CNS OncologyPub Date : 2019-11-29DOI: 10.2217/cns-2019-0016
Meetakshi Gupta, T. Gupta, N. Purandare, V. Rangarajan, A. Puranik, A. Moiyadi, P. Shetty, S. Epari, A. Sahay, A. Mahajan, A. Janu, B. Bagal, H. Menon, S. Kannan, R. Krishnatry, G. Sastri, R. Jalali
{"title":"Utility of flouro-deoxy-glucose positron emission tomography/computed tomography in the diagnostic and staging evaluation of patients with primary CNS lymphoma","authors":"Meetakshi Gupta, T. Gupta, N. Purandare, V. Rangarajan, A. Puranik, A. Moiyadi, P. Shetty, S. Epari, A. Sahay, A. Mahajan, A. Janu, B. Bagal, H. Menon, S. Kannan, R. Krishnatry, G. Sastri, R. Jalali","doi":"10.2217/cns-2019-0016","DOIUrl":"https://doi.org/10.2217/cns-2019-0016","url":null,"abstract":"Aim: To prospectively assess the clinical utility of pretreatment flouro-deoxy-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in patients with primary central nervous system (CNS) lymphoma (PCNSL). Materials & methods: Patients with suspected/proven PCNSL underwent baseline whole-body 18F-FDG-PET/CT. Maximum standardized uptake value and tumor/normal tissue ratios were compared between CNS lymphoma and other histological diagnoses. Results: The mean maximum standardized uptake value (27.5 vs 18.2; p = 0.001) and mean tumor/normal tissue ratio (2.34 vs 1.53; p < 0.001) of CNS lymphoma was significantly higher than other histologic diagnoses. Five of 50 (10%) patients with biopsy-proven CNS lymphomas had pathologically increased FDG-uptake at extraneuraxial sites uncovering systemic lymphoma. Conclusion: Pretreatment whole-body 18F-FDG-PET/CT provides valuable complementary information in the diagnostic and staging evaluation of patients with PCNSL to guide therapeutic decision-making.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89693127","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 : 2019-11-01DOI: 10.2217/cns-2019-0012
Margaret O Johnson, J. Kirkpatrick, Mallika P. Patel, A. Desjardins, D. Randazzo, H. Friedman, D. Ashley, K. Peters
{"title":"The role of chemotherapy in the treatment of central neurocytoma","authors":"Margaret O Johnson, J. Kirkpatrick, Mallika P. Patel, A. Desjardins, D. Randazzo, H. Friedman, D. Ashley, K. Peters","doi":"10.2217/cns-2019-0012","DOIUrl":"https://doi.org/10.2217/cns-2019-0012","url":null,"abstract":"Aim: Central neurocytoma (CN) is a rare WHO grade II central nervous system (CNS) tumor. This is an update on chemotherapeutic agents used in its treatment. Patients & methods: An institutional review board-approved, chart review of patients seen at our institution resulted in a single case treated with chemotherapy and is herein included. We proceeded with a comprehensive literature review. Results: We identified 18 citations, representing 39 cases of adult and pediatric CN treated with chemotherapy. With the addition of our single case, the total number of recurrent CN patients treated with temozolomide (TMZ) is nine. Conclusion: There exists marked heterogeneity in chemotherapy used to treat CN. TMZ is incorporated into treatment regimens in the setting of tumor recurrence: its role merits further study.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84966989","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 : 2019-11-01DOI: 10.2217/cns-2019-0002
J. Loya, Charlie Zhang, Emily J Cox, A. Achrol, S. Kesari
{"title":"Biological intratumoral therapy for the high-grade glioma part II: vector- and cell-based therapies and radioimmunotherapy","authors":"J. Loya, Charlie Zhang, Emily J Cox, A. Achrol, S. Kesari","doi":"10.2217/cns-2019-0002","DOIUrl":"https://doi.org/10.2217/cns-2019-0002","url":null,"abstract":"Management of high-grade gliomas (HGGs) remains a complex challenge with an overall poor prognosis despite aggressive multimodal treatment. New translational research has focused on maximizing tumor cell eradication through improved tumor cell targeting while minimizing collateral systemic side effects. In particular, biological intratumoral therapies have been the focus of novel translational research efforts due to their inherent potential to be both dynamically adaptive and target specific. This two part review will provide an overview of biological intratumoral therapies that have been evaluated in human clinical trials in HGGs, and summarize key advances and remaining challenges in the development of these therapies as a potential new paradigm in the management of HGGs. Part II discusses vector-based therapies, cell-based therapies and radioimmunotherapy.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87345475","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 : 2019-11-01DOI: 10.2217/cns-2019-0001
J. Loya, Charlie Zhang, Emily J Cox, A. Achrol, S. Kesari
