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Richey P, Funk M, Sakamoto F, Plotkin S, Ly I, Jordan J, Muzikansky A, Roberts J, Farinelli W, Levin Y, Garibyan L, Blakeley JO, Anderson RR. Noninvasive treatment of cutaneous neurofibromas (cNFs): Results of a randomized prospective, direct comparison of four methods. J Am Acad Dermatol 2024; 90:767-774. [PMID: 38086517 DOI: 10.1016/j.jaad.2023.11.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/20/2023] [Accepted: 11/13/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND People with Neurofibromatosis Type 1 (NF1) suffer disfigurement and pain when hundreds to thousands of cutaneous neurofibromas (cNFs) appear and grow throughout life. Surgical removal of cNFs under anesthesia is the only standard therapy, leaving surgical scars. OBJECTIVE Effective, minimally-invasive, safe, rapid, tolerable treatment(s) of small cNFs that may prevent tumor progression. METHODS Safety, tolerability, and efficacy of 4 different treatments were compared in 309, 2-4 mm cNFs across 19 adults with Fitzpatrick skin types (FST) I-IV: radiofrequency (RF) needle coagulation, 755 nm alexandrite laser with suction, 980 nm diode laser, and intratumoral injection of 10 mg/mL deoxycholate. Regional pain, clinical responses, tumor height and volume (by 3D photography) were assessed before, 3 and 6 months post-treatment. Biopsies were obtained electively at 3 months. RESULTS There was no scarring or adverse events > grade 2. Each modality significantly (P < .05) reduced or cleared cNFs, with large variation between tumors and participants. Alexandrite laser and deoxycholate were fast and least painful; 980 nm laser was most painful. Growth of cNFs was not stimulated by treatment(s) based on height and volume values at 3 and 6 months compared to baseline. LIMITATIONS Intervention was a single treatment session; dosimetry has not been optimized. CONCLUSIONS Small cNFs can be rapidly and safely treated without surgery.
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Affiliation(s)
- Patricia Richey
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
| | - Margaret Funk
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Fernanda Sakamoto
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Scott Plotkin
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Ina Ly
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Justin Jordan
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Alona Muzikansky
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Josh Roberts
- Department of Neurology, Johns Hopkins, Baltimore, Maryland
| | - William Farinelli
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Yakir Levin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Lilit Garibyan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | | | - R Rox Anderson
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Dermatology, Harvard Medical School, Boston, Massachusetts
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Ly I, Liu T, Cai W, Michaels O, Kwon D, Bredella M, Jordan J, Borcherding D, Boswell D, Burgess C, Chi P, de Blank P, Dombi E, Hirbe A, Korf B, Lee S, Mautner V, Melecio-Vázquez M, Mulder Z, Pollard K, Pratilas C, Salamon J, Srihari D, Steensma M, Widemann B, Blakeley J, Plotkin S. NIMG-16. COMPARISON OF A STIR- AND T1-WEIGHTED-BASED RADIOMICS MODEL TO DIFFERENTIATE BETWEEN PLEXIFORM NEUROFIBROMAS AND MALIGNANT PERIPHERAL NERVE SHEATH TUMORS IN NEUROFIBROMATOSIS TYPE 1 (NF1). Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Plexiform neurofibromas (PNF) and malignant peripheral nerve sheath tumors (MPNST) are best visualized on short TI inversion recovery (STIR) sequences on MRI. However, STIR sequences are not routinely acquired in the clinical setting. T1-weighted pre-contrast (T1W) sequences are more standardly obtained but provide insufficient contrast for tumor identification. We developed a radiomics model based on STIR and T1W sequences to differentiate between NF1-associated PNF and MPNST.
METHODS
Using a 3D quantitative imaging analysis software (3DQI), 68 MPNST and 79 PNF from 134 participants at nine centers were segmented on STIR sequences (if available) or T2 fat-saturated or T1-weighted fat-saturated post-contrast sequences. Tumor regions of interest were co-registered to T1W sequences. Standard pre-processing included N4 bias field correction, intensity normalization (mean 120 SI, SD 80 SI), and resampling (1 mm3 voxel resolution). 107 radiomic features were extracted using PyRadiomics. To classify tumors as PNF or MPNST, we applied the Boruta algorithm and correlation removal for selection of important features. A Random Forest model was built using the top five selected features. The data were divided into a training/validation and test set (7:3 ratio). Five-fold cross-validation was performed and repeated 100 times. Model performance was evaluated using AUC, sensitivity, specificity, accuracy, and 95% CI.
RESULTS
For the STIR-based model, AUC was 0.856 (95% CI 0.727-0.984), sensitivity 0.6, specificity 0.833, and accuracy 0.727 in the test set. For the T1W-based model, AUC was 0.867 (95% CI 0.743-0.990), sensitivity 0.8, specificity 0.79, and accuracy 0.794 in the test set.
CONCLUSIONS
Our radiomics models demonstrate high and comparable performance to distinguish between PNF and MPNST on STIR and T1W sequences. Our inclusion of multicenter MRIs enhances model generalizability. These models can potentially be integrated into the radiologic workflow to help clinicians in the early identification of MPNST or pre-malignant atypical neurofibromas on clinical MRIs.
