Neuro-oncology advances最新文献

{"title":"The potential of GPT-4 advanced data analysis for radiomics-based machine learning models.","authors":"Martha Foltyn-Dumitru, Aditya Rastogi, Jaeyoung Cho, Marianne Schell, Mustafa Ahmed Mahmutoglu, Tobias Kessler, Felix Sahm, Wolfgang Wick, Martin Bendszus, Gianluca Brugnara, Philipp Vollmuth","doi":"10.1093/noajnl/vdae230","DOIUrl":"https://doi.org/10.1093/noajnl/vdae230","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the potential of the Advanced Data Analytics (ADA) package of GPT-4 to autonomously develop machine learning models (MLMs) for predicting glioma molecular types using radiomics from MRI.</p><p><strong>Methods: </strong>Radiomic features were extracted from preoperative MRI of <i>n</i> = 615 newly diagnosed glioma patients to predict glioma molecular types (IDH-wildtype vs IDH-mutant 1p19q-codeleted vs IDH-mutant 1p19q-non-codeleted) with a multiclass ML approach. Specifically, ADA was used to autonomously develop an ML pipeline and benchmark performance against an established handcrafted model using various MRI normalization methods (N4, Zscore, and WhiteStripe). External validation was performed on 2 public glioma datasets D2 (<i>n</i> = 160) and D3 (<i>n</i> = 410).</p><p><strong>Results: </strong>GPT-4 achieved the highest accuracy of 0.820 (95% CI = 0.819-0.821) on the D3 dataset with N4/WS normalization, significantly outperforming the benchmark model's accuracy of 0.678 (95% CI = 0.677-0.680) (<i>P</i> < .001). Class-wise analysis showed performance variations across different glioma types. In the IDH-wildtype group, GPT-4 had a recall of 0.997 (95% CI = 0.997-0.997), surpassing the benchmark's 0.742 (95% CI = 0.740-0.743). For the IDH-mut 1p/19q-non-codel group, GPT-4's recall was 0.275 (95% CI = 0.272-0.279), lower than the benchmark's 0.426 (95% CI = 0.423-0.430). In the IDH-mut 1p/19q-codel group, GPT-4's recall was 0.199 (95% CI = 0.191-0.206), below the benchmark's 0.730 (95% CI = 0.721-0.738). On the D2 dataset, GPT-4's accuracy was significantly lower (<i>P</i> < .001) than the benchmark's, with N4/WS achieving 0.668 (95% CI = 0.666-0.671) compared with 0.719 (95% CI = 0.717-0.722) (<i>P</i> < .001). Class-wise analysis revealed the same pattern as observed in D3.</p><p><strong>Conclusions: </strong>GPT-4 can autonomously develop radiomics-based MLMs, achieving performance comparable to handcrafted MLMs. However, its poorer class-wise performance due to unbalanced datasets shows limitations in handling complete end-to-end ML pipelines.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae230"},"PeriodicalIF":3.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960798","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":"Post-intrathecal chemotherapy-related paraplegia syndrome in hematological cancer patients: A systematic review.","authors":"Matthijs Monnikhof, Gabriella Hamming, Sandra Crnko, Rick Brandsma, Anna van Rhenen, Thomas Monnikhof, Niels Bovenschen, Gertjan Kaspers, Thijs W H Flinsenberg","doi":"10.1093/noajnl/vdae217","DOIUrl":"10.1093/noajnl/vdae217","url":null,"abstract":"<p><strong>Background: </strong>Intrathecal (IT) chemotherapy is essential in treating hematological malignancies, but it can lead to ascending paraplegia, a condition that currently lacks clear management guidelines.</p><p><strong>Methods: </strong>We conducted a systematic review, analyzing 1219 studies and 116 patients, adhering to PRISMA guidelines for individual patient data. The study, registered under PROSPERO (CRD42022362121), focused on the onset, diagnostic approaches, and therapeutic interventions associated with this complication, and management strategies to tackle the ascending paraplegia.</p><p><strong>Results: </strong>Paraplegia typically manifests approximately 10 days after chemotherapy, irrespective of injection frequency. In 95% of cases, paralysis stabilizes around the umbilical region, although some patients progress to upper limb involvement and respiratory compromise. Despite various diagnostic methods, consistent inflammatory markers in blood or cerebrospinal fluid are lacking, with approximately 60% of patients showing normal magnetic resonance imaging results at presentation. Misdiagnoses often include transverse myelitis, Guillain-Barré syndrome, and autoimmune radiculitis. Common treatments such as corticosteroids and intravenous immunoglobulins show limited effectiveness.