Neuro-oncology practicePub Date : 2026-02-27eCollection Date: 2026-08-01DOI: 10.1093/nop/npag020
Marieke E C Blom, Maxine Gorter, Philip C de Witt Hamer, Johanna M Niers, Judith G M Jelsma, Martin Klein, Linda Douw
{"title":"Promoting physical activity in glioma patients: Insights from Dutch healthcare professionals.","authors":"Marieke E C Blom, Maxine Gorter, Philip C de Witt Hamer, Johanna M Niers, Judith G M Jelsma, Martin Klein, Linda Douw","doi":"10.1093/nop/npag020","DOIUrl":"10.1093/nop/npag020","url":null,"abstract":"<p><strong>Background: </strong>Although physical activity may play a significant role in enhancing quality of life for glioma patients, its integration into clinical care remains underexplored. This study assessed the experiences, perspectives, and barriers of healthcare professionals in promoting physical activity for glioma patients.</p><p><strong>Methods: </strong>An online survey with 19 questions was distributed to Dutch healthcare professionals registered with the Dutch Neuro-Oncology Society (LWNO). Additionally, professionals were individually asked to remind and invite their colleagues to participate. Participants provided informed consent.</p><p><strong>Results: </strong>Fifty-five professionals from 20 centers completed the survey, mainly neurologists (35%) and nurses (33%). Most professionals (58%) indicated receiving frequent questions about physical activity, particularly regarding safety and appropriate activities. Additionally, 76% stated they often proactively provide advice, recommending low-intensity activities like walking. Key barriers to making such recommendations included limited information materials (37%), knowledge (33%), and referral options (27%). Professionals' concerns about physical activity included risks of overexertion and patient discouragement if activity would prove too challenging. Despite these challenges, 89% supported integrating physical activity into glioma care, and 56% expressed a need for specific guidelines. While professionals believe in the benefits for symptom management and quality of life, 62% were neutral about the strength of supporting evidence.</p><p><strong>Conclusions: </strong>In this sample, physical activity is frequently discussed in glioma care, but recommendations are mostly inappropriate due to limited knowledge, resources, and guidance. Existing guidelines are rarely applied in practice. Future research should accumulate evidence, develop tailored guidelines, and equip professionals with tools to truly integrate physical activity into practice.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 4","pages":"685-693"},"PeriodicalIF":2.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448341","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}
Neuro-oncology practicePub Date : 2026-02-25eCollection Date: 2026-08-01DOI: 10.1093/nop/npag015
Charlotte Sleurs, Floortje Mols, Laurien De Roeck, Rhodé M Bijlsma, Suzanne E J Kaal, Jacqueline M Tromp, Monique E M M Bos, Tom van der Hulle, Ann Hoeben, Janine Nuver, Mathilde C M Kouwenhoven, Winette T A van der Graaf, Olga Husson
{"title":"Symptom burden in young adult brain tumor survivors: Key intervention targets based on patient-reported outcome network analyses.","authors":"Charlotte Sleurs, Floortje Mols, Laurien De Roeck, Rhodé M Bijlsma, Suzanne E J Kaal, Jacqueline M Tromp, Monique E M M Bos, Tom van der Hulle, Ann Hoeben, Janine Nuver, Mathilde C M Kouwenhoven, Winette T A van der Graaf, Olga Husson","doi":"10.1093/nop/npag015","DOIUrl":"10.1093/nop/npag015","url":null,"abstract":"<p><strong>Background: </strong>A brain tumor can lead to functional impairment, which is particularly concerning for adolescents and young adults (AYA). Patient-reported outcomes (PROs) have typically been examined as isolated domains, rather than as covarying symptoms. This study modeled PRO networks, symptom clustering, and topology among AYA oncology survivors.</p><p><strong>Methods: </strong>Patient-reported outcome networks from 4005 survivors were compared in topology between survivors of primary CNS tumors (n = 164) and non-CNS tumors (n = 3841). Survivors were diagnosed between 1999 and 2015 at ages 18 to 39 years, who completed the EORTC QLQ-SURV100 (Mdn follow-up = 12.31 years). Group-specific networks were estimated based on 33 health-related quality of life (HRQoL) scale scores using graphical LASSO. Wilcoxon rank-sum tests and the Network Comparison Test assessed group differences in the original PRO scales and their network centrality, respectively. Within the CNS subgroup (n = 164), associations with tumor-related and treatment-related characteristics were explored.