Neuro-oncology advances最新文献

{"title":"Real-world analysis of treatment patterns and survival outcome of glioblastoma patients in a German single-center study: Can survival rates of randomized controlled trials be achieved?","authors":"Samuel Paus, Johannes Hoffmann, Julia Roeper, Frank Griesinger","doi":"10.1093/noajnl/vdaf009","DOIUrl":"10.1093/noajnl/vdaf009","url":null,"abstract":"<p><strong>Background: </strong>The reported survival data for glioblastoma patients vary strongly between different studies. In our study, we therefore examined which data are applicable in a real-world population in a German center and how these real-world data perform in comparison to survival data presented in randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>Data of all patients treated with newly diagnosed glioblastoma in a single German center between 2010 and 2019 were analyzed and treatment patterns plus survival rates were matched to existing real-world data and results of RCTs.</p><p><strong>Results: </strong>Two hundred thirty-three patients were analyzed. Median age was 63 years, f/m ratio was 1:162, and 73% of patients underwent surgery, while 27% had biopsy only. The extent of resection had a significant impact on overall survival (OS; <i>P</i> <.001), as well as age (<i>P</i> <.001), methylguanine methyltransferase methylation status (<i>P</i> <.001), and eastern cooperative oncology group performance status (<i>P</i> <.001). The median OS of our whole study population was 10.55 months. While a fictitious Stupp study cohort (built by using eligibility criteria of the EORTC-22981-26981 trial) with an OS of 14.3 months nearly achieved the survival results of the presented data from the EORTC-22981-26981 trial, the OS of the patients who did not fulfill the eligibility criteria was only 6.9 months.</p><p><strong>Conclusion: </strong>Survival of patients with unfavorable prognostic factors is still poor and these patients are not represented in recent RCTs. Outcome data of RCTs can be transferred to real world cohorts, if in- and exclusion criteria are fulfilled, while outcome is significantly inferior in cohorts that do not fulfill these criteria.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdaf009"},"PeriodicalIF":3.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416032","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 single-arm phase 2 study of abemaciclib in adult patients with recurrent grade 3 oligodendroglioma.","authors":"Carson A Wills, Suyash Mohan, Ali Nabavizadeh, Thara Patel, Timothy Prior, Maikel Mansour, Emily McCoy, Shivani Shah, Natalie Angeloni, Meghan O'Neill, Suzanne Frangos, Caroline Blessing, Leah Coghlan, Eileen Maloney, E Paul Wileyto, Arati S Desai, Stephen J Bagley","doi":"10.1093/noajnl/vdaf011","DOIUrl":"10.1093/noajnl/vdaf011","url":null,"abstract":"<p><strong>Background: </strong>Novel treatments are needed for oligodendroglioma that has recurred following radiotherapy (RT) and chemotherapy. The cyclin D1-CDK4 axis is frequently dysregulated in oligodendroglioma. Abemaciclib is a selective CDK4/6 inhibitor that achieves pharmacologically relevant concentrations in brain tumor tissue.</p><p><strong>Methods: </strong>We conducted a single-arm, phase 2 trial evaluating the efficacy of abemaciclib in patients with recurrent oligodendroglioma, isocitrate dehydrogenase (IDH)-mutant and 1p/19q-codeleted, WHO grade 3, following prior RT and ≥1 line of alkylating chemotherapy. Patients received abemaciclib 200 mg twice daily. The primary endpoint was progression-free survival at 6 months (PFS-6).</p><p><strong>Results: </strong>Ten patients were enrolled. The most common treatment-related adverse event was grade 1-2 diarrhea, occurring in all patients. Five patients (50%) were alive and progression-free at 6 months, below the minimum required (80%) to meet the primary endpoint. In patients with enhancing tumor (<i>n</i> = 9), best response was partial response in 2 patients (objective radiographic response = 22.2%; duration of response [DOR] 13.1 and 7.7 months), stable disease (SD) in 3 patients (33.3%; duration of SD 17.0, 6.7, and 2.5 months), progressive disease in 3 patients (33.3%), and nonevaluable in 1 patient (11.1%). The patient with nonenhancing tumor showed SD lasting 10.2 months. Median PFS was 7.7 months (95% CI, 1.7-13.1 months); median overall survival was not reached (median follow-up 17 months).</p><p><strong>Conclusions: </strong>The efficacy of abemaciclib in recurrent grade 3 oligodendroglioma was inadequate to warrant further evaluation as monotherapy in unselected patients. However, given the objective responses and durable disease control observed in a subset of patients, further studies are warranted to identify subgroups that may benefit.