CNS Oncology最新文献

{"title":"Analysis of cell-free circulating tumor DNA in 419 patients with glioblastoma and other primary brain tumors.","authors":"David E Piccioni,&nbsp;Achal Singh Achrol,&nbsp;Lesli A Kiedrowski,&nbsp;Kimberly C Banks,&nbsp;Najee Boucher,&nbsp;Garni Barkhoudarian,&nbsp;Daniel F Kelly,&nbsp;Tiffany Juarez,&nbsp;Richard B Lanman,&nbsp;Victoria M Raymond,&nbsp;Minhdan Nguyen,&nbsp;Judy D Truong,&nbsp;Annie Heng,&nbsp;Jaya Gill,&nbsp;Marlon Saria,&nbsp;Sandeep C Pingle,&nbsp;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}

{"title":"Efficacy and safety of immune checkpoint blockade for brain metastases.","authors":"Maya Harary,&nbsp;David A Reardon,&nbsp;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}

{"title":"Patterns of long-term survivorship following bevacizumab treatment for recurrent glioma: a case series.","authors":"Liang Yen Liu,&nbsp;Matthew S Ji,&nbsp;Nhung T Nguyen,&nbsp;Frances E Chow,&nbsp;Donna M Molaie,&nbsp;Sean T Pianka,&nbsp;Richard M Green,&nbsp;Linda M Liau,&nbsp;Benjamin M Ellingson,&nbsp;Phioanh L Nghiemphu,&nbsp;Timothy F Cloughesy,&nbsp;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}

{"title":"Biweekly fotemustine schedule for recurrent glioblastoma in the elderly: activity and toxicity assessment of a multicenter study.","authors":"Raffaele Addeo,&nbsp;Giuseppe Lamberti,&nbsp;Giorgia Simonetti,&nbsp;Patrizia Iodice,&nbsp;Alfredo Marinelli,&nbsp;Liliana Montella,&nbsp;Salvatore Cappabianca,&nbsp;Paola Gaviani,&nbsp;Michele Caraglia,&nbsp;Salvatore Del Prete,&nbsp;Antonio Silvani","doi":"10.2217/cns-2019-0004","DOIUrl":"10.2217/cns-2019-0004","url":null,"abstract":"<p><p><b>Aim:</b> To assess the efficacy and safety of alternative fotemustine administration schedule in elderly patients with recurrent glioblastoma. <b>Patients & methods:</b> Patients aged >65 years with recurrent glioblastoma received fotemustine (80 mg/m²; days 1, 15, 30, 45 and 60, and subsequently every 4 weeks). Primary end point was progression-free survival (PFS) rate at 6 months. Main secondary end point was safety. <b>Results:</b> 58 patients were enrolled at two centers. PFS at 6 months was 47% (27 patients) and overall response rate was 29%. Median PFS and survival were 6 and 7 months, respectively, and longer in responders versus nonresponders. No grade 3-4 hematological toxicities occurred. <b>Conclusion:</b> The alternative fotemustine administration schedule was an effective and safe treatment for recurrent glioblastoma in elderly patients.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 2","pages":"CNS32"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2019-0004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37409139","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}

{"title":"Comparative proteogenomic characterization of glioblastoma.","authors":"Samia Asif, Rawish Fatima, Rebecca Krc, Joseph Bennett, Shahzad Raza","doi":"10.2217/cns-2019-0003","DOIUrl":"10.2217/cns-2019-0003","url":null,"abstract":"<p><p><b>Aim:</b> Glioblastoma multiforme (GBM) carries a dismal prognosis. Integrated proteogenomic analysis was performed to understand GBM pathophysiology. <b>Patients & methods:</b> 17 patient samples were analyzed for driver mutations, oncogenes, major pathway alterations and molecular changes at gene and protein level. Clinical, treatment and survival data were collected. <b>Results:</b> Significantly mutated genes included <i>TP53</i>, <i>EGFR</i>, <i>PIK3R1</i>, <i>PTEN</i>, <i>NF1</i>, <i>RET</i> and <i>STAG2</i>. EGFR mutations noted included EGFRvIII-expression, EGFR-<i>L816Q</i> missense mutation-exon 21 and EGFR fusion (FGFR3-TACC3). <i>TP53</i> mutations were noticed in COSMIC hot-spot driver gene and accompany <i>IDH1</i> and <i>ATRX</i> mutations suggesting low- to high-grade glioma transformation. Proteomics showed higher (53%) EGFR expression than genomic expression (23%). MGMT methylation was present in two-thirds of cases. <b>Conclusion:</b> This study identifies a distinct biological process that may characterize each GBM differently. Proteogenomic data identify potential therapeutic targets of GBM.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 2","pages":"CNS37"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/6e/cns-08-37.PMC6713026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37404356","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}

{"title":"Shifting paradigms: whole brain radiation therapy versus stereotactic radiosurgery for brain metastases.","authors":"Ashwin Shinde, David Akhavan, Mina Sedrak, Scott Glaser, Arya Amini","doi":"10.2217/cns-2018-0016","DOIUrl":"10.2217/cns-2018-0016","url":null,"abstract":"","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS27"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/38/cns-08-27.PMC6499015.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36914049","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}

{"title":"An early feasibility study of the Nativis Voyager^® device in patients with recurrent glioblastoma: first cohort in US.","authors":"Charles Cobbs,&nbsp;Edward McClay,&nbsp;J Paul Duic,&nbsp;L Burt Nabors,&nbsp;Donna Morgan Murray,&nbsp;Santosh Kesari","doi":"10.2217/cns-2018-0013","DOIUrl":"https://doi.org/10.2217/cns-2018-0013","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of the Nativis Voyager^® device in patients with recurrent glioblastoma (rGBM).</p><p><strong>Materials & methods: </strong>Voyager is a noninvasive, nonthermal, nonionizing and portable investigational device which delivers ultra-low radio frequency energy (ulRFE^®) that uses a magnetic field to penetrate tissues to alter specific biologic functions within cells. Patients with rGBM were treated with Voyager alone (V) or Voyager in combination with standard of care (V + SoC). Safety and clinical utility were assessed every 2-4 months.</p><p><strong>Results: </strong>Data from the first 11 patients treated are reported here. Median progression-free survival was 10 weeks in the V arm and 16 weeks in the V + SoC arm. Median overall survival was 16 months in V arm and 11 months in the V + SoC arm. No serious adverse events associated with the device were reported.</p><p><strong>Conclusion: </strong>These data suggest that the Voyager is safe and feasible for the treatment of rGBM.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS30"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36782179","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}

{"title":"A case report of high-grade astroblastoma in a young adult.","authors":"Sagar Bhalerao,&nbsp;Rajnish Nagarkar,&nbsp;Aditya Adhav","doi":"10.2217/cns-2018-0012","DOIUrl":"https://doi.org/10.2217/cns-2018-0012","url":null,"abstract":"<p><p>Astroblastoma is an uncommon neuroepithelial primary tumor of the brain which is of uncertain origin. We present a case of high-grade astroblastoma in an 18-year-old female with a severe headache, loss of appetite, vomiting and generalized weakness. The patient had undergone a right frontoparietal craniotomy. Large subfalcine meningioma was excised. The lesion was suspected to be a meningioma. Primary radiological investigation revealed a 6.8 cm × 5.8 cm × 5.4 cm lesion. Although the radiological and intraoperative findings were of an extra-axial tumor, the histology and immunophenotype was of an astroblastoma. The patient was treated with cyclophosphamide, cisplatin and etoposide chemotherapy regimen. The patient was later treated with bi-weekly bevacizumab. The patient had improved symptomatically post-chemotherapy. However, there was no significant difference in lesion size. The patient died after 2 weeks. The prognosis of patients with astroblastoma is extremely poor as observed in our case.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS29"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37006672","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}

{"title":"Use of the Response Assessment in Neuro-Oncology (RANO) criteria in clinical trials and clinical practice.","authors":"Ugonma N Chukwueke,&nbsp;Patrick Y Wen","doi":"10.2217/cns-2018-0007","DOIUrl":"10.2217/cns-2018-0007","url":null,"abstract":"Between 2010 and 2014, the incidence rate of primary brain tumors in persons (aged >20 years) was 29.2 per 100,000; in children (aged <20 years), the rate was 5.81 per 100,000 [1]. Metastatic CNS tumors are known to be the most commonly occurring malignancy of the brain, although reporting for this disease is limited. Likely owing to multiple factors including improving survival from systemic malignancies, better tolerability of treatments, as well as timely and effective integration of supportive care, the incidence of CNS metastatic disease is expected to continue to increase [2]. Newer therapies and emphasis on clinical trial enrollment has made the need for effective approaches to assessing disease response even more critical. The Response Assessment in Neuro-Oncology (RANO) working group was established to improve the assessment of tumor response and selection of end points, specifically in the context of clinical trial [3]. There has been an evolution in determining which endpoints and criteria are most important in determining therapeutic response, specifically with advances in imaging modalities. In the era of computed tomography (CT), Levin et al. conducted a retrospective analysis of 100 brain tumor patients, in which they reviewed the predictive value of specific factors and its impact upon response to treatment. In this study, the combination of radionuclide and CT scans, as well as diligent monitoring of changes in dexamethasone dose were thought to be predictive of clinical deterioration and response to chemotherapy [4]. In the following decades, the field of neuro-oncology relied upon methods derived from the extracranial solid tumor oncology, notably the MacDonald criteria and the Response Evaluation Criteria in Solid Tumors (RECIST), both methods presenting shortcoming and challenges to effective response assessment in CNS tumors. In 1990, the MacDonald criteria were proposed as the standard for assessment of response and progression, specifically in patients with high-grade glioma. These criteria used the product of the maximal perpendicular diameters but also incorporated changes in corticosteroid doses as well as neurologic function [5]. In this scheme, adopting standards from medical oncology, four categories were recommended: complete response, in which there is disappearance of all enhancing disease concomitant with neurological improvement or stability AND absence of steroids, partial response or ≥50% reduction in enhancing disease as well as stable neurologic status and steroid use; progressive disease (PD) or ≥ 25% increase in enhancing disease or worsening neurologic status in the setting of stable or increasing steroid use and last, stable disease (SD) defined as all other scenarios [5]. RECIST was used occasionally for evaluation of treatment response in primary and metastatic brain tumors but most brain tumor trials used the MacDonald criteria preferentially, since it was felt that use of two orthogonal diameters (2D","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS28"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36999734","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}

{"title":"A feasibility study of the Nativis Voyager^® device in patients with recurrent glioblastoma in Australia.","authors":"Michael Murphy,&nbsp;Anthony Dowling,&nbsp;Christopher Thien,&nbsp;Emma Priest,&nbsp;Donna Morgan Murray,&nbsp;Santosh Kesari","doi":"10.2217/cns-2018-0017","DOIUrl":"https://doi.org/10.2217/cns-2018-0017","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of the Nativis Voyager^®, an investigational medical device, as monotherapy for recurrent glioblastoma (rGBM).</p><p><strong>Materials & methods: </strong>A total of 15 patients with rGBM were treated with one of two Voyager ultra-low radio frequency energy cognates: A1A or A2HU. Safety and clinical utility were assessed every 2-4 months.</p><p><strong>Results: </strong>Median overall survival was 8.04 months in the A1A arm and 6.89 months in the A2HU arm. No serious adverse events associated with Voyager were reported. No clinically relevant trends were noted in clinical laboratory parameters or physical exams.</p><p><strong>Conclusion: </strong>The data suggest that the Voyager is safe and feasible for the treatment of rGBM.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS31"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36936361","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}