental survival benefit necessary for a future assessment of the incremental cost-effectiveness of TTFields.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 3","pages":"CNS23"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36412215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-07-01Epub Date: 2018-04-09DOI: 10.2217/cns-2017-0039
Andrea Wasilewski, Nimish Mohile
{"title":"Durable response to bevacizumab in adults with recurrent pilocytic astrocytoma.","authors":"Andrea Wasilewski, Nimish Mohile","doi":"10.2217/cns-2017-0039","DOIUrl":"https://doi.org/10.2217/cns-2017-0039","url":null,"abstract":"<p><strong>Background: </strong>Adult pilocytic astrocytomas are rare and highly vascular tumors.</p><p><strong>Aim: </strong>We hypothesized that they may be uniquely responsive to bevacizumab (BEV).</p><p><strong>Patients: </strong>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. Median time to recurrence was 8.5 months.</p><p><strong>Methods: </strong>All patients were treated with six cycles of BEV for recurrence.</p><p><strong>Results: </strong>At the end of treatment, all patients had achieved a clinical and radiographic response. Median follow-up time after BEV is 20.5 months.</p><p><strong>Conclusion: </strong>This suggests that BEV may have true antitumor activity in adult pilocytic astrocytomas and may be important for achieving durable disease control.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 3","pages":"CNS26"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2017-0039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35987127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-07-01Epub Date: 2018-08-29DOI: 10.2217/cns-2018-0009
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
{"title":"Phase II study of ERC1671 plus bevacizumab versus bevacizumab plus placebo in recurrent glioblastoma: interim results and correlations with CD4<sup>+</sup> T-lymphocyte counts.","authors":"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","doi":"10.2217/cns-2018-0009","DOIUrl":"https://doi.org/10.2217/cns-2018-0009","url":null,"abstract":"<p><strong>Aim: </strong>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.</p><p><strong>Methods: </strong>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<sup>®</sup> or sargramostim) and cyclophosphamide plus bevacizumab, or placebo plus bevacizumab. Interim results: Median overall survival (OS) of patients treated with ERC1671 plus bevacizumab was 12 months. In the placebo plus bevacizumab group, median OS was 7.5 months. The maximal CD4<sup>+</sup> T-lymphocyte count correlated with OS in the ERC1671 but not in the placebo group.</p><p><strong>Conclusion: </strong>The addition of ERC1671/GM-CSF/cyclophosphamide to bevacizumab resulted in a clinically meaningful survival benefit with minimal additional toxicity.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 3","pages":"CNS22"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36440923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-07-01Epub Date: 2018-06-19DOI: 10.2217/cns-2018-0006
Konstantin Brawanski, Gero Brockhoff, Peter Hau, Arabel Vollmann-Zwerenz, Christian Freyschlag, Annette Lohmeier, Markus J Riemenschneider, Claudius Thomé, Alexander Brawanski, Martin A Proescholdt
{"title":"Efficacy of D,L-methadone in the treatment of glioblastoma in vitro.","authors":"Konstantin Brawanski, Gero Brockhoff, Peter Hau, Arabel Vollmann-Zwerenz, Christian Freyschlag, Annette Lohmeier, Markus J Riemenschneider, Claudius Thomé, Alexander Brawanski, Martin A Proescholdt","doi":"10.2217/cns-2018-0006","DOIUrl":"10.2217/cns-2018-0006","url":null,"abstract":"<p><strong>Aim: </strong>Recently, D,L-methadone has been put forward as adjuvant treatment in glioblastoma (GBM).</p><p><strong>Methods: </strong>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. However, in lower dosages, reflecting clinically attainable concentrations, D,L-methadone alone showed no efficacy, and induced even higher proliferation in one specific cell line. Also, no interaction with TMZ was observed. These results suggest caution to the premature use of D,L-methadone in the treatment of GBM patients.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 3","pages":"CNS18"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/0c/cns-07-18.PMC6200059.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36234657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-04-01Epub Date: 2017-12-05DOI: 10.2217/cns-2017-0036
Kevin O Lillehei, Steven N Kalkanis, Linda M Liau, Dellann Elliott Mydland, Jeffrey Olson, Nina A Paleologos, Timothy Ryken, Tania Johnson, Evan Scullin
{"title":"Rationale and design of the 500-patient, 3-year, and prospective Vigilant ObservatIon of GlIadeL WAfer ImplaNT registry.","authors":"Kevin O Lillehei, Steven N Kalkanis, Linda M Liau, Dellann Elliott Mydland, Jeffrey Olson, Nina A Paleologos, Timothy Ryken, Tania Johnson, Evan Scullin","doi":"10.2217/cns-2017-0036","DOIUrl":"https://doi.org/10.2217/cns-2017-0036","url":null,"abstract":"<p><p>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. Subgroup analyses will include tumor type, molecular marker status, and treatment combinations. Interim analyses from the VIGILANT registry will be reported until complete results are available in 2024.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 2","pages":"CNS08"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2017-0036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35223746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CNS OncologyPub Date : 2018-04-01Epub Date: 2018-04-30DOI: 10.2217/cns-2017-0034
Tine Rosenberg, Charlotte Aaberg-Jessen, Stine Asferg Petterson, Bjarne Winther Kristensen
{"title":"Heterogenic expression of stem cell markers in patient-derived glioblastoma spheroid cultures exposed to long-term hypoxia.","authors":"Tine Rosenberg, Charlotte Aaberg-Jessen, Stine Asferg Petterson, Bjarne Winther Kristensen","doi":"10.2217/cns-2017-0034","DOIUrl":"https://doi.org/10.2217/cns-2017-0034","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the time profile of hypoxia and stem cell markers in glioblastoma spheroids of known molecular subtype.</p><p><strong>Materials & methods: </strong>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.</p><p><strong>Results: </strong>Hypoxia markers as well as CD133 and partially nestin increased in long-term hypoxia. The proliferation rate and spheroid size were highest in normoxia.</p><p><strong>Conclusion: </strong>We found differences in hypoxia and stem cell marker profiles between the patient-derived glioblastoma cultures. This heterogeneity should be taken into consideration in development of future therapeutic strategies.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 2","pages":"CNS15"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2017-0034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36054983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}