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdaf011"},"PeriodicalIF":3.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412187","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":"Synthetic O-(2-¹⁸F-fluoroethyl)-l-tyrosine-positron emission tomography generation and hotspot prediction via preoperative MRI fusion of gliomas lacking radiographic high-grade characteristics.","authors":"Eric Suero Molina, Mehnaz Tabassum, Ghasem Azemi, Zeynep Özdemir, Wolfgang Roll, Philipp Backhaus, Philipp Schindler, Alex Valls Chavarria, Carlo Russo, Sidong Liu, Walter Stummer, Antonio Di Ieva","doi":"10.1093/noajnl/vdaf001","DOIUrl":"https://doi.org/10.1093/noajnl/vdaf001","url":null,"abstract":"<p><strong>Background: </strong>Limited amino acid availability for positron emission tomography (PET) imaging hinders therapeutic decision-making for gliomas without typical high-grade imaging features. To address this gap, we evaluated a generative artificial intelligence (AI) approach for creating synthetic O-(2-¹⁸F-fluoroethyl)-l-tyrosine ([¹⁸F]FET)-PET and predicting high [¹⁸F]FET uptake from magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>We trained a deep learning (DL)-based model to segment tumors in MRI, extracted radiomic features using the Python PyRadiomics package, and utilized  a Random Forest classifier to predict high [¹⁸F]FET uptake. To generate [¹⁸F]FET-PET images, we employed a generative adversarial network framework and utilized a split-input fusion module for processing different MRI sequences through feature extraction, concatenation, and self-attention.</p><p><strong>Results: </strong>We included magnetic resonance imaging (MRI) and PET images from 215 studies for the hotspot classification and 211 studies for the synthetic PET generation task. The top-performing radiomic features achieved 80% accuracy for hotspot prediction. From the synthetic [¹⁸F]FET-PET, 85% were classified as clinically useful by senior physicians. Peak signal-to-noise ratio analysis indicated high signal fidelity with a peak at 40 dB, while structural similarity index values showed structural congruence. Root mean square error analysis demonstrated lower values below 5.6. Most visual information fidelity scores ranged between 0.6 and 0.7. This indicates that synthetic PET images retain the essential information required for clinical assessment and diagnosis.</p><p><strong>Conclusion: </strong>For the first time, we demonstrate that predicting high [¹⁸F]FET uptake and generating synthetic PET images from preoperative MRI in lower-grade and high-grade glioma are feasible. Advanced MRI modalities and other generative AI models will be used to improve the algorithm further in future studies.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdaf001"},"PeriodicalIF":3.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048795","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 immunopeptidomic landscape of ependymomas provides actionable antigens for T-cell-based immunotherapy.","authors":"Lena Mühlenbruch, David Rieger, Hannes Becker, Ana Maia Santos Leite, Irina Mäurer, Jens Schittenhelm, Marissa Dubbelaar, Leon Bichmann, Oliver Kohlbacher, Hans-Georg Rammensee, Cécile Gouttefangeas, Marcos Tatagiba, Juliane S Walz, Ghazaleh Tabatabai","doi":"10.1093/noajnl/vdae226","DOIUrl":"https://doi.org/10.1093/noajnl/vdae226","url":null,"abstract":"<p><strong>Background: </strong>Ependymoma are primary tumors of the nervous system. Due to their growth pattern, many ependymomas can be managed with neurosurgical resection alone. A substantial proportion of these tumors recurs or displays infiltrative growth patterns. Further established therapeutic options include radiation therapy. Systemic treatment options include platinum-based therapeutic regimes or a combination of lapatinib and temozolomide. Peptide-based immunotherapy represents a promising therapeutic strategy relying on the induction of tumor-specific T cells targeting human leukocyte antigens (HLA)-presented peptides. Our work aimed to analyze the landscape of naturally presented HLA class I and II ligands of primary ependymomas (EPN) to delineate EPN-associated antigens.</p><p><strong>Methods: </strong>We investigated 22 EPN tissue samples using a comparative mass spectrometry-based immunopeptidomic approach. Additionally, EPN-specific antigens were functionally characterized in T-cell-based immunogenicity assays.</p><p><strong>Results: </strong>We discovered a subset of EPN-exclusive peptides including HLA-A*02 and HLA-A*25/HLA-A*26-restricted HLA ligands and identified a small panel of cancer/testis antigens (CTAs)-derived HLA ligands. Furthermore, we outlined immunopeptidomic alterations in different ependymoma subgroups and progressive ependymoma. Subsequently, we performed functional characterization of the previously identified HLA-A*02:01 restricted peptide FLDS to demonstrate immunogenicity in vitro.