Neuro-oncology practice最新文献

{"title":"Preoperative neurocognitive function as an independent survival prognostic marker in primary glioblastoma.","authors":"Evangelia Liouta, Christos Koutsarnakis, Spyridon Komaitis, Aristotelis V Kalyvas, Evangelos Drosos, Juan M García-Gómez, Javier Juan-Albarracín, Vasileios Katsaros, Lampis Stavrinou, George Stranjalis","doi":"10.1093/nop/npad027","DOIUrl":"10.1093/nop/npad027","url":null,"abstract":"<p><strong>Background: </strong>Aim of the present study is to investigate whether preoperative neurocognitive status is prognostically associated with overall survival (OS) in newly diagnosed glioblastoma (GBM) patients.</p><p><strong>Methods: </strong>Ninety patients with dominant-hemisphere IDH-wild-type GBM were assessed by Mini Mental Status Exam (MMSE), Trail Making Test (TMT) A and B parts, and Control Word Association Test (COWAT) phonemic and semantic subtests. Demographics, Karnofsky Performance Scale, tumor parameters, type of surgery, and adjuvant therapy data were available for patients.</p><p><strong>Results: </strong>According to Cox proportional hazards model the neurocognitive variables of TMT B (<i>P</i> < .01), COWAT semantic subset (<i>P</i> < .05), and the MMSE (<i>P</i> < .01) were found significantly associated with survival prediction. From all other factors, only tumor volume and operation type (debulking vs biopsy) showed a statistical association (<i>P</i> < .05) with survival prediction. Kaplan Meier Long rank test showed statistical significance (<i>P</i> < .01) between unimpaired and impaired groups for TMT B, with median survival for the unimpaired group 26 months and 10 months for the impaired group, for COWAT semantic (<i>P</i> < .01) with median survival 23 months and 12 months, respectively and for MMSE (<i>P</i> < .01) with medial survival 19 and 12 months respectively.</p><p><strong>Conclusions: </strong>Our study demonstrates that neurocognitive status at baseline-prior to treatment-is an independent prognostic factor for OS in wild-type GBM patients, adding another prognostic tool to assist physicians in selecting the best treatment plan.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10666798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42279759","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":"Financial toxicity of radiotherapy for multiple brain metastases: Will it get worse or better?","authors":"Tomas Kazda, Katerina Polachova","doi":"10.1093/nop/npad018","DOIUrl":"10.1093/nop/npad018","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828964","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":"Epigenetic profiling reveals a strong association between lack of 5-ALA fluorescence and <i>EGFR</i> amplification in <i>IDH</i>-wildtype glioblastoma.","authors":"Richard Drexler, Thomas Sauvigny, Ulrich Schüller, Alicia Eckhardt, Cecile L Maire, Robin Khatri, Fabian Hausmann, Sonja Hänzelmann, Tobias B Huber, Stefan Bonn, Helena Bode, Katrin Lamszus, Manfred Westphal, Lasse Dührsen, Franz L Ricklefs","doi":"10.1093/nop/npad025","DOIUrl":"10.1093/nop/npad025","url":null,"abstract":"<p><strong>Background: </strong>5-aminolevulinic acid (5-ALA) fluorescence-guided resection increases the percentage of complete CNS tumor resections and improves the progression-free survival of <i>IDH</i>-wildtype glioblastoma patients. A small subset of <i>IDH</i>-wildtype glioblastoma shows no 5-ALA fluorescence. An explanation for these cases is missing. In this study, we used DNA methylation profiling to further characterize non-fluorescent glioblastomas.</p><p><strong>Methods: </strong>Patients with newly diagnosed and recurrent <i>IDH</i>-wildtype glioblastoma that underwent surgery were analyzed. The intensity of intraoperative 5-ALA fluorescence was categorized as non-visible or visible. DNA was extracted from tumors and genome-wide DNA methylation patterns were analyzed using Illumina EPIC (850k) arrays. Furthermore, 5-ALA intensity was measured by flow cytometry on human gliomasphere lines (BT112 and BT145).