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Affiliation(s)
- Ina Ly
- Massachusetts General Hospital , Boston, MA , USA
| | - Tianyu Liu
- Massachusetts General Hospital , Boston , USA
| | - Wenli Cai
- Massachusetts General Hospital , Boston , USA
| | | | - Daniel Kwon
- Massachusetts General Hospital , Boston , USA
| | | | | | | | | | | | - Ping Chi
- Memorial Sloan Kettering Cancer Center , New York , USA
| | - Peter de Blank
- Cincinnati Children’s Hospital Medical Center , Cincinnati , USA
| | - Eva Dombi
- National Cancer Institute , Bethesda , USA
| | | | - Bruce Korf
- University of Alabama at Birmingham , Birmingham , USA
| | - Shernine Lee
- University of Alabama at Birmingham , Birmingham , USA
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Plotkin S, Allen J, Babovic-Vuksanovic D, Dinh C, Nghiemphu L, Trippa L, Yohay K, Blakeley J. CTNI-65. INTUITT-NF2, AN ADAPTIVE PLATFORM-BASKET TRIAL FOR NEUROFIBROMATOSIS 2 PATIENTS WITH PROGRESSIVE TUMORS: INTERIM RESULTS OF THE BRIGATINIB TREATMENT ARM. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac209.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Neurofibromatosis type 2 (NF2) predisposes affected individuals to vestibular schwannomas (VS), non-vestibular schwannomas (NVS), meningiomas, and ependymomas. We developed an adaptive platform-basket trial to screen multiple drugs against any type of progressive NF2-related tumor. We report the interim analysis of the first treatment arm with brigatinib, an ALK inhibitor that inhibits multiple tyrosine kinases. We conducted a multicenter, phase II, open-label study for subjects ≥12 years old with NF2 and progressive target tumors (baskets: VS, NVS, meningioma, or ependymoma). Up to 5 non-target tumors were followed in each participant. In stage 1, 20 participants (minimum of 2 participants per basket) were treated with brigatinib 180 mg daily. Tumor response was evaluated by MRI every 3 months in year 1 and every 6 months thereafter. Radiographic response (RR) was defined as ≥20% decrease in target tumor volume from baseline. The primary outcome was RR rate. Per protocol, the brigatinib arm would be discontinued if no target tumor achieved a RR at interim analysis. Twenty subjects (median age=25 years, 7 pediatric, 12 females) were treated. Target tumors included 10 VS, 3 NVS, 5 meningiomas, and 2 ependymomas; non-target tumors included 18 VS, 36 NVS, and 14 meningiomas. RR rate for target and non-target tumors was 5% and 22%, respectively. By tumor basket, RR was 28% for meningioma, 26% for non-VS, 4% for VS, and 0% for ependymomas. Annualized tumor growth rates decreased for VS, NVS, and meningioma during treatment. Brigatinib was well tolerated with one dose reduction and one discontinuation due to grade 2 diarrhea. Brigatinib treatment was associated with RR in meningiomas, VS, and NVS. In stage 2, the study will enroll 20 participants in the two most promising baskets (meningioma and NVS). This novel design provides unique ability to assess treatments for hereditary syndromes with multiple primary tumors.
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Affiliation(s)
| | | | | | | | - Leia Nghiemphu
- University of California, Los Angeles , Los Angeles , USA
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4
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Merker V, Von Imhof L, Park E, Babovic-Vuksanovic D, NghiemPhu P[L, Yohay K, Plotkin S. CLRM-16 PATIENT-FOCUSED DRUG DEVELOPMENT IN NEURO-ONCOLOGY: A PILOT STUDY OF QUALITATIVE PATIENT INTERVIEWS EMBEDDED WITHIN A NEUROFIBROMATOSIS 2 CLINICAL TRIAL. Neurooncol Adv 2022. [PMCID: PMC9354217 DOI: 10.1093/noajnl/vdac078.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The Food and Drug Administration recently issued guidance on conducting qualitative research to support patient-focused drug development. In prior FDA submissions, qualitative data has been critical to demonstrate the content validity of and meaningfulness of change in quantitative trial endpoints. Qualitative patient interviews embedded within neuro-oncology trials can supplement traditional quantitative measures by providing nuanced information on patients’ treatment priorities, benefit/risk assessments, and quality of life. METHODS We interviewed people with neurofibromatosis 2 (NF2) in stage one of the brigatinib arm of a multicenter, phase II, adaptive platform-basket trial for progressive NF2-related tumors (NCT04374305). Transcripts were coded by two analysts using a hybrid inductive/deductive framework; cross-cutting themes were generated using the Framework Method. RESULTS 16/20 trial enrollees participated in interviews May 2021-March 2022. The radiographic response rate (volume shrinkage ≥20% from baseline) at 6 months for target and non-target tumors was 5% and 22%, respectively. However, most participants rated their change in overall status as minimally (10/16) or much (3/16) improved. Several participants acknowledged their tumor size had not changed significantly but felt tumor stability was an improvement over previously accelerated growth rates; this importantly allowed them to avoid or postpone future surgery. Participants also valued prevention of symptomatic decline, minimal impact of side effects on social roles and activities, the convenience of oral medication, and the sense of hope and agency gained from participating in a trial. CONCLUSIONS Virtual, in-depth qualitative interviews were feasible across multiple sites and provided unique information on NF2 patients’ conceptualization of clinical benefit. Qualitative interviews embedded within neuro-oncology trials can reveal 1) whether trial design and choice of outcome measures align with patient priorities; 2) whether and how new treatments improve patients’ quality of life; and 3) what degree of change in quantitative measures such as radiographic progression are clinically meaningful.
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Affiliation(s)
- Vanessa Merker
- Massachusetts General Hospital , Boston, MA , USA
- Harvard Medical School , Boston, MA , USA
| | | | - Elyse Park
- Massachusetts General Hospital , Boston, MA , USA
- Harvard Medical School , Boston, MA , USA
| | | | | | - Kaleb Yohay
- New York University Langone Medical Center, New York , NY , USA
| | - Scott Plotkin
- Massachusetts General Hospital , Boston, MA , USA
- Harvard Medical School , Boston, MA , USA
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5
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Zhang JW, Chen W, Ly KI, Zhang X, Yan F, Jordan J, Harris G, Plotkin S, Hao P, Cai W. DINs: Deep Interactive Networks for Neurofibroma Segmentation in Neurofibromatosis Type 1 on Whole-Body MRI. IEEE J Biomed Health Inform 2022; 26:786-797. [PMID: 34106871 PMCID: PMC8855964 DOI: 10.1109/jbhi.2021.3087735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant tumor predisposition syndrome that involves the central and peripheral nervous systems. Accurate detection and segmentation of neurofibromas are essential for assessing tumor burden and longitudinal tumor size changes. Automatic convolutional neural networks (CNNs) are sensitive and vulnerable as tumors' variable anatomical location and heterogeneous appearance on MRI. In this study, wepropose deep interactive networks (DINs) to address the above limitations. User interactions guide the model to recognize complicated tumors and quickly adapt to heterogeneous tumors. We introduce a simple but effective Exponential Distance Transform (ExpDT) that converts user interactions into guide maps regarded as the spatial and appearance prior. Comparing with popular Euclidean and geodesic distances, ExpDT is more robust to various image sizes, which reserves the distribution of interactive inputs. Furthermore, to enhance the tumor-related features, we design a deep interactive module to propagate the guides into deeper layers. We train and evaluate DINs on three MRI data sets from NF1 patients. The experiment results yield significant improvements of 44% and 14% in DSC comparing with automated and other interactive methods, respectively. We also experimentally demonstrate the efficiency of DINs in reducing user burden when comparing with conventional interactive methods.