</p><p><strong>Results: </strong>Survivors of central nervous system (CNS) tumors reported higher symptom burden on most PRO scales, along with a more diffuse network showing weaker within-domain cohesion (lower nodal strength and expected influence) and limited cross-domain integration (lower bridge strength). A small subset of nodes showed higher bridge expected influence (ie, fatigue, physical functioning, sexual problems when sexually active, work), which may represent key targets for intervention. Across both groups, negative health outlook, health distress, and physical functioning emerged as consistent core targets.</p><p><strong>Conclusion: </strong>Core symptoms may warrant prioritization in clinical follow-up and treatment of cancer survivors. These findings contribute to further development and optimization of tailored neurorehabilitation programs in neuro-oncological care.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 4","pages":"782-796"},"PeriodicalIF":2.5,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448403","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}
Neuro-oncology practicePub Date : 2026-02-23eCollection Date: 2026-08-01DOI: 10.1093/nop/npag016
Matthijs Van Der Meulen, Joost S P Vermaat, Norbert Galldiks, Samar Issa, Jeroen De Bresser, Jeanette K Doorduijn, Jacoline E C Bromberg
{"title":"Primary central nervous system lymphoma-current standards and recent developments.","authors":"Matthijs Van Der Meulen, Joost S P Vermaat, Norbert Galldiks, Samar Issa, Jeroen De Bresser, Jeanette K Doorduijn, Jacoline E C Bromberg","doi":"10.1093/nop/npag016","DOIUrl":"10.1093/nop/npag016","url":null,"abstract":"<p><p>Primary central nervous system lymphoma (PCNSL) is a rare aggressive B-cell non-Hodgkin lymphoma confined to the central nervous system, without systemic involvement. The incidence has increased over the past 3 decades. The prognosis has improved in patients up to 70 years old, and this type of lymphoma can be potentially cured. The gold standard of diagnosing PCNSL is histological, usually on a brain biopsy specimen via a neurosurgical procedure. Recent developments in both imaging and laboratory analyses of the cerebrospinal fluid, can be helpful in narrowing the differential diagnosis, diagnosing PCNSL itself, and in follow-up after treatment. This narrative review gives an overview of the epidemiology, diagnosis, and treatment of PCNSL, with an emphasis on recent developments in diagnostic techniques and treatment.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 4","pages":"640-648"},"PeriodicalIF":2.5,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448419","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}
Neuro-oncology practicePub Date : 2026-02-23eCollection Date: 2026-08-01DOI: 10.1093/nop/npag011
Yasmin Abdel Moneim, Patrick Roth, Michael Weller, Dorothee Gramatzki
{"title":"Prognostic associations of steroid use in patients with glioblastoma: A population-based study.","authors":"Yasmin Abdel Moneim, Patrick Roth, Michael Weller, Dorothee Gramatzki","doi":"10.1093/nop/npag011","DOIUrl":"10.1093/nop/npag011","url":null,"abstract":"<p><strong>Background: </strong>Steroids are broadly used in patients with brain tumors. A possible detrimental association of corticosteroid treatment with outcome in patients with glioblastoma has been reported but not explored on a population level.</p><p><strong>Methods: </strong>Clinical data, including corticosteroid use and related complications, of 223 patients diagnosed with isocitrate dehydrogenase wild-type glioblastoma in the years from 2010 to 2014 in the Canton of Zurich, Switzerland, were retrospectively analyzed. Survival data were estimated with the Kaplan-Meier method. Cox proportional hazards regression models were used to test the association of clinical variables with survival.</p><p><strong>Results: </strong>Most patients (<i>N</i> = 201, 95%) received steroids at least once in the first year after diagnosis, the majority (<i>N</i> = 151, 69%) in the perioperative setting (hospitalization for surgery ± 7 days), and 92 patients (61%) in the first 3 months. Steroid use at 3 months was associated with steroid use at 6 months (OR = 7.66, <i>P</i> < .001), and the latter was associated with inferior survival even after correction for known prognostic and predictive factors (<i>P</i> = .003).</p><p><strong>Conclusion: </strong>Steroid use at the 6-month landmark after diagnosis is independently associated with inferior survival in patients with glioblastoma. Limitations of the study include its retrospective design and the confounding factor that 1 frequent indication of steroid treatment is a symptomatic tumor. The biological mechanisms mediating this effect remain incompletely understood. Our findings support a cautious use of steroids and highlight the importance of minimizing dose and duration whenever clinically feasible.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 4","pages":"715-722"},"PeriodicalIF":2.5,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448347","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}
Neuro-oncology practicePub Date : 2026-02-06eCollection Date: 2026-06-01DOI: 10.1093/nop/npag006
Darren Hargrave, Daniel C Bowers, Stewart Goldman, Grant T Liu, Jennifer T Huang, Hanneke M van Santen, Nathan J Robison, Michal Zapotocky, Eric Bouffet
{"title":"Management of adverse events in patients with pediatric low-grade glioma treated with MAPK-directed therapies: Delphi consensus recommendations and unmet needs.","authors":"Darren Hargrave, Daniel C Bowers, Stewart Goldman, Grant T Liu, Jennifer T Huang, Hanneke M van Santen, Nathan J Robison, Michal Zapotocky, Eric Bouffet","doi":"10.1093/nop/npag006","DOIUrl":"10.1093/nop/npag006","url":null,"abstract":"<p><strong>Background: </strong>Pediatric low-grade gliomas (pLGGs) are the most common childhood central nervous system (CNS) tumors. Targeted therapies are effective treatments in patients with pLGGs harboring mutations in the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase 1/2 (ERK) signaling pathway. Understanding the toxicity profile and tolerability of emerging MAPK inhibitors (MAPKi) and how adverse events (AEs) can be managed to avoid treatment discontinuation, interruption, or dose reduction is important for optimizing clinical benefit.</p><p><strong>Methods: </strong>A modified Delphi consensus initiative was conducted to provide recommendations on the monitoring and management of AEs that occur with MAPKi in patients with pLGG. A 9-member steering committee was convened to develop statements based on the findings of a comprehensive literature review of AEs reported with the use of MAPKi in pediatric cancers. Consensus on statements was determined via online surveys completed by a large, global panel of experts in pLGG.</p><p><strong>Results: </strong>Of the 129 statements drafted, consensus (≥75% agreement) among 82 global experts in pLGG was reached for 50 statements, mostly pertaining to the general management of AEs occurring with MAPKi and the management of cutaneous AEs. Consensus statements include guidance on skin care and specific cutaneous conditions. Many AEs were rare with limited evidence or experience to achieve consensus recommendations.</p><p><strong>Conclusions: </strong>The consensus statements developed provide guidance and recommendations for the management of common AEs in patients with pLGG treated with MAPKi. Sharing this knowledge may lead to patients with pLGG achieving optimal benefit from MAPKi while minimizing and effectively managing AEs.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 3","pages":"620-633"},"PeriodicalIF":2.5,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931881","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}
Neuro-oncology practicePub Date : 2026-01-22eCollection Date: 2026-06-01DOI: 10.1093/nop/npaf121
Floor R Pijl, Maik L Landers, Tanvi Kamra, Melissa Kerkhof, Maaike J Vos, Jaap D Zindler, Thijs van Der Vaart, Mar Rodríguez-Girondo, Rob J A Nabuurs, Marike L D Broekman, Wouter A Moojen, Wilco C Peul, Jeroen T J M van Dijck, Rishi D S Nandoe Tewarie
{"title":"In-hospital costs of malignant brain tumor surgery: A systematic review and quality assessment.","authors":"Floor R Pijl, Maik L Landers, Tanvi Kamra, Melissa Kerkhof, Maaike J Vos, Jaap D Zindler, Thijs van Der Vaart, Mar Rodríguez-Girondo, Rob J A Nabuurs, Marike L D Broekman, Wouter A Moojen, Wilco C Peul, Jeroen T J M van Dijck, Rishi D S Nandoe Tewarie","doi":"10.1093/nop/npaf121","DOIUrl":"10.1093/nop/npaf121","url":null,"abstract":"<p><p>The increasing financial burden of therapies for brain tumor patients necessitates strategies that preserve equitable access and optimize resource allocation. The aim of this systematic review was to evaluate the in-hospital costs for malignant brain tumor surgery. A systematic review was carried out according to PRISMA guidelines on January 10, 2025, using the following databases: PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, CENTRAL, CINAHL, PsycINFO, and Academic Search Premier. Articles published after January 1, 2000, describing perioperative hospital costs for malignant brain tumor surgery patients were included. Study quality assessment was performed based on the 2022 CHEERS statement. Nine studies were included, encompassing a total of 140 813 patients. Total in-hospital costs were highly variable and ranged between $2382.47 and $30 836.98 per patient. Mean length of stay (LOS) was 5.24 days, ranging from 3 to 7.12 days. LOS and in-hospital costs were positively correlated. Study quality was low due to missing data on health economic analysis plans, and lack of reporting of uncertainty in the findings. In-hospital costs for malignant brain tumors are high, rising over time, and were significantly impacted by LOS. Study outcomes showed high variability, poor methodological quality due to inconsistent methods and inadequate cost data. Future research needs standardized, comprehensive cost analyses to support informed healthcare policy and resource allocation decisions.