</p><p><strong>Results: </strong>Of 74 included patients, 12 (16.2%) patients had a non-fluorescent glioblastoma, which were compared to 62 glioblastomas with 5-ALA fluorescence. Clinical characteristics were equally distributed between both groups. We did not find significant differences between DNA methylation subclasses and 5-ALA fluorescence (<i>P</i> = .24). The distribution of cells of the tumor microenvironment was not significantly different between the non-fluorescent and fluorescent tumors. Copy number variations in <i>EGFR and</i> simultaneous EGFRvIII expression were strongly associated with 5-ALA fluorescence since all non-fluorescent glioblastomas were <i>EGFR</i>-amplified (<i>P</i> < .01). This finding was also demonstrated in recurrent tumors. Similarly, <i>EGFR</i>-amplified glioblastoma cell lines showed no 5-ALA fluorescence after 24 h of incubation.</p><p><strong>Conclusions: </strong>Our study demonstrates an association between non-fluorescent <i>IDH</i>-wildtype glioblastomas and <i>EGFR</i> gene amplification which should be taken into consideration for recurrent surgery and future studies investigating <i>EGFR</i>-amplified gliomas.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10360903","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":"RNA fusion transcript panel identifies diverse repertoire of fusions in adult glioma patients with therapeutic implications.","authors":"Shawn Kothari, Anna C Dusenbery, Abigail Doucette, Daniel Y Zhang, Dominique Ballinger, Arati Desai, Jennifer J D Morrissette, Stephen J Bagley, MacLean P Nasrallah","doi":"10.1093/nop/npad022","DOIUrl":"10.1093/nop/npad022","url":null,"abstract":"<p><strong>Background: </strong>Recurrent gliomas are therapeutically challenging diseases with few treatment options available. One area of potential therapeutic vulnerability is the presence of targetable oncogenic fusion proteins.</p><p><strong>Methods: </strong>To better understand the clinical benefit of routinely testing for fusion proteins in adult glioma patients, we performed a retrospective review of 647 adult patients with glioma who underwent surgical resection at our center between August 2017 and May 2021 and whose tumors were analyzed with an in-house fusion transcript panel.</p><p><strong>Results: </strong>Fifty-two patients (8%) were found to harbor a potentially targetable fusion with 11 (21%) of these patients receiving treatment with a fusion-targeted inhibitor. The targetable genes found to be involved in a fusion included <i>FGFR3, MET, EGFR, NTRK1, NTRK2, BRAF, ROS1,</i> and <i>PIK3CA</i>.</p><p><strong>Conclusions: </strong>This analysis demonstrates that routine clinical testing for gene fusions identifies a diverse repertoire of potential therapeutic targets in adult patients with glioma and can offer rational therapeutic options for patients with recurrent disease.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184109","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":"Lower middle-income countries: A risk factor for lower survival in glioblastoma? Evidence for health care providers.","authors":"Stefan Oberndorfer","doi":"10.1093/nop/npad020","DOIUrl":"10.1093/nop/npad020","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10346381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10184112","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":"Depression and anxiety in glioma patients.","authors":"Pim B van der Meer, Linda Dirven, Caroline Hertler, Florien W Boele, Albert Batalla, Tobias Walbert, Alasdair G Rooney, Johan A F Koekkoek","doi":"10.1093/nop/npad019","DOIUrl":"10.1093/nop/npad019","url":null,"abstract":"<p><p>AbstractGlioma patients carry the burden of having both a progressive neurological disease and cancer, and may face a variety of symptoms, including depression and anxiety. These symptoms are highly prevalent in glioma patients (median point prevalence ranging from 16-41% for depression and 24-48% for anxiety when assessed by self-report questionnaires) and have a major impact on health-related quality of life and even overall survival time. A worse overall survival time for glioma patients with depressive symptoms might be due to tumor progression and/or its supportive treatment causing depressive symptoms, an increased risk of suicide or other (unknown) factors. Much is still unclear about the etiology of depressive and anxiety symptoms in glioma. These psychiatric symptoms often find their cause in a combination of neurophysiological and psychological factors, such as the tumor and/or its treatment. Although these patients have a particular idiosyncrasy, standard treatment guidelines for depressive and anxiety disorders apply, generally recommending psychological and pharmacological treatment. Only a few nonpharmacological trials have been conducted evaluating the efficacy of psychological treatments (eg, a reminiscence therapy-based care program) in this population, which significantly reduced depressive and anxiety symptoms. No pharmacological trials have been conducted in glioma patients specifically. More well-designed trials evaluating the efficacy of nonpharmacological treatments for depressive and anxiety disorders in glioma are urgently needed to successfully treat psychiatric symptoms in brain tumor patients and to improve (health-related) quality of life.