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Affiliation(s)
- Jian-Wei Zhang
- State Key Lab of CAD&CG, Zhejiang University, Hangzhou, 310012, China
| | - Wei Chen
- The State Key Lab of CAD&CG, Zhejiang University, Hangzhou, 310012, China
| | - K. Ina Ly
- Cancer Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Xubin Zhang
- State Key Lab of CAD&CG, Zhejiang University, Hangzhou, 310012, China
| | - Fan Yan
- State Key Lab of CAD&CG, Zhejiang University, Hangzhou, 310012, China
| | - Justin Jordan
- Cancer Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Gordon Harris
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Scott Plotkin
- Cancer Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Pengyi Hao
- School of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, 310024, China
| | - Wenli Cai
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
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6
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Ly I, Liu T, Cai W, Kwon D, Michaels O, Bredella M, Jordan J, Dombi E, Widemann B, Hirbe A, Borcherding D, Srihari D, Melecio-Vázquez M, Chi P, Boswell D, de Blank P, Pollard K, Pratilas C, Salamon J, Mautner V, Mulder Z, Steensma M, Lee S, Korf B, Blakeley J, Plotkin S. NIMG-08. A MULTI-CENTER RADIOMICS-BASED MODEL TO DIFFERENTIATE BETWEEN NEUROFIBROMATOSIS TYPE 1-ASSOCIATED PLEXIFORM NEUROFIBROMAS AND MALIGNANT PERIPHERAL NERVE SHEATH TUMORS. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Several MRI features are proposed to distinguish between plexiform neurofibromas (PNF) and malignant peripheral nerve sheath tumors (MPNST) in neurofibromatosis type 1 (NF1), including tumor size, margins, and degree of heterogeneity. However, most of these features are descriptive in nature, subject to intra-/interrater variability, and based on small single-institution studies. The goal of this study was to identify radiomic features that can differentiate between NF1-associated PNF and MPNST.
METHODS
31 MPNSTs and 24 PNFs from five centers were segmented on short TI inversion recovery sequences using a semi-automated segmentation software (3DQI). Standard pre-processing was performed, including N4 bias field correction, intensity normalization (using a mean of 120 SI and standard deviation of 80 SI), and resampling to 1 mm3 voxel resolution. 1688 radiomic features were extracted from the tumor region of interest using PyRadiomics, an open-source Python radiomics package. To classify tumors as PNF or MPNST, we implemented the Boruta algorithm and correlation removal for selection of important features. A Random Forest model was built using the top ten selected features. Five-fold cross-validation was performed and repeated 100 times. Model performance was evaluated using the area under the ROC curve (AUC), sensitivity, specificity, accuracy, and confidence intervals.
RESULTS
The top ten features included in the model were five intensity features, two shape features, and three texture features. The model demonstrated an AUC of 0.891 (95% CI 0.882-0.899), sensitivity of 0.744, specificity of 0.847, and accuracy of 0.802 (95% CI 0.792-0.813).
CONCLUSIONS
Our machine learning model demonstrated high performance in classifying tumors as either PNF or MPNST in NF1 individuals. Inclusion of additional tumors for model training and testing on an independent dataset are underway. Ultimately, our model may enable improved differentiation between PNF and MPNST compared to descriptive MRI features, permit early patient risk stratification, and improve patient outcomes.
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Affiliation(s)
- Ina Ly
- Massachusetts General Hospital, Boston, MA, USA
| | - Tianyu Liu
- Massachusetts General Hospital, Boston, MA, USA
| | - Wenli Cai
- Massachusetts General Hospital, Boston, MA, USA
| | - Daniel Kwon
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | - Eva Dombi
- National Cancer Institute, Bethesda, USA
| | | | - Angela Hirbe
- Washington University School of Medicine, St Louis, USA
| | | | - Divya Srihari
- Washington University School of Medicine, St Louis, USA
| | | | - Ping Chi
- Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Peter de Blank
- Cincinnati Children’s Hospital Medical Center, Cincinnati, USA
| | | | | | - Johannes Salamon
- Department of Radiology, University Medical Center Hamburg Eppendorf, Germany, Hamburg, Germany
| | - Viktor Mautner
- Department of Neurology, University Medical Center Hamburg-Eppendorf,, Hamburg, Germany
| | | | | | - Shernine Lee
- University of Alabama at Birmingham, BIrmingham, USA
| | - Bruce Korf
- University of Alabama at Birmingham, BIrmingham, USA
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7
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Odia Y, Wen P, Mehta M, Colman H, Dunbar E, Butowski N, Harrison R, Schulder M, Boockvar J, Chow F, Kumthekar P, Mason W, Venur V, Plotkin S, Lassman A, Duic P, Tamir S, Li K, Liu Y, Mundy G, Damestani Y, Sbar E, Shah J, Shacham S, Goldlust S. CTNI-17. A PHASE 1 WITH DOSE EXPANSION/PHASE 2 STUDY OF SELINEXOR IN COMBINATION WITH STANDARD OF CARE THERAPY FOR NEWLY DIAGNOSED OR RECURRENT GLIOBLASTOMA. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma (GBM) is the most common and aggressive primary brain tumor with median overall survival of 15 months and 5-7 months for patients with newly diagnosed or recurrent disease (nGBM or rGBM), respectively. Selinexor is a first-in-class, oral, selective inhibitor of nuclear export which blocks exportin 1 (XPO1), forcing the nuclear retention and reactivation of tumor suppressor proteins, ultimately causing cancer cell death. Increased XPO1 expression in gliomas is associated with higher pathological grade and poorer prognosis. Consistent with these data, selinexor inhibited tumor growth and prolonged survival in an animal model of GBM. Importantly, selinexor showed encouraging intra-tumoral penetration and single-agent efficacy in rGBM (KING study). The current trial tests the hypothesis that adding selinexor to standard therapy will improve clinical outcomes for patients with nGBM or rGBM.
METHODS
To facilitate the successful development of new therapies, consensus recommendations are to use biomarker enrichment and flexible design that allows expansion of promising cohorts. Accordingly, this phase 1a dose finding study is followed by a phase 1b dose expansion (and ultimately by a 1:1 randomized phase 2 efficacy exploration trial) to independently evaluate: radiation + selinexor in nGBM with unmethylated MGMT promoter (Arm A), radiation + temozolomide + selinexor for nGBM with methylated MGMT promoter (Arm B), and lomustine + selinexor in rGBM (Arm C). Bevacizumab or TTField + selinexor in rGBM (Arms D & E, respectively) are being considered. The Phase 1a primary endpoint is maximum tolerated dose/recommended phase 2 dose. The phase 1b primary endpoint is PFS at 3 months against historic controls. The phase 1b dose expansion is included to evaluate preliminary efficacy before launching into a randomized phase 2 trial. Patient quality of life during the trial will be objectively measured using digital devices (e.g. smartwatch/customized smartphone app). We are currently enrolling patients nationwide. Clinical Trial Registration number: NCT04421378.