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 3","pages":"438-451"},"PeriodicalIF":2.5,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931922","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}
Neuro-oncology practicePub Date : 2026-01-16eCollection Date: 2026-04-01DOI: 10.1093/nop/npaf127
{"title":"Erratum to: An analysis of the influence of social determinants of health on treatment and survival among adult patients with high-grade glioma in Utah.","authors":"","doi":"10.1093/nop/npaf127","DOIUrl":"https://doi.org/10.1093/nop/npaf127","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/nop/npaf029.].</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"e2"},"PeriodicalIF":2.5,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868959","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}
Neuro-oncology practicePub Date : 2026-01-10eCollection Date: 2026-06-01DOI: 10.1093/nop/npag001
Eva E van Grinsven, Fia Cialdella, Marielle E P Philippens, Joost J C Verhoeff, Szabolcs David, Martine J E van Zandvoort
{"title":"Negative impact of hippocampal radiotherapy dose on memory function in patients with brain metastases.","authors":"Eva E van Grinsven, Fia Cialdella, Marielle E P Philippens, Joost J C Verhoeff, Szabolcs David, Martine J E van Zandvoort","doi":"10.1093/nop/npag001","DOIUrl":"10.1093/nop/npag001","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases (BMs) are often treated with stereotactic radiosurgery (SRS). Even with the high dose fall-off at tumor borders, some dose is delivered outside the BMs to ensure adequate tumor coverage. This may include radiation to the neurogenic niches (ie, subventricular zones [SVZ] and hippocampi), which possibly play a role in neurocognitive functioning (NCF). In this study, we assessed the impact of radiotherapy dose on the SVZ and hippocampi compared with changes in NCF 3 months post-SRS, focusing on memory and information processing speed (IPS) in adult patients with BMs.</p><p><strong>Methods: </strong>Neurocognitive assessments were performed before and 3 months post-SRS, and reliable change indices were calculated to assess NCF changes. The SVZ and hippocampal regions were delineated on pre-SRS T1-weighted MRI images and median radiotherapy dose per region was calculated.</p><p><strong>Results: </strong>Multivariable linear regression analyses in 36 patients corrected for age, previous brain radiotherapy, number of BMs, and previous systemic therapy indicated a significant association between higher hippocampal radiotherapy dose and decline in memory, specifically in Hopkins Verbal Learning Test-Revised immediate recall, delayed recall, and Rey Osterieth Complex Figure Test delayed copy (all <i>P</i> < .05). Conversely, no significant association was found between dose to the SVZ and memory, nor between dose to either region and IPS.</p><p><strong>Conclusions: </strong>These results suggest potential benefits of minimizing radiation exposure to the hippocampi, even with SRS, to help preserve memory in patients with BMs. Further prospective evaluation is warranted to validate these findings and inform clinical decision-making regarding radiotherapy protocols for preserving NCF in this patient population.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 3","pages":"506-517"},"PeriodicalIF":2.5,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931905","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}
Neuro-oncology practicePub Date : 2026-01-09eCollection Date: 2026-08-01DOI: 10.1093/nop/npag002
Anouk M de Jong, Maud E Kortman, Maarten W Kreek, Christina M Flies, Aline P Becker, Matthijs van der Meulen, Filip Y F L de Vos, Jan-Willem Dankbaar, Joost J C Verhoeff, Pierre A J T Robe, Tom J Snijders
{"title":"Functional outcome after repeat surgery of tumor progression or treatment-associated changes in high-grade glioma: Clinical and radiological predictors.","authors":"Anouk M de Jong, Maud E Kortman, Maarten W Kreek, Christina M Flies, Aline P Becker, Matthijs van der Meulen, Filip Y F L de Vos, Jan-Willem Dankbaar, Joost J C Verhoeff, Pierre A J T Robe, Tom J Snijders","doi":"10.1093/nop/npag002","DOIUrl":"10.1093/nop/npag002","url":null,"abstract":"<p><strong>Background: </strong>Recurrence of high-grade glioma after primary treatment is inevitable. New contrast-enhancing lesions on follow-up MRI may indicate tumor progression, treatment-associated changes (TAC), or both. A repeated surgical procedure, either biopsy or resection, provides diagnostic clarity and therapeutic benefit, but carries risks. In the patient-specific decision to operate, current literature offers limited guidance on which patients may benefit. This study aimed to describe functional outcomes after repeat surgery of previously irradiated glioma, and to identify predictors of functional deterioration.</p><p><strong>Methods: </strong>Single-center retrospective cohort study. Adults with diffuse glioma who underwent first-line radiotherapy and subsequent repeat surgery (biopsy or resection) for suspected high-grade radiological progression were included. Lesions were histologically classified as progression, TAC, or both. The primary endpoint was functional outcome 30 days postoperatively, expressed as decline of Karnofsky Performance Status (KPS). Logistic regression identified predictors of KPS decline. Survival was assessed with Kaplan-Meier and Cox regression.</p><p><strong>Results: </strong>Of 166 patients, 37 (22.3%) experienced a KPS deterioration, 127 (76.5%) remained stable, and 2 (1.2%) improved. Rates of functional deterioration were similar after biopsies and resections. Preoperative steroid usage (odds ratio = 2.73, 95% confidence interval = 1.09-6.79, <i>P</i> = .031) was associated with KPS deterioration. Histological diagnosis was not associated with functional outcome (χ<sup>2</sup>, <i>P</i> = .361). Patients with deterioration had shorter median survival (4 vs 11 months, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>In this cohort, 22.3% of patients experienced functional decline 30 days after a repeat surgery (biopsy or resection). Preoperative steroid usage predicted deterioration. These findings may provide clinical guidance in identifying which patients will benefit from repeat surgery.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 4","pages":"673-684"},"PeriodicalIF":2.5,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448509","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}
Neuro-oncology practicePub Date : 2025-12-31eCollection Date: 2026-04-01DOI: 10.1093/nop/npaf130
Andrew Rodriguez, Karan Dixit, Richard M O'Hara, Morana Vojnic
{"title":"Efficacy of tepotinib in patients with high-grade glioma with <i>MET</i> alterations: A case series.","authors":"Andrew Rodriguez, Karan Dixit, Richard M O'Hara, Morana Vojnic","doi":"10.1093/nop/npaf130","DOIUrl":"10.1093/nop/npaf130","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma is the most common and aggressive adult brain malignancy, characterized by poor prognosis and limited treatment options. The <i>MET</i> (hepatocyte growth factor receptor) oncogene plays a crucial role in tumor progression, with alterations such as gene amplification and fusion events contributing to worsened prognosis, decreased survival rates, and resistance to standard chemotherapy treatments.</p><p><strong>Case summary: </strong>This case series documents the clinical outcomes of 5 patients with <i>MET</i>-altered glioblastoma treated with tepotinib, a highly selective MET tyrosine kinase inhibitor approved for patients with <i>MET</i> exon 14 skipping advanced/metastatic non-small cell lung cancer, in routine clinical practice in the United States. The patients received tepotinib through ad hoc off-label requests, with a daily dosage of 450 mg after progression following radiotherapy-based first-line treatment, with or without temozolomide. The efficacy and safety outcomes were assessed based on physicians' evaluations. Tepotinib demonstrated clinical benefit, with partial response observed in 2 patients, stable disease in 2 patients, and progressive disease in 1 patient. The duration of tepotinib treatment ranged from 0.7 to >15 months, with treatment ongoing in 1 patient as of June 2025. Adverse events were generally mild to moderate, including grade 2 peripheral edema, grade 1 increased alanine aminotransferase levels, and grade 2 elevated liver function tests.</p><p><strong>Conclusions: </strong>These findings support the potential of tepotinib as a targeted therapy for <i>MET</i>-altered glioblastoma, consistent with preclinical evidence and previous case reports. Further research is warranted to better understand the efficacy and safety of MET inhibition in this patient population.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"13 2","pages":"422-427"},"PeriodicalIF":2.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868982","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}