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/c7/npad019.PMC10346395.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10098814","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":"Forthcoming Meetings","authors":"","doi":"10.1093/nop/npad034","DOIUrl":"https://doi.org/10.1093/nop/npad034","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135077959","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":"Association between preoperative neurocognitive status and IDH1 mutation status in high-grade gliomas.","authors":"Evangelia Liouta,&nbsp;Aristotelis V Kalyvas,&nbsp;Spyridon Komaitis,&nbsp;Evangelos Drosos,&nbsp;Christos Koutsarnakis,&nbsp;Juan M García-Gómez,&nbsp;Javier Juan-Albarracín,&nbsp;Vasileios Katsaros,&nbsp;Theodosis Kalamatianos,&nbsp;Theodoros Argyrakos,&nbsp;George Stranjalis","doi":"10.1093/nop/npac077","DOIUrl":"https://doi.org/10.1093/nop/npac077","url":null,"abstract":"<p><strong>Background: </strong>High-grade glioma (HGG) patients present with variable impairment in neurocognitive function (NCF). Based on that, isocitrate dehydrogenase 1 (IDH1) wild-type HGGs are more aggressive than IDH1 mutant-type ones, we hypothesized that patients with IDH1 wild-type HGG would exhibit more severe NCF deficits than their IDH1 mutant counterparts.</p><p><strong>Methods: </strong>NCF was assessed by Mini Mental Status Exam (MMSE), Trail Making Test (TMT), Digit Span (DS), and Controlled Word Association Test (COWAT) tests in 147 HGG patients preoperatively.</p><p><strong>Results: </strong>Analyses between IDH1 groups revealed a significant difference on MMSE concentration component (<i>p</i> ≤ .01), DS (<i>p</i> ≤ .01), TMTB (<i>p</i> ≤ .01), and COWAT (<i>p</i> ≤ .01) scores, with the IDH1 wild group performing worse than the IDH1 mutant one. Age and tumor volume were inversely correlated with MMSE concentration component (<i>r</i> = -4.78, <i>p</i> < .01), and with MMSE concentration (<i>r</i> = -.401, <i>p</i> < .01), TMTB (<i>r</i> = -.328, <i>p</i> < .01), and COWAT phonemic scores (<i>r</i> = -.599, <i>p</i> < .01), respectively, but only for the IDH1 wild-type group. Analyses between age-matched subsamples of IDH1 groups revealed no age effect on NCF. Tumor grade showed nonsignificance on NCF (<i>p</i> > .05) between the 2 IDH1 mutation subgroups of grade IV tumor patients. On the contrary, grade III group showed a significant difference in TMTB (<i>p</i> < .01) and DS backwards (<i>p</i> < .01) between IDH1 subgroups, with the mutant one outperforming the IDH1 wild one.</p><p><strong>Conclusions: </strong>Our findings indicate that IDH1 wild-type HGG patients present greater NCF impairment, in executive functions particularly, compared to IDH1 mutant ones, suggesting that tumor growth kinetics may play a more profound role than other tumor and demographic parameters in clinical NCF of HGG patients.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246419","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":"Review of 20 years of adult medulloblastoma treatment: Chemotherapy prescription trends and survival.","authors":"Marissa Sherwood,&nbsp;Seth Climans,&nbsp;Ronald Ramos,&nbsp;Normand J Laperriere,&nbsp;Andrew F Gao,&nbsp;Barbara-Ann Millar,&nbsp;David B Shultz,&nbsp;Derek S Tsang,&nbsp;Warren P Mason","doi":"10.1093/nop/npac074","DOIUrl":"https://doi.org/10.1093/nop/npac074","url":null,"abstract":"<p><strong>Background: </strong>The historic standard of care for adult medulloblastoma has been considered surgery and radiation, while chemotherapy is increasingly being prescribed. This study reviewed 20-year chemotherapy trends at a high-volume center, as well as overall and progression free-survival.