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Affiliation(s)
- Yazmin Odia
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Patrick Wen
- Center For Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Minesh Mehta
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Howard Colman
- University of Utah - Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Erin Dunbar
- Piedmont Brain Tumor Center, Atlanta, GA, USA
| | | | - Rebecca Harrison
- University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Schulder
- Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - John Boockvar
- Lenox Hill Hospital-Northwell Health, New York, NY, USA
| | - Frances Chow
- University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Priya Kumthekar
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Vyshak Venur
- University of Washington - Alvord Brain Tumor Center, Seattle, WA, USA
| | | | - Andrew Lassman
- Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Paul Duic
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | - Kai Li
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | - Yang Liu
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | | | - Eric Sbar
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | - Jatin Shah
- Karyopharm Therapeutics Inc, Newton, MA, USA
| | | | - Samuel Goldlust
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
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8
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Ly I, Hirbe A, Jordan J, Michaels O, Kwon D, Borcherding D, Srihari D, Dombi E, Widemann B, Pollard K, Pratilas C, Boswell D, de Blank P, Melecio-Vázquez M, Chi P, Salamon J, Mautner V, Mulder Z, Steensma M, Lee S, Korf B, Blakeley J, Plotkin S. INNV-04. A MULTI-INSTITUTIONAL CLINICAL AND MRI REPOSITORY OF NEUROFIBROMATOSIS TYPE 1-ASSOCIATED PERIPHERAL NERVE SHEATH TUMORS. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Individuals with neurofibromatosis type 1 (NF1) frequently have peripheral nerve sheath tumors (PNST), including plexiform neurofibromas (PNF), atypical neurofibromas (ANF), and malignant peripheral nerve sheath tumors (MPNST). These tumors reflect a histologic spectrum from benign to malignant. Various clinical and MRI-based features are proposed as risk factors for MPNST development based on small single-institution studies. A major barrier to study these risk factors is collation and annotation of multi-center serial MRIs. To address this, we created a standardized database of clinical data and longitudinal MRIs from NF1-associated PNST from nine international NF1 referral centers.
METHODS
Clinical data from NF1 patients are collected in Research Electronic Data Capture databases housed at Massachusetts General Hospital and Washington University, including demographic information, genotype, disease course, treatment history, and survival. ANF and MPNST require histologic confirmation whereas a diagnosis of PNF can also be made based on clinical/radiographic stability. Longitudinal MRIs predating the histologic diagnosis are uploaded to a HIPAA-compliant cloud-based system.
RESULTS
Data from 200 patients (87 females, 113 males) with 217 tumors (75 PNF, 40 ANF, 102 MPNST) have been collected. 280 regional and 108 whole-body MRIs have been identified. Median age at the time of histologic diagnosis is 30 years (range 5-64). All tumors are histologically confirmed except for 6 PNF which remained stable over time. Median follow-up time is 32 months. Of 147 patients with available survival data, 32 (21.7%) have died from MPNST progression; estimated median overall survival is 20 months.
CONCLUSIONS
In this ongoing work, we have assembled one of the largest systematically annotated clinical and MRI repositories of NF1-associated PNST from pediatric and adult NF1 patients. The data will be accessible to outside researchers which will promote interdisciplinary and multi-center collaborations. Active efforts include the identification of radiomic MRI features to differentiate between PNF and MPNST.
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Affiliation(s)
- Ina Ly
- Massachusetts General Hospital, Boston, MA, USA
| | - Angela Hirbe
- Washington University School of Medicine, St Louis, WA, USA
| | | | | | - Daniel Kwon
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Divya Srihari
- Washington University School of Medicine, St Louis, WA, USA
| | - Eva Dombi
- National Cancer Institute, Bethesda, MD, USA
| | | | - Kai Pollard
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Peter de Blank
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | | | - Ping Chi
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Johannes Salamon
- Department of Radiology, University Medical Center, Hamburg-Eppendorf, Germany
| | - Viktor Mautner
- Department of Neurology, University Medical Center, Hamburg-Eppendorf,, Hamburg, Germany
| | | | | | - Shernine Lee
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bruce Korf
- University of Alabama at Birmingham, Birmingham, AL, USA
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9
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Plotkin S, Kumthekar P, Wen P, Barker F, Beauchamp R, Gerstner E, Muzikansky A, Smith M, Stemmer-Rachamimov A, Jordan J, Ramesh V. CTNI-54. A SINGLE ARM PHASE II STUDY OF THE DUAL MTORC1/MTORC2 INHIBITOR VISTUSERTIB PROVIDED FOR SPORADIC PATIENTS WITH GRADE II-III MENINGIOMAS THAT RECUR OR PROGRESS AFTER SURGERY AND RADIATION. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab196.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Grade II/III meningiomas have increased rates of recurrence with no approved medical therapies. The historical progression-free survival at 6 months (PFS-6) is 25% with rates >35% declared of interest for drug development. NF2 gene inactivation occurs in about half of meningiomas. Based on our studies showing mTORC1 and mTORC2/SGK1 pathway activation in NF2-deficient meningiomas and the paradoxical activation of the mTORC2/AKT pathway, we hypothesized that mTORC1/mTORC2 inhibitors would be active in meningiomas. We studied the effect of vistusertib in patients with progressive/recurrent grade II/III meningiomas (NCT03071874). Vistusertib was administered orally at 125mg twice daily on two consecutive days each week. MRIs were obtained every 56 days. Tumor size was defined as the largest cross-sectional area. Progression was defined as ≥ 25% increase in the sum of products of all measurable lesions over smallest sum observed. The primary endpoint was PFS-6. Secondary endpoints included toxicity, radiographic response, and correlative studies including immunohistochemistry for mTORC1/2 pathway activation and genetic biomarkers. Twenty-eight patients (13 female, median age 58 years, median KPS 80%) were enrolled. Median tumor size was 4.4cm; 71% were grade II and 50% harbored pathogenic NF2 variants. Four patients discontinued treatment voluntarily and 1 each withdrew for intercurrent illness and non-compliance. PFS-6 is 47% (CI, 26%-65%) and OS-12 is 72% (95%CI, 48%-86%). PFS but not OS was shorter for patients with grade 3 meningiomas; there was no difference in PFS/OS between genetic groups. Adverse events at least possibly related to vistusertib with frequency >10% include nausea, fatigue, hypophosphatemia, diarrhea, anorexia, dry mouth, hypertriglyceridemia, hypertension, vomiting, increased ALT, constipation, and weight loss. Vistusertib treatment was associated with a PFS-6 rate exceeding the target of 35% for recurrent high-grade meningioma. Adverse events were tolerable in this patient population. These data support the continued development of mTORC1/2 inhibitors in this setting.