</p><p><strong>Conclusion: </strong>Our review delineates the clinical entity of ascending paraplegia following IT chemotherapy, aiming to increase clinician awareness and provide prognostic insight. We introduce the term post-IT paraplegia syndrome to facilitate accurate diagnosis and optimize treatment strategies for affected patients.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae217"},"PeriodicalIF":3.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960797","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":"Clinical value of the <i>MGMT</i> promoter methylation score in IDHmt low-grade glioma for predicting benefit from temozolomide treatment.","authors":"Amélie Darlix, Pierre Bady, Jérémy Deverdun, Karine Lefort, Valérie Rigau, Emmanuelle Le Bars, Justine Meriadec, Mathilde Carrière, Arthur Coget, Thomas Santarius, Tomasz Matys, Hugues Duffau, Monika E Hegi","doi":"10.1093/noajnl/vdae224","DOIUrl":"10.1093/noajnl/vdae224","url":null,"abstract":"<p><strong>Background: </strong>Diffuse IDH mutant low-grade gliomas (IDHmt LGG) (World Health Organization grade 2) typically affect young adults. The outcome is variable, with survival ranging from 5 to over 20 years. The timing and choice of initial treatments after surgery remain controversial. In particular, radiotherapy is associated with early and late cognitive toxicity. Over 90% of IDHmt LGG exhibit some degree of promoter methylation of the repair gene O(6)-methylguanine-DNA methytransferase (<i>MGMTp)</i> that when expressed blunts the effect of alkylating agent chemotherapy, for example, temozolomide (TMZ). However, the clinical value of <i>MGMTp</i> methylation predicting benefit from TMZ in IDHmt LGG is unclear.</p><p><strong>Methods: </strong>Patients treated in the EORTC-22033 phase III trial comparing TMZ versus radiotherapy served as training set to establish a cutoff based on the MGMT-STP27 methylation score. A validation cohort was established with patients treated in a single-center first-line with TMZ after surgery/surgeries.</p><p><strong>Results: </strong>The MGMT<i>-</i>STP27 methylation score was associated with better progression-free survival (PFS) in the training cohort treated with TMZ, but not radiotherapy. In the validation cohort, an association with next treatment-free survival (<i>P</i> = .045) after TMZ was observed, and a trend using RANO criteria (<i>P</i> = .07). A cutoff value set above the 95% confidence interval of being methylated was significantly associated with PFS in the TMZ-treated training cohort, but not in the radiotherapy arm. However, this cutoff could not be confirmed in the test cohort.</p><p><strong>Conclusions: </strong>While the <i>MGMTp</i> methylation score was associated with better outcomes in TMZ-treated IDHmt LGG, a cutoff could not be established to guide treatment decisions.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae224"},"PeriodicalIF":3.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560431","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":"Ivosidenib for the treatment of IDH1-mutant glioma, grades 2-4: Tolerability, predictors of response, and outcomes.","authors":"Tyler A Lanman, Gilbert Youssef, Raymond Huang, Rifaquat Rahman, Matthew DeSalvo, Thomas Flood, Elmira Hassanzadeh, Min Lang, Jason Lauer, Christopher Potter, Albert Jiao, Ian Pan, Daniel P Cahill, Zhou Lan, Juan Pablo Ospina, Vihang Nakhate, Natalie E Stec, Diana Shi, Wenya Linda Bi, Samuel K McBrayer, Isabel Arrillaga-Romany, Eudocia Q Lee, Ugonma N Chukwueke, Lakshmi Nayak, Deborah A Forst, Elizabeth R Gerstner, Justin T Jordan, Jorg Dietrich, Julie Miller, Tracy T Batchelor, David A Reardon, Patrick Y Wen, L Nicolas Gonzalez Castro","doi":"10.1093/noajnl/vdae227","DOIUrl":"10.1093/noajnl/vdae227","url":null,"abstract":"<p><strong>Background: </strong>Mutant isocitrate dehydrogenase (IDHm) inhibitors represent a novel targeted approach for treating IDHm glioma patients, yet their optimal use in clinical practice outside of clinical trials remains undefined. This study describes the real-world utilization of the mutant IDH1 inhibitor (IDHi), ivosidenib, in patients with IDHm glioma.