Neuro-oncology practice最新文献

{"title":"A feasibility, safety, and efficacy evaluation of supervised aerobic and resistance exercise for patients with glioblastoma undertaking adjuvant chemoradiotherapy.","authors":"Anna K Nowak,&nbsp;Robert U Newton,&nbsp;Travis Cruickshank,&nbsp;Prue Cormie,&nbsp;Georgia K B Halkett,&nbsp;Daphne Tsoi,&nbsp;Daniel A Galvão","doi":"10.1093/nop/npad006","DOIUrl":"https://doi.org/10.1093/nop/npad006","url":null,"abstract":"<p><strong>Background: </strong>While therapeutically effective, chemoradiotherapy treatment for high-grade glioma (glioblastoma) is often accompanied by side effects. Exercise has been demonstrated to alleviate the adverse effects of such treatments in other cancers. We aimed to evaluate the feasibility and preliminary efficacy of supervised exercise incorporating autoregulation.</p><p><strong>Methods: </strong>Thirty glioblastoma patients were recruited, five declined exercise and 25 were provided with a multimodal exercise intervention for the duration of their chemoradiotherapy treatment. Patient recruitment, retention, adherence to training sessions and safety were evaluated throughout the study. Physical function, body composition, fatigue, sleep quality, and quality of life were evaluated before and after the exercise intervention.</p><p><strong>Results: </strong>Eight of the 25 participants commencing exercise withdrew prior to completion of the study (32%). Seventeen patients (68%) demonstrated low to high adherence (33%-100%) and exercise dosage compliance (24%-83%). There were no reported adverse events. Significant improvements were observed for all trained exercises and lower limb muscle strength and function with no significant changes observed for any other physical function, body composition, fatigue, sleep, or quality of life outcomes.</p><p><strong>Conclusions: </strong>Only half of glioblastoma patients recruited were willing or able to commence, complete or meet minimum dose compliance for the exercise intervention during chemoradiotherapy indicating the intervention evaluated may not be feasible for part of this patient cohort. For those who were able to complete the exercise program, supervised, autoregulated, multimodal exercise was safe and significantly improved strength and function and may have prevented deterioration in body composition and quality of life.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 3","pages":"261-270"},"PeriodicalIF":2.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/56/npad006.PMC10180379.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9477269","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":"Neuro-oncology in the crosshairs during the coronavirus disease 2019 pandemic.","authors":"Daniel W Fults","doi":"10.1093/nop/npad029","DOIUrl":"10.1093/nop/npad029","url":null,"abstract":"","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 5","pages":"406-407"},"PeriodicalIF":2.4,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308450","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":"Radio-chemotherapy feasibility for biopsy-only unresectable <i>IDH</i> wild-type glioblastomas (BO-GBM)","authors":"Vincent Harlay, Romain Appay, Céline Bequet, Gregorio Petrirena, Chantal Campello, Maryline Barrié, Didier Autran, Thomas Graillon, Sébastien Boissonneau, Henry Dufour, Dominique Figarella-Branger, Laetitia Padovani, Anne Barlier, Isabelle Nanni, Emeline Tabouret, Olivier Chinot","doi":"10.1093/nop/npad028","DOIUrl":"https://doi.org/10.1093/nop/npad028","url":null,"abstract":"Abstract Abstract Background “Biopsy-only” glioblastoma (BO-GBM) is a heterogeneous, understudied group of patients associated with a poor outcome. Our objective was to explore the pattern of care and prognosis associated with BO-GBM in our center. Methods Patients with IDH wild-type BO-GBM included in a prospective regional cohort initiated in 2014 and closed in 2017 were retrospectively reviewed for patient characteristics, MRI findings, treatment allocation, and delivery. Results Of 535 patients included in the cohort, 137 patients were included in the present analysis. The median age was 66 years old and the median KPS was 70. Forty-six patients (33.6%) were referred to radiotherapy and chemotherapy (RT–TMZ) regimen, 75 (54.7%), considered unfitted for RT, received chemotherapy upfront (CT) and 16 (11.7%) were referred to palliative care (PC). Regarding the first group, 91% of patients completed the RT–TMZ. In the CT group, 11 of 75 patients (14.7%) underwent radiotherapy after chemotherapy upfront. Median overall survival was 12.3 months (95% CI, 15.30–24.16), 5.7 months (95% CI, 6.22–9.20), and 1.9 months (95% CI, 1.43–5.08) in RT–TMZ, CT, and PC groups, respectively. In multivariate analyses, progression-free survival was impacted by baseline KPS (P &amp;lt; .001) and MGMT status (P = .004). Overall survival was impacted by baseline KPS (P &amp;lt; .001) and age (P = .030). Conclusion BO-GBM constitute a large and heterogeneous population in which one-third of patients is amenable to the standard of care, with survival outcome close to one of the patients who underwent surgery. Reliable criteria are needed to help select patients for adequate treatment while new strategies are warranted for BO-GBM unfit for RT.","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135478547","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":"The effects of educational interventions and the COVID-19 pandemic on the time to diagnosis in pediatric patients with primary central nervous system tumors.","authors":"Tyler Canova, Neil McNinch, Alexis Judd, Sarah Rush, Erin Wright","doi":"10.1093/nop/npad024","DOIUrl":"10.1093/nop/npad024","url":null,"abstract":"<p><strong>Background: </strong>Primary central nervous system tumors are a leading cause of death and disability amongst pediatric cancer patients. Akron Children's Hospital published data in 2018 on response time for brain tumor diagnosis and implemented components of an established program to decrease diagnostic delays and thereby reduce tumor- and treatment-related morbidities. This study evaluates if there was an improvement in the total diagnostic interval (TDI, time from symptom onset to diagnosis) after provider education. During the study, the COVID-19 pandemic forced alterations in care delivery. The impact this had on the TDI was also assessed.</p><p><strong>Methods: </strong>A retrospective chart review was performed, and patients were separated into 2008-2017 (historical) and 2018-2021 (posteducation) groups to assess the effect of educational interventions on TDI. The posteducation cohort was analyzed separately to assess the impact of COVID-19 pandemic.</p><p><strong>Results: </strong>The 85 patients studied in the post-education group showed a median TDI of 31 days. Though not statistically significant (<i>P</i> = .939), this represents an 11-day decrease in median TDI compared to the historical group (42 days). In addition, the posteducation group showed an increase in the average number of healthcare provider visits (HCP, 2.4 historical to 3.2 posteducation, <i>P</i> = .009). The pre-COVID-19 group (median TDI 43.5 days) did not differ statistically from the post-COVID-19 group (30-day median TDI).</p><p><strong>Conclusion: </strong>The nonsignificant decrease in TDI and concurrent increase in HCP visits after implementation of education suggests a potential gap amongst providers in working-up primary CNS tumors. These results will influence expansion of education to further improve TDI.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 5","pages":"437-445"},"PeriodicalIF":2.7,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10655879","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 evaluation of biobanking and therapeutic clinical trial representation among adult glioma patients from rural and urban Utah.","authors":"Emma R Earl, Howard Colman, Joe Mendez, Randy L Jensen, Michael Karsy","doi":"10.1093/nop/npad026","DOIUrl":"10.1093/nop/npad026","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOHs)-specifically those related to rurality, health care accessibility, and income-may play as-yet-unidentified roles in prognosis for glioma patients, and their impact on access to clinical trials is important to understand. We examined SDOHs of patients enrolled in glioma clinical trials and evaluate disparities in trial participation and outcomes between rural and urban patients.</p><p><strong>Methods: </strong>We retrospectively identified patients enrolled in glioma clinical trials at Huntsman Cancer Institute (HCI) from May 2012 to May 2022 to evaluate clinical trial participation. We used multivariable models to evaluate SDOHs and geographic information system mapping to assess representation across Utah's counties. We utilized the most recent 10-year datasets of patients treated for glioma at HCI and from the Utah Cancer Registry to analyze survival and incidence, respectively.</p><p><strong>Results: </strong>A total of 570 participants (68 trials) resided in Utah, 84.4% from urban counties, 13.5% from rural counties, and 2.1% from frontier (least-populous) counties. Nineteen counties (65.5%) were underrepresented in trials (enrolled participants vs. eligible), 1 (3.5%) was represented in a near-1:1 ratio, and 9 (31.0%) were overrepresented. Counties with greater enrollment had greater population densities, highest per-capita income, and proximity to HCI. Among patients treated at HCI, patients from rural/frontier counties had equivalent survival with urban patients across nearly all glioma types, including glioblastomas, despite underrepresentation in clinical trials.</p><p><strong>Conclusions: </strong>By highlighting disparities in clinical trial enrollment, our results can support efforts to improve recruitment in underrepresented regions, which can assist providers in delivering equitable care for all patients.</p>","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"10 5","pages":"472-481"},"PeriodicalIF":2.7,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10502782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308445","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/npad021","DOIUrl":"https://doi.org/10.1093/nop/npad021","url":null,"abstract":"Journal Article Forthcoming Meetings Get access Neuro-Oncology Practice, Volume 10, Issue 3, June 2023, Page 315, https://doi.org/10.1093/nop/npad021 Published: 12 May 2023 Article history Corrected and typeset: 12 May 2023 Published: 12 May 2023","PeriodicalId":19234,"journal":{"name":"Neuro-oncology practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135337483","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":"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":"10 4","pages":"318-319"},"PeriodicalIF":2.4,"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":"10 5","pages":"462-471"},"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":"10 4","pages":"370-380"},"PeriodicalIF":2.4,"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":"10 4","pages":"320-321"},"PeriodicalIF":2.4,"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}