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Affiliation(s)
| | - Priya Kumthekar
- Northwestern Medicine; Feinberg School of Medicine, Chicago, IL, USA
| | - Patrick Wen
- Center For Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Fred Barker
- Massachusetts General Hospital, Boston, MA, USA
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10
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Sell B, Shahryari J, Shah A, Duncton M, Sun W, Fenn P, Plotkin S, Kincaid J, Sarin K, Tsai K. 487 Topical MEK inhibition as precision targeted chemoprevention. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Lassman A, Wen P, van den Bent M, Plotkin S, Walenkamp A, Green A, Wang H, Li K, Liu Y, Xu H, Shah J, Kauffman M, Shacham S, Mau-Soerensen M. CTNI-18. FINAL RESULTS OF A PHASE 2 STUDY OF EFFICACY, SAFETY AND INTRATUMORAL PHARMACOKINETICS (PK) OF SELINEXOR MONOTHERAPY IN RECURRENT GLIOBLASTOMA (rGBM). Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Selinexor is an FDA-approved first-in-class, oral selective nuclear export inhibitor which forces nuclear retention of many tumor suppressor proteins.
METHODS
We conducted a phase 2 trial of selinexor monotherapy for adults with recurrent GBM including a surgical arm to explore intratumoral PK and 3 medical arms to optimize dosing. Prior treatment with radiotherapy and temozolomide was required; prior bevacizumab was exclusionary. The primary endpoint was 6-month progression-free survival (6mPFS) rate.
RESULTS
Selinexor administered ~2 hours pre-operatively yieleded average intratumoral concentration (136 nM, n=6) comparable to the in vitro IC50 (130 nM) from 7 primary human GBM cell lines. Among all 68 patients accrued to 3 medical arms (~85 mg BIW, n=24; 60 mg BIW, n=14; 80 mg QW, n=30), median age was 56 years (21–78). Median number of prior lines of therapies was 2 (1–7). At 80 mg QW, 28% patients were progression-free at the end of cycle 6; the 6mPFS was 17%; disese control rate by RANO was 37% (1 CR, 2 PRs, 7 SD) among 27 evaluable patients; responses were durable (median 11.1 months), and treatment lasted for 442, 547 and 1282 days in 3 responders, as of data lock, with one responder remaining on treatment off study; median overall survival was 10.2 months with 95% CI (7.0, 15.4). The ~85 mg BIW-schedule was abandoned due to poor tolerability. The related adverse events (all grades) in patients on ~85 mg BIW/60 mg BIW/80 mg QW were nausea (41.7%/64.3%/66.7%), fatigue (70.8%/71.4%/50.0%), neutropenia (29.2%/14.3%/33.3%), decreased appetite (45.8%/71.4%/26.7%), thrombocytopenia (66.7%/28.6%/23.3%) and weight loss (16.7%,/42.9%/6.7%).
CONCLUSION
Selinexor monotherapy demonstrated encouraging intratumoral penetration and efficacy, with durable disease control in rGBM. Monotherapy dose at 80 mg QW is recommended for further development in rGBM. A phase 1/2 study of combination therapy for newly diagnosed or rGBM has been initiated (NCT04421378).
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Affiliation(s)
- Andrew Lassman
- New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Patrick Wen
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | | | | | - Kai Li
- Karyopharm, Newton, MA, USA
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12
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Ly I, Thalheimer R, Cai W, Bredella M, Muzikansky A, Merker V, Herr H, Da J, Harris G, Plotkin S, Jordan J. NIMG-07. LONG-TERM FOLLOW-UP OF SCHWANNOMA GROWTH BEHAVIOR IN ADULT NEUROFIBROMATOSIS TYPE 2 AND SCHWANNOMATOSIS PATIENTS USING WHOLE-BODY MRI. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
Neurofibromatosis type 2 (NF2) and schwannomatosis (SWN) are related genetic tumor predisposition syndromes caused by distinct germline pathogenic variants on chromosome 22. Both conditions are characterized by the presence of cranial, peripheral, and/or spinal nerve schwannomas. The long-term growth behavior of schwannomas is unknown but knowledge thereof would help guide patient surveillance and selection for treatment and improvement of clinical trial design. Whole-body MRI (WBMRI) can detect whole-body schwannoma burden in a single image acquisition session.
METHODS
12 NF2 and 10 SWN patients who underwent a WBMRI between 2007-2010 underwent a repeat WBMRI between 2018-2019. Schwannomas were segmented on short tau inversion recovery (STIR) sequences. Tumor volume was calculated using a three-dimensional tumor quantification software (3DQI). Tumor growth and shrinkage were defined as a volume change ≥ 20% over the entire study period.
RESULTS
Median time between scans was 10 years. A total of 103 schwannomas (46 NF2-associated, 57 SWN-associated) were analyzed. In both NF2 and SWN, 50% of tumors grew. Median growth was 88.3% in NF2 and 100.4% in SWN. All growing NF2-associated schwannomas grew in the setting of exposure to systemic therapy whereas only one growing SWN-associated tumor had been treated systemically. Excluding resected tumors, 19.4% of schwannomas shrank. Median shrinkage was 48.5% in NF2 and 37.4% in SWN. All shrinking NF2-associated tumors had been treated with systemic therapy whereas none of the shrinking SWN-associated tumors had been. 19 new tumors (7 NF2-associated, 12 SWN-associated) developed in 8 patients.
CONCLUSIONS
Half of NF2- and SWN-associated schwannomas grow significantly over a decade. In NF2 patients, growth occurs despite systemic treatment whereas, in SWN patients, schwannomas may shrink spontaneously without treatment. These findings may suggest a more aggressive tumor phenotype in NF2. Continued patient enrollment and correlation of MRI findings with functional outcomes and hormone exposure history are ongoing.
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Affiliation(s)
- Ina Ly
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Wenli Cai
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Vanessa Merker
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA
| | | | - Jennifer Da
- Massachusetts General Hospital, Boston, MA, USA
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13
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Plotkin S, Tonsgard J, Ullrich N, Allen J, Blakeley J, Dhall G, Campian J, Clapp W, Fisher M, Cutter G, Korf B, Packer R, Thomas C, Edwards L, Karajannis M. CTNI-10. MAINTENANCE CHEMOTHERAPY USING BEVACIZUMAB FOR NEUROFIBROMATOSIS 2 PATIENTS WITH HEARING LOSS AND PROGRESSIVE VESTIBULAR SCHWANNOMAS: AN NF CLINICAL TRIALS CONSORTIUM STUDY (NF104). Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Bevacizumab treatment at 2.5–5 mg/kg/week is associated with hearing improvement and tumor shrinkage in about 40% of patients with neurofibromatosis 2 (NF2) and progressive vestibular schwannomas (VS). Treatment-emergent hypertension and proteinuria are common with prolonged treatment, and data supporting strategies to maintain hearing and minimize toxicity are lacking.