{"title":"Biological intratumoral therapy for the high-grade glioma part I: intratumoral delivery and immunotoxins","authors":"J. Loya, Charlie Zhang, Emily J Cox, A. Achrol, S. Kesari","doi":"10.2217/cns-2019-0001","DOIUrl":"https://doi.org/10.2217/cns-2019-0001","url":null,"abstract":"Management of high-grade gliomas remains a complex challenge. Standard of care consists of microsurgical resection, chemotherapy and radiation, but despite these aggressive multimodality therapies the overall prognosis remains poor. A major focus of ongoing translational research studies is to develop novel therapeutic strategies that can maximize tumor cell eradication while minimizing collateral side effects. Particularly, biological intratumoral therapies have been the focus of new translational research efforts due to their inherent potential to be both dynamically adaptive and target specific. This two-part review will provide an overview of biological intratumoral therapies and summarize key advances and remaining challenges in intratumoral biological therapies for high-grade glioma. Part I focuses on discussion of the concepts of intratumoral delivery and immunotoxin therapies.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84785003","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 : 2019-11-01DOI: 10.2217/cns-2019-0015
Marthe C. M. Peeters, L. Dirven, J. Koekkoek, M. Numans, M. Taphoorn
{"title":"Prediagnostic presentations of glioma in primary care: a case–control study","authors":"Marthe C. M. Peeters, L. Dirven, J. Koekkoek, M. Numans, M. Taphoorn","doi":"10.2217/cns-2019-0015","DOIUrl":"https://doi.org/10.2217/cns-2019-0015","url":null,"abstract":"Aim: This study aimed to assess the prevalence of symptoms glioma patients may present with to the general practitioner, and whether these can be distinguished from patients with other CNS disorders or any other condition. Methods: Glioma patients were matched to CNS patients and ‘other controls’ using anonymized general practitioner registries. Prevalences were evaluated in the 5 years prior to diagnosis. Result: CNS patients reported significantly more motor symptoms in the period 60–24 months, (p = 0.039). Moreover, <6 months before diagnosis CNS patients differed significantly in mood disorders/fear compared with ‘other controls’ (p = 0.012) but not glioma patients (p = 0.816). Conclusion: Glioma patients could not be distinguished from both control groups with respect to the number or type of prediagnostic symptoms.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84070153","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 : 2019-07-03DOI: 10.2217/cns-2019-0013
Vaibhav Kumar, Patrick J. Eulitt, A. Bermudez, S. Khagi
{"title":"Hemophagocytic lymphohistiocytosis in a patient with glioblastoma: a case report","authors":"Vaibhav Kumar, Patrick J. Eulitt, A. Bermudez, S. Khagi","doi":"10.2217/cns-2019-0013","DOIUrl":"https://doi.org/10.2217/cns-2019-0013","url":null,"abstract":"Adult onset hemophagocytic lymphohistiocytosis (HLH) is a rare condition, usually secondary to either a precipitating infective or hematologic malignancy. We present a case of Epstein–Barr virus associated HLH in a 55-year-old female receiving treatment for a glioblastoma (GBM). It is possible that HLH is under recognized, as patients with GBM often have features of a nonspecific systemic inflammatory response syndrome, multiorgan failure and cognitive decline. A high index of suspicion and increased awareness can help improve timeliness of diagnosis. Therapeutically, Epstein–Barr virus associated HLH in patients with solid organ malignancy poses significant challenges. An individualized, multidisciplinary approach is essential when managing adult-onset HLH and providers will need to be mindful of the high mortality rate despite treatment.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"45 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2019-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72459642","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 : 2019-06-20DOI: 10.2217/cns-2019-0010
Ugur T Sener, Nassim Matin, H. Yu, A. Lin, T. Yang, R. Malani
{"title":"Radiographic appearance of leptomeningeal disease in patients with EGFR-mutated non-small-cell lung carcinoma treated with tyrosine kinase inhibitors: a case series","authors":"Ugur T Sener, Nassim Matin, H. Yu, A. Lin, T. Yang, R. Malani","doi":"10.2217/cns-2019-0010","DOIUrl":"https://doi.org/10.2217/cns-2019-0010","url":null,"abstract":"EGFR is frequently mutated in non-small-cell lung carcinomas (NSCLCs). Clinically available tyrosine kinase inhibitors (TKIs) are effective in treating EGFR-mutant NSCLC. In this case series, we present five patients with TKI-treated EGFR-mutated NSCLC who developed leptomeningeal disease (LMD) lacking characteristic imaging findings. All five patients received TKIs prior to development of cytology-confirmed LMD. Clinical signs of LMD preceded radiographic evidence by 2–12 months. T790M, the most common resistance mutation to first-generation EGFR inhibitors, was identified in four cases. These cases illustrate that in patients with EGFR-mutant NSCLC, TKIs may effectively control LMD, creating a lag between onset of symptoms and observation of radiographic findings.","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89427591","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 : 2019-06-01Epub Date: 2019-03-11DOI: 10.2217/cns-2018-0015