</p><p><strong>Conclusion: </strong>The immunopeptidome landscape of EPNs provides actionable targets that could further be explored as a T cell-based immunotherapeutic strategy in this tumor entity.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae226"},"PeriodicalIF":3.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083056","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":"ICAM-1 and IL-10 are associated with cognitive dysfunction using the MoCA test in glioma: Findings from the NCI Neuro-Oncology Branch Natural History Study.","authors":"Kaitlynn Slattery, McKenzie C Kauss, Dhaivat Raval, Emory Hsieh, Ann Choi, Tara S Davis, Kimberly R Robins, Hope Miller, Elizabeth Vera, Michelle L Wright, Marta Penas-Prado, Mark R Gilbert, Tito Mendoza, Terri S Armstrong, Vivian A Guedes","doi":"10.1093/noajnl/vdaf002","DOIUrl":"10.1093/noajnl/vdaf002","url":null,"abstract":"<p><strong>Background: </strong>Cognitive dysfunction is common among patients with malignant glioma, yet the underlying mechanisms of this dysfunction remain unclear. Protein markers of neurodegeneration, inflammation, and vascular damage have been associated with central nervous system pathology and with cognitive changes in neurological diseases, but their clinical utility in gliomas is unknown. This study examined the relationships between cognitive dysfunction, tumor isocitrate dehydrogenase (IDH) mutation status in gliomas, and a panel of blood-based protein biomarkers.</p><p><strong>Methods: </strong>This retrospective cohort study included 73 glioma patients with either IDH-mutant (<i>n</i> = 45) or IDH-wildtype tumors (<i>n</i> = 28) enrolled in a natural history study. Cognitive function was assessed using the Montreal Cognitive Assessment (scores <26 indicated cognitive dysfunction). Serum levels of 17 proteins were measured using ultrasensitive assays.</p><p><strong>Results: </strong>Cognitive dysfunction was present in 53% of participants (<i>n</i> = 39), and more frequently in the IDH-wildtype group (75%) than in the IDH-mutant group (40%). Patients with wildtype tumors had higher levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1, interleukin-6 (IL-6), and tumor necrosis factor-α than patients with IDH-mutant tumors, which remained in multivariate analysis. ICAM-1 and IL-10 were higher in patients with cognitive dysfunction compared to those with normal cognition, even after adjusting for tumor IDH-mutation status, age, tumor grade, and surgery history.</p><p><strong>Conclusions: </strong>Cognitive dysfunction was associated with protein markers linked to vascular damage and inflammation regardless of tumor IDH status. Our findings suggest an association of cognitive dysfunction with heightened systemic inflammatory status that requires further interrogation for its role in pathophysiologic mechanisms.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdaf002"},"PeriodicalIF":3.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560433","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":"Therapeutic manipulation and bypass of the blood-brain barrier: powerful tools in glioma treatment.","authors":"Alexandra M Giantini-Larsen, Abhinav Pandey, Andrew L A Garton, Margherita Rampichini, Graham Winston, Jacob L Goldberg, Rajiv Magge, Philip E Stieg, Mark M Souweidane, Rohan Ramakrishna","doi":"10.1093/noajnl/vdae201","DOIUrl":"10.1093/noajnl/vdae201","url":null,"abstract":"<p><p>The blood-brain barrier (BBB) remains an obstacle for delivery of chemotherapeutic agents to gliomas. High grade and recurrent gliomas continue to portend a poor prognosis. Multiple methods of bypassing or manipulating the BBB have been explored, including hyperosmolar therapy, convection-enhanced delivery (CED), laser-guided interstitial thermal therapy (LITT), and Magnetic Resonance Guided Focused Ultrasound (MRgFUS) to enhance delivery of chemotherapeutic agents to glial neoplasms. Here, we review these techniques, currently ongoing clinical trials to disrupt or bypass the BBB in gliomas, and the results of completed trials.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae201"},"PeriodicalIF":3.