</p><p><strong>Methods: </strong>We retrospectively reviewed clinical and radiographic data from patients with IDHm glioma treated with ivosidenib monotherapy from 2020 to 2024 at the Dana-Farber Cancer Institute and Massachusetts General Hospital.</p><p><strong>Results: </strong>This cohort included 74 patients with a median age of 39. There were 35 astrocytomas and 39 oligodendrogliomas, with 49, 23, and 2, grade 2, 3, and 4 tumors, respectively. Nineteen patients (26%) experienced an adverse event, although only 1 patient discontinued ivosidenib for adverse events. Median progression-free survival was 31 months and median overall survival was not reached. Seven patients (9%) had partial response, 3 (4%) had minor response, 47 (64%) had stable disease, and 17 (23%) had progressive disease. The presence of enhancing disease at ivosidenib initiation was associated with lower disease control rates (DCR) whereas DCR differences were not detected based on grade (grade 2 vs. 3), tumor histology, or age. Subsequent-line ivosidenib use had lower DCR although this may have been explained by enrichment of patients with enhancing disease.</p><p><strong>Conclusions: </strong>In this large cohort of IDHm glioma patients, ivosidenib was well tolerated. Our results support the use of IDHi therapy in patients with grade 2 or 3 astrocytoma or oligodendroglioma and highlight limited effectiveness in patients with enhancing disease.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae227"},"PeriodicalIF":3.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257582","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":"Combination checkpoint blockade and laser interstitial thermal therapy in radiographically progressive non-small cell lung cancer brain metastases.","authors":"Aden P Haskell-Mendoza, Ethan S Srinivasan, Ariel T Gonzalez, Ellery H Reason, Joshua D Jackson, Ann Marie Flusche, Lucas P Wachsmuth, Emily Lerner, Delaney Underwood, Evan D Buckley, Saif E Zaidi, James E Herndon, Peter E Fecci","doi":"10.1093/noajnl/vdae207","DOIUrl":"10.1093/noajnl/vdae207","url":null,"abstract":"<p><strong>Background: </strong>Laser interstitial thermal therapy (LITT) is a minimally invasive surgical treatment being employed frequently for radiographically progressive brain metastases. Considerable interest exists in combining LITT-mediated in situ vaccination to license immune checkpoint blockade (ICB). No studies have examined the clinical feasibility of this combination in brain metastases.</p><p><strong>Methods: </strong>All patients receiving LITT for radiographically progressive non-small cell lung carcinoma (NSCLC) brain metastases at a single center from 2015 to 2023 were retrospectively reviewed. Combination therapy was defined as ICB within 6 weeks of LITT. Clinical data, post-LITT freedom from local progression, and overall survival (OS) were collected. Adverse events (AEs) were evaluated according to Common Terminology Criteria.</p><p><strong>Results: </strong>Eighteen patients received LITT + ICB for a total of 19 lesions. The median time between therapies was 2.29 weeks (range 0.85-5.98). In comparison to NSCLC patients receiving LITT alone or with targeted therapy (LITT only) (<i>n</i> = 25), there was no decrement in procedural outcomes. Patients receiving LITT + ICB discontinued steroids at a median of 11 (4-147) days post-LITT vs. 24 (3-242) days for patients receiving LITT only (<i>P</i> = .62). At study cutoff, the local control rate was 18/19 (94.7%) lesions in the LITT + ICB group and 22/25 (88.0%) in the LITT only group. There were 3 and 5 AEs ≥Grade 3 in the LITT + ICB and LITT-only groups, respectively.</p><p><strong>Conclusions: </strong>Combination of LITT and ICB does not compromise procedural outcomes or time to steroid discontinuation in NSCLC. Prospective studies are needed to assess biomarkers of immune response.