METHODS
We conducted a multicenter, phase II, open-label study of bevacizumab for subjects (≥6 years old) with NF2, hearing loss, and progressive VS. After 6 months of induction therapy (10 mg/kg every 2 weeks), subjects received low dose bevacizumab at 5 mg/kg every 3 weeks during maintenance therapy (18 months). Hearing decline was defined as a significant decrease in word recognition score below baseline. Progressive disease was defined as ≥20% increase in tumor volume from baseline.
RESULTS
Twenty of 22 subjects (median age=23 years) were treated with maintenance bevacizumab. The proportion of subjects free from hearing decline at 6, 12, and 18 months was 88%, 94%, and 85%, respectively; the proportion free from tumor progression at 6, 12, and 18 months from baseline was 88%, 94%, and 85%, respectively. Three subjects (15%) experienced hearing loss during maintenance and required dose escalation. Maintenance chemotherapy with bevacizumab was well tolerated: 1 subject discontinued due to perirectal abscess and 2 discontinued by choice. Grade 3 hypertension occurred in 2 subjects (10%). Adverse events of interest included hypertension (55%), proteinuria (20%), and irregular menstruation (6/13, 46%).
CONCLUSIONS
Maintenance chemotherapy with bevacizumab at 5 mg/kg every 3 weeks is associated with prolonged hearing and tumor stability that surpasses historical controls. A minority of subjects require dose escalation during low dose bevacizumab treatment.
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Affiliation(s)
| | | | | | - Jeffrey Allen
- Division of Pediatric Neuro-Oncology, Department of Pediatrics, NYU Grossman School of Medicine, NYU Langone Health, New York City, NY, USA
| | | | - Girish Dhall
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jian Campian
- Washington University School of Medicine, St. Louis, MO, USA
| | - Wade Clapp
- University of Indiana, Indianapolis, IN, USA
| | - Michael Fisher
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Gary Cutter
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bruce Korf
- Children’s National Medical Center, Washington, DC, USA
| | - Roger Packer
- Children’s National Medical Center, Washington, DC, USA
| | - Coretta Thomas
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lloyd Edwards
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Matthias Karajannis
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, NY, USA
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14
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Walker C, Shen Y, Mau-Soerensen M, Wen P, van den Bent M, Plotkin S, Walenkamp A, Green A, Califano A, Chang H, Tamir S, Henegar L, Shacham S, Alvarez M, Landesman Y, Lassman A. BIOM-26. MOLECULAR PREDICTORS OF RESPONSE TO SELINEXOR IN RECURRENT GLIOBLASTOMA (GBM). Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The nuclear export protein exportin 1 (XPO1) is overexpressed in many cancers, including GBM. Selinexor is an inhibitor of XPO1 that crosses the blood-brain-barrier and targets cancer cells by sequestering tumor suppressor proteins and oncoprotein mRNAs in the nucleus, inducing cancer cell apoptosis. We previously reported encouraging results from a phase II trial of selinexor for molecularly unselected patients with recurrent GBM (ASCO 2019). Pre-treatment tumors from 57 patients were exome and RNA sequenced to explore molecular correlates of response, in a hypothesis generating, post-hoc, exploratory analysis. We compared overall survival (OS) and progression-free survival (PFS) between mutated and wild-type patients. Two mutated genes were associated with longer survival in selinexor treated patients: DOCK8 (n=7; PFS, P=0.013, hazard ratio [HR]=3.75 [1.32–10.62]; overall survival, P=0.009, HR=15.39 [2.00–118.34]) and PDX1 (n=5, PFS, P=0.014, HR=4.468 [1.361–14.670]). Other commonly mutated genes in glioma, including IDH1 (n=9) were observed but not associated with survival. RNAseq data were used to infer differential protein activities, which were input into a machine learning model that compared patients with selinexor sensitive disease (best response of partial or complete response, n=7) and resistant disease (best response of progressive disease, n=23). We found the inferred activities of three proteins emerged as the most associated with response and could be combined in a model to accurately predict benefit from selinexor treatment (area under the ROC curve from leave one out cross validation = 0.89 permutation test P< 0.04). The three proteins were ZC3H12A (also called MCPIP-1), a negative regulator of inflammation; RAB43, a member of the RAS family that binds GTP and regulates vesicle trafficking, and SOCS3, a suppressor of cytokine signaling that can antagonize JAK/STAT signaling. Together these data identified mutations and proteins activities for identifying patients most likely to benefit from selinexor treatment. Further studies are required for validation. ClinicalTrials.gov:NCT01986348.
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Affiliation(s)
| | | | | | - Patrick Wen
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | | | | | - Hua Chang
- Karyopharm Therapeutics, Inc., Newton, MA, USA
| | | | | | | | | | | | - Andrew Lassman
- New York Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
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15
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Mansouri S, Suppiah S, Mamatjan Y, Paganini I, Liu J, Karimi S, Patil V, Nassiri F, Singh O, Sundaravadanam Y, Rath P, Sestini R, Gensini F, Agnihotri S, Blakeley J, Ostrow K, Largaespada D, Plotkin S, Stemmer-Rachamimov A, Ferrer MM, Pugh T, Aldape K, Papi L, Zadeh G. EPCO-04. GENOMIC AND EPIGENOMIC HALLMARKS OF SCHWANNOMATOSIS SCHWANNOMAS. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Schwannomatosis (SWNTS) is a genetic cancer predisposition syndrome that manifests as multiple and often, painful neuronal tumors called schwannomas (SWNs). Very little is known about the epigenomic and genomic alterations in SWNTS related SWNs (SWNTS-SWNs) other than germline mutations in SMARCB1 and LZTR1 plus somatic mutations in NF2 and loss of heterozygosity in chromosome 22q. Herein, we have comprehensively established the specific molecular signatures of SWNTS-SWNs. We found that tumor anatomic location was associated with pain and distinct DNA methylation and transcriptional signatures. DNA sequencing revealed several novel non-22q deletions, specifically in LZTR1-mutant cases. Whole-genome sequencing identified novel recurrent structural rearrangements. Further, chromosomal aberrations in SWNTS-SWNs were accompanied by increased transcription of mismatch repair genes. Our transcriptome analysis detected the SH3PXD2A-HTRA1 gene fusion in SWNTS-SWNs, more commonly in LZTR1-mutant tumors. In addition, we identified the specific genetic, epigenetic, and transcriptional hallmarks of painful SWNs that may be harnessed to develop new treatments for this debilitating syndrome.