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061806","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 value of AI for assessing longitudinal brain metastases treatment response.","authors":"Vincent Andrearczyk, Luis Schiappacasse, Matthieu Raccaud, Jean Bourhis, John O Prior, Michel A Cuendet, Andreas F Hottinger, Vincent Dunet, Adrien Depeursinge","doi":"10.1093/noajnl/vdae216","DOIUrl":"10.1093/noajnl/vdae216","url":null,"abstract":"<p><strong>Background: </strong>Effective follow-up of brain metastasis (BM) patients post-treatment is crucial for adapting therapies and detecting new lesions. Current guidelines (Response Assessment in Neuro-Oncology-BM) have limitations, such as patient-level assessments and arbitrary lesion selection, which may not reflect outcomes in high tumor burden cases. Accurate, reproducible, and automated response assessments can improve follow-up decisions, including (1) optimizing re-treatment timing to avoid treating responding lesions or delaying treatment of progressive ones, and (2) enhancing precision in evaluating responses during clinical trials.</p><p><strong>Methods: </strong>We compared manual and automatic (deep learning-based) lesion contouring using unidimensional and volumetric criteria. Analysis focused on (1) agreement in size and RANO-BM categories, (2) stability of measurements under scanner rotations and over time, and (3) predictability of 1-year outcomes. The study included 49 BM patients, with 184 MRI studies and 448 lesions, retrospectively assessed by radiologists.</p><p><strong>Results: </strong>Automatic contouring and volumetric criteria demonstrated superior stability (<i>P</i> < .001 for rotation; <i>P</i> < .05 over time) and better outcome predictability compared to manual methods. These approaches reduced observer variability, offering reliable and efficient response assessments. The best outcome predictability, defined as 1-year response, was achieved using automatic contours and volumetric measurements. These findings highlight the potential of automated tools to streamline clinical workflows and provide consistency across evaluators, regardless of expertise.</p><p><strong>Conclusion: </strong>Automatic BM contouring and volumetric measurements provide promising tools to improve follow-up and treatment decisions in BM management. By enhancing precision and reproducibility, these methods can streamline clinical workflows and improve the evaluation of response in trials and practice.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae216"},"PeriodicalIF":3.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082098","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":"High-dose MTX-based polychemotherapy for primary CNS lymphoma in younger patients: Long-term efficacy of the modified Bonn protocol.","authors":"Thomas Zeyen, Johannes Weller, Matthias Schneider, Anna-Laura Potthoff, Christina Schaub, Lea Roever, Eleni Gkika, Hartmut Vatter, Tobias A W Holderried, Peter Brossart, Ulrich Herrlinger, Niklas Schaefer","doi":"10.1093/noajnl/vdaf005","DOIUrl":"10.1093/noajnl/vdaf005","url":null,"abstract":"<p><strong>Background: </strong>Polychemotherapy based on high-dose methotrexate (HD-MTX) is the standard therapy for newly diagnosed younger patients (<65 years) with primary CNS lymphoma (PCNSL). In the modified Bonn protocol, consolidation therapy consists of intraventricular chemotherapy that is added to the continuation of HD-MTX-based chemotherapy. This study investigates the efficacy and toxicity of the modified Bonn protocol in first-line therapy of young patients with PCNSL.</p><p><strong>Methods: </strong>All consecutive immunocompetent patients aged <65 years who were newly diagnosed with PCNSL from 2012 to 2021 and started first-line therapy with the modified Bonn protocol at the Neurooncology Center Bonn were included in this retrospective analysis. Treatment comprised 3 courses of rituximab/HD-MTX/IFO followed by consolidation therapy with 2 courses of HD-AraC and 2 courses of HD-MTX/IFO, including intrathecal MTX and intrathecal AraC. Progression-free and overall survival were evaluated.</p><p><strong>Results: </strong>Forty-three patients were included. Thirty-seven patients (86%) reached intrathecal consolidation therapy. Grade 3/4 toxicity was observed in 58.1%. The median PFS was 102.8 months; 5-year OS rate was 76% (median not reached). Eighteen patients developing refractory/relapsed PCNSL received second-line therapy using the modified Freiburg protocol (AraC/TT +/- HD-MTX/rituximab followed by BCNU/TT-based HD-ASCT). A second relapse was observed in 11/18 patients (median follow-up of 17 months (IQR 5-43.7 months)).</p><p><strong>Conclusions: </strong>First-line treatment of PCNSL with the modified Bonn protocol is highly effective. The outcome compares well with other seemingly more toxic PCNSL protocols for younger patients. In patients with disease recurrence, second-line therapy according to the modified Freiburg protocol appears to be effective.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdaf005"},"PeriodicalIF":3.