</p><p><strong>Methods: </strong>Adults with medulloblastoma treated at an academic center from January 1, 1999 to -December 31, 2020 were reviewed. Patient baseline data were summarized and Kaplan-Meier estimators were used for survival.</p><p><strong>Results: </strong>Forty-nine patients were included; median age was 30 years and male: female ratio was 2:1. Desmoplastic and classical histologies were most common. Of all patients, 23 (47%) were high risk and 7 (14%) metastatic at diagnosis. Only 10 (20%) received initial chemotherapy, of which 70% were high risk and 30% metastatic, with most treated from 2010 to 2020. Forty percent of initial chemotherapy patients received salvage chemotherapy for recurrence or metastases (of all patients, 49% required salvage). Initial chemotherapy regimens were mainly cisplatin/lomustine/vincristine, and at recurrence cisplatin/etoposide. Median overall survival was 8.6 years (95% CI 7.5-∞), with 1-, 5-, and 10-year survival at 95.8%, 72%, and 46.7%. Median overall survival for those who did not receive initial chemotherapy was 12.4 years and 7.4 years for those who did (<i>P</i>-value .2).</p><p><strong>Conclusions: </strong>Twenty years of adult medulloblastoma treatment was reviewed. Initial chemotherapy patients, most of whom were high risk, trended towards worse survival, but this was nonsignificant. The ideal timing and choice of chemotherapy for adult medulloblastoma is unknown-challenges of administering chemotherapy following photon craniospinal irradiation may have prevented it from becoming routine.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037945/pdf/npac074.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10288581","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":"The predictive value of partial <i>MGMT</i> promoter methylation for IDH-wild-type glioblastoma patients.","authors":"Matthew Torre,&nbsp;Patrick Y Wen,&nbsp;J Bryan Iorgulescu","doi":"10.1093/nop/npac070","DOIUrl":"https://doi.org/10.1093/nop/npac070","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma patients with hypermethylation of the O⁶-methylguanine-methyltransferase (<i>MGMT</i>) gene promoter have significantly improved survival when treated with temozolomide compared to patients with unmethylation of the <i>MGMT</i> promoter. However, the prognostic and predictive significance of partial <i>MGMT</i> promoter methylation is unclear.</p><p><strong>Methods: </strong>The National Cancer Database was queried for patients newly diagnosed in 2018 with histopathologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma. The overall survival (OS) associated with <i>MGMT</i> promoter methylation status was assessed using multivariable Cox regression with Bonferroni correction for multiple testing (<i>P</i> < .008 was significant).</p><p><strong>Results: </strong>Three thousand eight hundred twenty-five newly diagnosed IDH-wildtype glioblastoma patients were identified. The <i>MGMT</i> promoter was unmethylated in 58.7% (<i>n</i> = 2245), partially methylated in 4.8% (<i>n</i> = 183), hypermethylated in 3.5% (<i>n</i> = 133), and methylated not otherwise specified (NOS; likely consisting predominantly of hypermethylated cases) in 33.0% (<i>n</i> = 1264) of cases. Among patients that received first-line single-agent chemotherapy (ie likely temozolomide), compared to partial methylation (referent), <i>MGMT</i> promoter unmethylation was associated with worse OS (hazard ratio [HR] 1.94; 95% confidence interval [95 CI]: 1.54-2.44; <i>P</i> < .001) in multivariable Cox regression adjusted for major prognostic confounders. In contrast, a significant OS difference was not observed between partially methylated promoters and either hypermethylated (HR 1.02; 95 CI: 0.72-1.46; <i>P</i> = .90) or methylated NOS (HR 0.99; 95 CI: 0.78-1.26; <i>P</i> = .93) promoters. Among IDH-wildtype glioblastoma patients who did not receive first-line chemotherapy, <i>MGMT</i> promoter methylation status was not associated with significant differences in OS (<i>P</i> = 0.39-0.83).</p><p><strong>Conclusions: </strong>Compared to <i>MGMT</i> promoter unmethylation, partial methylation was predictive of improved OS among IDH-wildtype glioblastoma patients treated with first-line single-agent chemotherapy-supporting the use of temozolomide therapy in these patients.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10037633/pdf/npac070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193594","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}