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"6 1","pages":"vdae207"},"PeriodicalIF":3.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883448","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":"Impact of resection location on depressive symptoms following glioma surgery.","authors":"Vera Belgers, Maisa N G van Genderen, Michel Thiebaut de Schotten, Marcus Cakmak, Linda Douw, Alexandros Ferles, Frederik Barkhof, Martin Klein, Johanna M Niers, Roelant S Eijgelaar, Philip C de Witt Hamer","doi":"10.1093/noajnl/vdae222","DOIUrl":"https://doi.org/10.1093/noajnl/vdae222","url":null,"abstract":"<p><strong>Background: </strong>Glioma surgery aims to maximize tumor removal while preserving functional integrity. Functional outcome usually focuses on neurological and neurocognitive functions, but surgery may also affect mood regulation. We determined the occurrence of depressive symptoms after surgery and investigated associated factors, including preoperative depressive symptoms and the location of the resection.</p><p><strong>Methods: </strong>We included a single-center retrospective cohort of patients with supratentorial diffuse glioma (WHO grade 2-4) who underwent first-time surgical resection between 2009 and 2021 and who completed the Center for Epidemiologic Studies Depression Scale (CES-D) before and one year after surgery. Resection cavities were segmented on postoperative MRI scans. White matter disconnections were computed, the so-called disconnectome, to examine distant effects. Multivariable regression analysis was used to relate patient, tumor, and treatment characteristics to postoperative depression scores and changes after surgery. Lesion-symptom mapping was used to relate resection and disconnectome locations to these scores and changes.</p><p><strong>Results: </strong>The study included 83 patients. Before surgery, 25% of patients had depressive symptoms and one year after surgery 34%, which was not statistically different. Resections of gliomas in the right hemisphere were significantly associated with increased depression scores after surgery. A resection involving the left anterior temporal region was significantly associated with low postoperative depression scores. Disconnectome locations were not associated with either postoperative or change in depression scores.</p><p><strong>Conclusions: </strong>Resection locations affect depressive symptoms in glioma patients. This information may be useful for patient counseling.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae222"},"PeriodicalIF":3.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083055","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":"Multi-center real-world data-driven web calculator for predicting outcomes in IDH-mutant gliomas: Integrating molecular subtypes and treatment modalities.","authors":"Houshi Xu, Beining Liu, Yue Wang, Ruize Zhu, Shan Jiang, Lina Akmal Fouad Abdelhamid Soliman, Huihui Chai, Maoyuan Sun, Jiawen Chen, Kay Ka-Wai Li, Ho-Keung Ng, Zhenyu Zhang, Junji Wei, Zhifeng Shi, Ying Mao","doi":"10.1093/noajnl/vdae221","DOIUrl":"10.1093/noajnl/vdae221","url":null,"abstract":"<p><strong>Background: </strong>Isocitrate dehydrogenase (IDH)-mutant gliomas generally have a better prognosis than IDH-wild-type glioblastomas, and the extent of resection significantly impacts prognosis. However, there is a lack of integrated tools for predicting outcomes based on molecular subtypes and treatment modalities. This study aimed to identify factors influencing gross total resection (GTR) rates and to develop a clinical prognostic tool for IDH-mutant gliomas.</p><p><strong>Methods: </strong>We analyzed 650 patients with IDH-mutant gliomas from 3 Chinese medical centers (Shanghai, Hong Kong, and Zhengzhou). Data included age, sex, extent of resection, radiotherapy status, tumor grade, histology, and molecular markers (1p19q, TERT promoter, BRAF, EGFR, 10q). Patients were categorized based on GTR status, and a nomogram predicting 3-, 5-, and 10-year overall survival (OS) was developed using Cox proportional hazards regression and validated with time-dependent ROC and calibration plot analyses.</p><p><strong>Results: </strong>Non-GTR was associated with diffuse astrocytoma (73.0% vs. 53.5%), 1p19q non-codeletion (67.9% vs. 48.7%), and wildtype TERT promoter (63.6% vs. 52.4%). The nomogram, incorporating age, TERT promoter status, extent of resection, grade, and radiotherapy status, demonstrated strong discriminatory ability (AUC > 0.75) and good calibration. Decision curve analysis indicated that it outperformed WHO grade-based classification in identifying high-risk patients. An online calculator was developed for clinical use (http://www.szflab.site/nomogram/).</p><p><strong>Conclusion: </strong>We developed and validated a nomogram and online tool that integrates molecular and clinical factors for predicting outcomes in IDH-mutant gliomas, enhancing clinical decision-making.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae221"},"PeriodicalIF":3.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026204","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":"Stalking the stalk: Isolated pituitary stalk thickening and predictive factors for proliferative disease.","authors":"Julie Bennett, Liana Nobre, Eric Bouffet, Oussama Abla, Bryan Maguire, Afsaneh Amirabadi, Cynthia Hawkins, Jonathan D Wasserman, Birgit Ertl-Wagner, Ute Bartels","doi":"10.1093/noajnl/vdae214","DOIUrl":"10.1093/noajnl/vdae214","url":null,"abstract":"<p><strong>Background: </strong>Few studies have evaluated predictive factors of isolated pituitary stalk thickening (iPST) in children.</p><p><strong>Methods: </strong>In this retrospective study, radiology, endocrinology, and neuro-oncology databases were interrogated to identify patients with iPST between January 2000 and June 2019. A blinded, longitudinal assessment of MRIs was performed using quantitative, semi-quantitative, and qualitative metrics. Neuroimaging parameters were correlated to clinical parameters.</p><p><strong>Results: </strong>Forty-seven patients were identified, with 40 meeting the inclusion criteria. Median age at baseline MRI was 9.6 years (range 0.9-17.5) with median follow-up of 5.2 years (range 0.3-18.6). Twenty-five (63%) were female. Thirty-four (85%) had pituitary dysfunction, including 31 with central diabetes insipidus (cDI). cDI was not predictive of proliferative disease (PfD): 69% of those with presumed primary hypophysitis (PPH) versus 93% with PfD (<i>P</i> = .1). Fourteen (35%) patients were diagnosed with PfD (germinoma = 8, Langerhans cell histiocytosis = 5, lymphoma = 1) at median of 1.3 years (range 0.3-4.0) after initial MRI. Progressive thickening of the stalk over time was associated with PfD (86% vs 4% in PPH, <i>P</i> < .0001), as was thickening of the entire stalk (56% in PfD vs 27% in PPH, <i>P</i> < .0001) with different imaging trends over time observed in PfD versus PPH. A \"sack of marbles\" appearance with heterogeneous enhancement on post-contrast imaging was associated with germinoma.</p><p><strong>Conclusions: </strong>In this cohort, 35% of children with iPST were diagnosed with PfD. The association of cDI and PfD was not statistically significant. Progressive thickening of the entire stalk was predictive of PfD and a \"sack of marbles\" pattern was found to be highly suggestive of germinoma.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"6 1","pages":"vdae214"},"PeriodicalIF":3.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904657","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":"Neuroimaging of postoperative pediatric cerebellar mutism syndrome: a systematic review.","authors":"Iris V Obdeijn, Kirsten M van Baarsen, Shivaram Avula, Sebastian Toescu, Maarten H Lequin, Eelco W Hoving, Marita Partanen","doi":"10.1093/noajnl/vdae212","DOIUrl":"https://doi.org/10.1093/noajnl/vdae212","url":null,"abstract":"<p><strong>Background: </strong>Postoperative pediatric cerebellar mutism syndrome (ppCMS) poses serious morbidity after posterior fossa tumor surgery. Neuroimaging studies aim to understand its pathophysiology, yet these vary in methodology and outcome measures. Therefore, we systematically reviewed the current literature to evaluate the evidence for differences in neuroimaging features between children with and without ppCMS.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic review was conducted by searching for original articles on neuroimaging in children undergoing posterior fossa tumor surgery, comparing patients with and without ppCMS. Articles were selected based on predefined eligibility criteria. Data were systematically extracted, and risk of bias was evaluated.</p><p><strong>Results: </strong>From the 866 articles identified, 50 studies fulfilled the inclusion criteria. Studies were categorized into 3 imaging domains: structural, diffusion, and functional imaging. Risk of bias assessment revealed a medium risk in most articles, predominantly due to unclear ppCMS definition and qualitative image analysis without blinding for ppCMS diagnosis. Preoperative structural imaging showed the association of ppCMS with midline tumor localization and involvement of the brainstem, superior cerebellar peduncle (SCP), or middle cerebellar peduncle. Postoperative structural and diffusion imaging highlighted SCP injury with reduced white matter integrity, while functional imaging demonstrated hypoperfusion in frontal lobes. Late follow-up showed T2-weighted hyperintensities in the inferior olivary nuclei of ppCMS patients.</p><p><strong>Conclusion: </strong>Neuroimaging features suggest that ppCMS is associated with efferent cerebellar pathway injury and hypoperfusion in frontal lobes, with level 2 a/b evidence. Large-scale prospective longitudinal neuroimaging studies comparing pre- and postoperative imaging are needed to further elucidate the pathophysiological mechanism of ppCMS.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"7 1","pages":"vdae212"},"PeriodicalIF":3.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960795","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":"Phase II trial of blood-brain barrier permeable peptide-paclitaxel conjugate ANG1005 in patients with recurrent high-grade glioma.","authors":"Crismita Dmello, Andrew Brenner, David Piccioni, Patrick Y Wen, Jan Drappatz, Maciej Mrugala, Lionel D Lewis, David Schiff, Camilo E Fadul, Marc Chamberlain, Santosh Kesari, Manmeet Ahluwalia, Debora Ghosh, Adam M Sonabend, Priya Kumthekar","doi":"10.1093/noajnl/vdae186","DOIUrl":"10.1093/noajnl/vdae186","url":null,"abstract":"<p><strong>Background: </strong>This study is a phase II clinical trial to evaluate the efficacy, safety, and tolerability of the blood-brain barrier (BBB) permeable peptide-paclitaxel conjugate ANG1005 in patients with recurrent high-grade glioma (HGG) (NCT01967810).</p><p><strong>Methods: </strong>Seventy-three patients were enrolled in 3 separate arms-recurrent glioblastoma (GBM) (Arm 1), bevacizumab refractory GBM (Arm 2), and grade 3 anaplastic gliomas (AGs) (Arm 3). The study was started in October 2013, and the data were locked on September 29, 2017. Safety was evaluated for all three arms (<i>n</i> = 73), and the primary endpoint for Arms 1 and 3 was objective response rate (ORR), and Arm 2 primary endpoint was progression-free survival rate at 3 months (PFS3).</p><p><strong>Results: </strong>Overall, the safety of ANG1005 was found to be consistent with a taxane toxicity profile. Otherwise, the primary efficacy endpoints of ORR and PFS were not met. The most common adverse events (AEs) were hematologic (32.9%), alopecia (31.5%), and fatigue (30.1%). The median PFS was 1.4 months (95% CI: 1.4, 2.1) and similar across all the treatment arms. The median overall survival was 13.4 months (95% CI: 3.4, 14.6) in Arm 1, 5.8 months (95% CI: 1.9, 9.7) in Arm 2, and 18.2 months (95% CI: 10.7, 35.3) in Arm 3.</p><p><strong>Conclusion: </strong>A dose of 600 mg/m² was determined to be safe in this study. However, the primary efficacy endpoint was not met in the NCT01967810-ANG1005 trial, and no further studies are planned in the glioma setting with this compound.</p>","PeriodicalId":94157,"journal":{"name":"Neuro-oncology advances","volume":"6 1","pages":"vdae186"},"PeriodicalIF":3.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879391","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}