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Affiliation(s)
| | - Suganth Suppiah
- MacFeeters Hamilton Centre for Neuro-Oncology Research, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | | | - Jeff Liu
- University Health Network, Toronto, ON, Canada
| | | | - Vikas Patil
- Princess Margaret Cancer Center, Toronto, ON, Canada
| | | | | | | | - Prisni Rath
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | | | | | | | | | | | | | | | | | - Trevor Pugh
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Kenneth Aldape
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | | | - Gelareh Zadeh
- Princess Margaret Cancer Center, Toronto, ON, Canada
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16
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Lester E, DiStefano S, Mace R, Macklin E, Plotkin S, Vranceanu AM. Virtual mind-body treatment for geographically diverse youth with neurofibromatosis: A pilot randomized controlled trial. Gen Hosp Psychiatry 2020; 62:72-78. [PMID: 31841875 DOI: 10.1016/j.genhosppsych.2019.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine the feasibility, acceptability, preliminary effect, and durability of a mind-body videoconferencing program for youth with neurofibromatosis (Resilient Youth with NF; RY-NF) against an experimental educational control (Health Education for NF; HE-NF) via a single-blind pilot RCT. METHOD Adolescents with NF (N = 51; age 12-17) completed baseline assessments and were randomized (1:1/ to intervention or experimental educational control). The multiple primary outcomes were physical health and psychological quality of life (QoL). Secondary outcomes were social relations QoL, environmental QoL, depression, anxiety, pain intensity and pain interference. Posttreatment and at 6-month follow-up assessments were collected. RESULTS Forty-five adolescents (88%) completed posttreatment, and 37 (82%) completed 6-month follow-up. Satisfaction was high in both conditions. The RY-NF showed greater baseline to posttreatment improvements in physical health QoL (10.18; 95% CI: 0.47-19.90; p = .040), psychological QoL (9.45; 95% CI: 0.78-18.11; p = .033), social relations QoL (13.19; 95% CI: 1.87-24.50; p = .023), and environmental QoL (9.26; 95% CI: 3.49-15.49; p = .002), compared to the HE-NF (between group effects). Improvements were clinically meaningful and maintained through follow-up. CONCLUSIONS The RY-NF was well accepted, highly feasible and resulted in sustained improvement in QoL, demonstrating adolescents are receptive to and benefit from learning resiliency skills in groups via live video.
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Affiliation(s)
- Ethan Lester
- Integrated Brain Health Clinical and Research Program, Psychiatry Department, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
| | - Sofia DiStefano
- Integrated Brain Health Clinical and Research Program, Psychiatry Department, Massachusetts General Hospital, Boston, MA, United States of America.
| | - Ryan Mace
- Integrated Brain Health Clinical and Research Program, Psychiatry Department, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
| | - Eric Macklin
- Harvard Medical School, Boston, MA, United States of America; Biostatistics Center, Massachusetts General Hospital, Boston, MA, United States of America.
| | - Scott Plotkin
- Harvard Medical School, Boston, MA, United States of America; Neurofibromatosis Clinic, Massachusetts General Hospital, Boston, MA, United States of America.
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Psychiatry Department, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
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17
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Karajannis M, Goldberg J, Thomas Roland J, Sen C, Placantonakis D, Golfinos J, Allen J, Dunbar E, Plotkin S, Akshintala S, Schneider R, Deng J, Neubert TA, Giancotti F, Zagzag D, O Blakeley J. ACTR-09. A PHASE 0 PHARMACODYNAMIC AND PHARMACOKINETIC STUDY OF EVEROLIMUS IN VESTIBULAR SCHWANNOMA (VS) AND MENINGIOMA PATIENTS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Inhibition of mTORC1 signaling has been shown to diminish growth of NF2 deficient tumors in preclinical studies, and clinical data suggest that everolimus, an orally administered mTORC1 inhibitor, may slow tumor progression in a subset of adult and pediatric NF2 patients with VS. To assess the pharmacokinetics, pharmacodynamics and potential mechanisms of treatment resistance, we performed a pre-surgical (“phase 0”) clinical trial of everolimus in patients undergoing surgery for VS or meningiomas.
METHODS
Eligible patients with meningioma or VS requiring tumor resection received everolimus 10 mg daily for 10 days immediately prior to surgery. Everolimus blood levels were determined immediately prior to and after surgery. Tumor samples were collected intraoperatively.
RESULTS
Ten patients completed protocol therapy, including 5 patients with NF2-related meningioma, 3 patients with sporadic meningioma, and 2 patients with NF2-related VS. Median pre- and post-operative plasma levels of everolimus were found to be in a high therapeutic range (17.4 ng/ml and 9.4 ng/ml, respectively). Median tumor tissue drug concentration determined by mass spectrometry was 24.3 ng/g (range 9.2–169.2), and median tumor tissue to post-operative plasma drug concentration ratio was 0.39. We observed only partial inhibition of phospho-S6 in the treated tumors, indicating incomplete target inhibition compared to matched control tissues from untreated patients (p = 0.005). Consistent with prior observations that inhibition of mTORC1 may lead to MAPK pathway activation through a PI3K-dependent feedback loop, we observed a statistically significant increase of phospho-ERK (p < 0.03) versus untreated controls.
CONCLUSIONS
In patients with meningioma or VS, treatment with everolimus leads to incomplete inhibition of mTORC1 signaling and upregulation phospho-ERK. These data may explain the limited anti-tumor effect of everolimus observed in clinical studies for NF2 patients and identify upregulation of phospho-ERK as a likely resistance mechanism that could be addressed with combination therapies.
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18
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Ly I, Thalheimer R, Cai W, Bredella M, Merker V, Plotkin S, Jordan J. NIMG-66. LONG-TERM FOLLOW-UP OF NEUROFIBROMATOSIS TYPE 1 PATIENTS USING WHOLE-BODY MRI DEMONSTRATES DYNAMIC CHANGES IN INTERNAL NEUROFIBROMA SIZE. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Neurofibromas affect 40–50% of neurofibromatosis type 1 (NF1) patients and can cause significant morbidity and mortality. They grow more rapidly during childhood and adolescence but studies in adults are limited by their retrospective nature and follow-up time < 3 years. The long-term natural history of neurofibromas remains unknown. No guidelines exist on the need and frequency of surveillance imaging for patients. Whole-body MRI (WBMRI) can detect whole-body tumor burden, including internal neurofibromas.
METHODS
17 adult NF1 patients who underwent WBMRI between 2007–2010 (Scan 1) underwent repeat WBMRI between 2018–2019 (Scan 2). Internal neurofibromas were segmented on short tau inversion recovery (STIR) sequences and tumor volume was calculated using a computerized volumetry and three-dimensional segmentation software. Circumscribed tumors were defined as discrete; invasive tumors or those involving multiple nerves were defined as plexiform. Tumor growth and shrinkage were defined as volume change ≥ 20% over the entire study period.