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124236","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":"Mapping glioma's impact on cognition: Insights from macrostructure, microstructure, and beyond.","authors":"Nuria Cayuela, Cristina Izquierdo, Lucía Vaquero, Estela Càmara, Jordi Bruna, Marta Simó","doi":"10.1093/noajnl/vdaf003","DOIUrl":"10.1093/noajnl/vdaf003","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment (CI) significantly impacts the quality of life of glioma patients. The main contributing risk factors include tumor characteristics, treatment-related factors, and their complex interplay. This review explores the role of advanced structural neuroimaging techniques in understanding CI in glioma patients.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, PsycINFO, and ISI Web of Knowledge using specific keywords. We included studies with advanced magnetic resonance imaging techniques and objective neuropsychological exams.</p><p><strong>Results: </strong>At diagnosis, during the pre-surgery phase, associations between glioma characteristics and cognitive outcomes have been described. Specifically, patients with isocitrate dehydrogenase (IDH)-wild-type gliomas exhibit more adverse cognitive outcomes, accompanied by disruptions in gray (GM) and white matter (WM) networks when compared to IDH-mutant. In addition, pre- and post-surgery imaging analyses highlight the importance of preserving specific WM tracts, such as the inferior longitudinal and arcuate fasciculus, in mitigating verbal memory and language processing decline. Furthermore, examining gliomas in perisylvian regions emphasizes deleterious effects on various cognitive domains. Additionally, it has been suggested that neuroplastic reorganization could serve as a compensatory mechanism against CI. Lastly, a limited number of studies suggest long-term CI linked to GM atrophy and leukoencephalopathy induced by radiotherapy ± chemotherapy in glioma survivors, highlighting the need for improving treatment approaches, particularly for patients with extended survival expectations.</p><p><strong>Conclusion: </strong>This review underscores the need for nuanced understanding and an individual approach in the management of glioma patients. Neuroplastic insights offer clinicians valuable guidance in surgical decision-making and personalized therapeutic approaches thus improving patient outcomes in neuro-oncology.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdaf003"},"PeriodicalIF":3.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257584","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":"cIMPACT-NOW update 9: Recommendations on utilization of genome-wide DNA methylation profiling for central nervous system tumor diagnostics.","authors":"Kenneth Aldape, David Capper, Andreas von Deimling, Caterina Giannini, Mark R Gilbert, Cynthia Hawkins, Jürgen Hench, Thomas S Jacques, David Jones, David N Louis, Sabine Mueller, Brent A Orr, MacLean Nasrallah, Stefan M Pfister, Felix Sahm, Matija Snuderl, David Solomon, Pascale Varlet, Pieter Wesseling","doi":"10.1093/noajnl/vdae228","DOIUrl":"10.1093/noajnl/vdae228","url":null,"abstract":"<p><p>Genome-wide DNA methylation signatures correlate with and distinguish central nervous system (CNS) tumor types. Since the publication of the initial CNS tumor DNA methylation classifier in 2018, this platform has been increasingly used as a diagnostic tool for CNS tumors, with multiple studies showing the value and utility of DNA methylation-based classification of CNS tumors. A Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) Working Group was therefore convened to describe the current state of the field and to provide advice based on lessons learned to date. Here, we provide recommendations for the use of DNA methylation-based classification in CNS tumor diagnostics, emphasizing the attributes and limitations of the modality. We emphasize that the methylation classifier is one diagnostic tool to be used alongside previously established diagnostic tools in a fully integrated fashion. In addition, we provide examples of the inclusion of DNA methylation data within the layered diagnostic reporting format endorsed by the World Health Organization (WHO) and the International Collaboration on Cancer Reporting. We emphasize the need for backward compatibility of future platforms to enable accumulated data to be compatible with new versions of the array. Finally, we outline the specific connections between methylation classes and CNS WHO tumor types to aid in the interpretation of classifier results. It is hoped that this update will assist the neuro-oncology community in the interpretation of DNA methylation classifier results to facilitate the accurate diagnosis of CNS tumors and thereby help guide patient management.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae228"},"PeriodicalIF":3.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124235","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}