David E Piccioni, Achal Singh Achrol, Lesli A Kiedrowski, Kimberly C Banks, Najee Boucher, Garni Barkhoudarian, Daniel F Kelly, Tiffany Juarez, Richard B Lanman, Victoria M Raymond, Minhdan Nguyen, Judy D Truong, Annie Heng, Jaya Gill, Marlon Saria, Sandeep C Pingle, Santosh Kesari
{"title":"Analysis of cell-free circulating tumor DNA in 419 patients with glioblastoma and other primary brain tumors.","authors":"David E Piccioni, Achal Singh Achrol, Lesli A Kiedrowski, Kimberly C Banks, Najee Boucher, Garni Barkhoudarian, Daniel F Kelly, Tiffany Juarez, Richard B Lanman, Victoria M Raymond, Minhdan Nguyen, Judy D Truong, Annie Heng, Jaya Gill, Marlon Saria, Sandeep C Pingle, Santosh Kesari","doi":"10.2217/cns-2018-0015","DOIUrl":"https://doi.org/10.2217/cns-2018-0015","url":null,"abstract":"<p><p><b>Aim:</b> Genomically matched trials in primary brain tumors (PBTs) require recent tumor sequencing. We evaluated whether circulating tumor DNA (ctDNA) could facilitate genomic interrogation in these patients. <b>Methods:</b> Data from 419 PBT patients tested clinically with a ctDNA NGS panel at a CLIA-certified laboratory were analyzed. <b>Results:</b> A total of 211 patients (50%) had ≥1 somatic alteration detected. Detection was highest in meningioma (59%) and gliobastoma (55%). Single nucleotide variants were detected in 61 genes, with amplifications detected in <i>ERBB2, MET, EGFR</i> and others. <b>Conclusion:</b> Contrary to previous studies with very low yields, we found half of PBT patients had detectable ctDNA with genomically targetable off-label or clinical trial options for almost 50%. For those PBT patients with detectable ctDNA, plasma cfDNA genomic analysis is a clinically viable option for identifying genomically driven therapy options.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 2","pages":"CNS34"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37042504","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 : 2019-06-01Epub Date: 2019-03-11DOI: 10.2217/cns-2018-0018
Maya Harary, David A Reardon, J Bryan Iorgulescu
{"title":"Efficacy and safety of immune checkpoint blockade for brain metastases.","authors":"Maya Harary, David A Reardon, J Bryan Iorgulescu","doi":"10.2217/cns-2018-0018","DOIUrl":"https://doi.org/10.2217/cns-2018-0018","url":null,"abstract":"hepatocellular carcinoma,","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 2","pages":"CNS33"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37042597","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 : 2019-06-01Epub Date: 2019-07-11DOI: 10.2217/cns-2019-0007
Liang Yen Liu, Matthew S Ji, Nhung T Nguyen, Frances E Chow, Donna M Molaie, Sean T Pianka, Richard M Green, Linda M Liau, Benjamin M Ellingson, Phioanh L Nghiemphu, Timothy F Cloughesy, Albert Lai
{"title":"Patterns of long-term survivorship following bevacizumab treatment for recurrent glioma: a case series.","authors":"Liang Yen Liu, Matthew S Ji, Nhung T Nguyen, Frances E Chow, Donna M Molaie, Sean T Pianka, Richard M Green, Linda M Liau, Benjamin M Ellingson, Phioanh L Nghiemphu, Timothy F Cloughesy, Albert Lai","doi":"10.2217/cns-2019-0007","DOIUrl":"https://doi.org/10.2217/cns-2019-0007","url":null,"abstract":"<p><p><b>Aim:</b> Long-term survivors (LTS) after glioma recurrence while on bevacizumab (Bev) therapy are rarely reported in the current literature. The purpose of this case series is to confirm the existence of and describe a large cohort of recurrent glioma LTS treated with Bev (Bev-LTS). <b>Patients & methods:</b> We identified Bev-LTS as patients with post-Bev initiation survival times of ≥3 years among 1397 Bev treated recurrent glioma patients. <b>Results:</b> Among 962 grade-IV, 221 grade III, and 214 grade II Bev-treated glioma patients, we identified 28 (2.9%), 14 (6.3%) and 8 (3.7%) Bev-LTS patients, respectively. 45 Bev-LTS patients recurred on Bev, with 36 of those patients continuing therapy. <b>Conclusion:</b> Our study shows that a small portion of grade-IV, -III, and -II glioma patients can have long-term survival on Bev therapy even after Bev recurrence.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 2","pages":"CNS35"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2019-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37406325","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}