RESULTS
Median patient age was 43 years during Scan 1 and 53 years during Scan 2. Median time between Scan 1 and 2 was 9 years. A total of 140 neurofibromas were assessed. 24% of tumors grew by a median 63% (6.8% per year). 54% of tumors spontaneously decreased in volume by a median 60% (7% per year) without treatment. On a per-patient basis, 18% of patients had overall tumor growth and 41% overall tumor shrinkage. 8 new tumors developed in 7 patients. 16 tumors resolved entirely without medical or surgical intervention. Growth behavior did not correlate with discrete or plexiform morphology.
CONCLUSION
A subset of internal neurofibromas in adult NF1 patients grow significantly over a long-term period, suggesting that continued monitoring of these patients may be warranted. Surprisingly, more than half of neurofibromas shrink spontaneously without intervention. Continued patient enrollment and correlation of imaging findings with functional outcomes are underway.
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Affiliation(s)
- Ina Ly
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Wenli Cai
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Vanessa Merker
- Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA
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Shih CS, Blakeley J, Clapp DW, Armstrong AE, Wolters P, Dombi E, Cutter G, Ullrich NJ, Allen J, Packer R, Goldman S, Gutmann DH, Plotkin S, Rosser T, Robertson K, Widemann B, Rhodes S, Angus S, Johnson G, Korf B, Fisher MJ. Abstract CT233: Treatment of neurofibromatosis type 1 (NF1)-related plexiform neurofibromas (PN) with cabozantinib (XL184): A Neurofibromatosis Clinical Trials Consortium Phase II trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-ct233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Cabozantinib, an oral FDA approved multi-receptor tyrosine kinase inhibitor, was tested in our preclinical mouse model of PN. After finding significant reduction of tumor number and size in cabozantinib treated versus control mice, we sought to translate these findings to a phase 2 human study. Here we report the activity of cabozantinib in adolescents and adults with NF1-associated PN.
Methods: A multicenter, nonrandomized phase 2 trial (NCT02101736) of cabozantinib in subjects ≥16 years with NF1 and either progressive or clinically significant inoperable PN was performed by the NFCTC (NF-105). The primary study aim was volumetric response of the target PN determined by MRI read centrally. Cabozantinib was administered continuously for up to 24 cycles, each cycle was 28 days. The starting dose was 40 mg once daily with planned escalation to a target dose of 60 mg once daily after 2 cycles. Dose reductions for toxicity were allowed to 20 mg once daily. Partial response (PR) was defined as ≥20% reduction in tumor volume from baseline. Subjects were considered evaluable for response if they completed ≥1 cycle of therapy and had a follow-up MRI. Success was defined as ≥25% of subjects achieving and maintaining a PR after 12 cycles without significant toxicity. Investigation of the impact of cabozantinib on the PN kinome network was performed on murine samples.
Results: Twenty-three subjects enrolled; 21 subjects (median age 22 years) were evaluable for toxicity (2 noted to be ineligible before receiving study drug) and 19 subjects (median age 23 years) were evaluable for response (1 subject withdrew during cycle 1 and 1 was found ineligible after starting study drug). Baseline median tumor size was 557 mL (range 57-2954 mL). Among the evaluable patients, 8 (42%) met criteria for PR by cycle 12. Median change in tumor volume was -15.2% (range +2.2% to -36.9%). No subject had PN progression on treatment; maximal tumor response was not achieved until at least 18 cycles in 6/8 responders. A significant portion of patients underwent dose reductions or discontinued cabozantinib due to low grade adverse events (AE) that impaired quality of life; however, 3 responders reduced to 20 mg maintained or improved their response at this dose. The most common AEs (any grade) in ≥10 patients included gastrointestinal toxicity, hypothyroidism, fatigue and palmar plantar erythrodysesthesia (PPE). Eleven grade 3 AEs occurred in 8 patients, mainly PPE (n=4) and hypertension (n=2); no grade 4 or 5 AEs occurred. Analysis of kinase activity in murine PN treated with cabozantinib showed significantly decreased activity of AXL, MERTK and MET, known cabozantinib targets, but also of DDR1 and DDR2.
Conclusions: Cabozantinib demonstrates considerable clinical activity for PN with a radiographic response rate of 42%. Although there were few severe AEs, low grade toxicities impacted the willingness of many subjects to continue treatment. Quantitative kinome analysis revealed that inhibition of DDR1, DDR2, AXL, MERTK and MET might underpin the therapeutic responses seen in these patients. Lower doses of cabozantinib may be optimal for the NF1 population and still lead to therapeutic response. This trial is now enrolling a pediatric cohort of children aged 3 to 15 years. Supported by DOD Award W81XWH-12-1-0155 and Exelixis
Citation Format: Chie-Schin Shih, Jaishri Blakeley, D. Wade Clapp, Amy E. Armstrong, Pam Wolters, Eva Dombi, Gary Cutter, Nicole J. Ullrich, Jeffrey Allen, Roger Packer, Stewart Goldman, David H. Gutmann, Scott Plotkin, Tena Rosser, Kent Robertson, Brigitte Widemann, Steven Rhodes, Steven Angus, Gary Johnson, Bruce Korf, Michael J. Fisher. Treatment of neurofibromatosis type 1 (NF1)-related plexiform neurofibromas (PN) with cabozantinib (XL184): A Neurofibromatosis Clinical Trials Consortium Phase II trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT233.
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Affiliation(s)
- Chie-Schin Shih
- 1Indiana University, Riley Hospital for Children, Indianapolis, IN
| | | | - D. Wade Clapp
- 1Indiana University, Riley Hospital for Children, Indianapolis, IN
| | - Amy E. Armstrong
- 1Indiana University, Riley Hospital for Children, Indianapolis, IN
| | - Pam Wolters
- 3National Cancer Institute-Pediatric Oncology Branch, Bethesda, MD
| | - Eva Dombi
- 3National Cancer Institute-Pediatric Oncology Branch, Bethesda, MD
| | - Gary Cutter
- 4University of Alabama-Birmingham, Birmingham, AL
| | | | | | - Roger Packer
- 7Children’s National Medical Center, Washington D.C., DC
| | | | | | | | - Tena Rosser
- 11Children’s Hospital of Los Angeles, Los Angeles, CA
| | - Kent Robertson
- 1Indiana University, Riley Hospital for Children, Indianapolis, IN
| | | | - Steven Rhodes
- 1Indiana University, Riley Hospital for Children, Indianapolis, IN
| | - Steven Angus
- 12University of North Carolina-Chapel Hill, Chapel-Hill, NC
| | - Gary Johnson
- 12University of North Carolina-Chapel Hill, Chapel-Hill, NC
| | - Bruce Korf
- 4University of Alabama-Birmingham, Birmingham, AL
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Karajannis M, Wang S, Goldberg J, Roland T, Sen C, Placantonakis D, Golfinos J, