CNS Oncology最新文献

{"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":"How far will the Voyager^® take us?","authors":"Victor A Levin","doi":"10.2217/cns-2018-0019","DOIUrl":"https://doi.org/10.2217/cns-2018-0019","url":null,"abstract":"Need for better treatments for glioblastoma Overall survival of people afflicted with glioblastoma (GBM) has improved modestly over the past 30 years and ranges between a median overall survival of 10 and 16 months depending on factors such as age, gender, extent of surgery, molecular-genetic features of resected tumors, radiation therapy and chemotherapy. Treatment options for people afflicted with GBM have changed somewhat based on molecular-genetic profiles that define worst-case scenarios [1–3] and improvements in radiation therapy that have also reduced CNS toxicity somewhat [4]. Based on patient convenience and outcomes, temozolomide has become the major anticancer drug therapy for these tumors [5]. Most recently, chronic treatment with alternating electric tumor treating fields to the head has gained US FDA approval for the treatment of GBM [6,7]. New therapies, especially new chemotherapy drugs, have been limited to brain penetrant alkylating agents (i.e., carmustine, lomustine, and temozolomide) since the 1970s. There are several reasons for this, which relate to drug delivery to infiltrative tumor cells behind the blood–brain barrier (BBB), drug residence time on tumor cell target, appropriateness of cellular target and the need to inhibit more than one cellular target, drug pharmacokinetics and drug safety [8,9].","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"8 1","pages":"CNS26"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36561995","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}

{"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":"Journal Watch: our panel of experts highlight the most important research articles across the spectrum of topics relevant to the field of CNS oncology.","authors":"W. Ng, L. Qiu, Jia Xu Lim, N. Primalani","doi":"10.2217/cns-2019-0005","DOIUrl":"https://doi.org/10.2217/cns-2019-0005","url":null,"abstract":"","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"3 1","pages":"CNS32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75741391","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}

{"title":"Glioblastoma formation in a recurrent intracranial epidermoid cyst: a case report.","authors":"Paul MacMahon,&nbsp;Collin M Labak,&nbsp;Sarah E Martin-Bach,&nbsp;Ahmad Issawi,&nbsp;Kiran Velpula,&nbsp;Andrew J Tsung","doi":"10.2217/cns-2018-0002","DOIUrl":"https://doi.org/10.2217/cns-2018-0002","url":null,"abstract":"<p><strong>Background: </strong>Transformation to glioblastoma following recurrent epidermoid cyst resection has not been reported. Chronic inflammation can underlie malignant transformation of epidermoid cysts. Astrogliosis following repeated resections may have induced the rare transformation to glioblastoma.</p><p><strong>Clinical presentation: </strong>A patient presenting with left lower extremity weakness was found to harbor a parietal mass lesion. Histopathology demonstrated an epidermoid cyst. Following multiple re-resections, an intra-axial mass was discovered within the operative bed, confirmed as glioblastoma.</p><p><strong>Conclusion: </strong>This is the first report of glioblastoma associated with a resected epidermoid cyst. Subsequent to resection, the chronic inflammatory milieu propagated by astrogliosis is thought to have induced malignancy. The progression to glioblastoma draws attention to neoplastic transformation in the context of recurrent epidermoids.</p>","PeriodicalId":10469,"journal":{"name":"CNS Oncology","volume":"7 4","pages":"CNS25"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/cns-2018-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36820977","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}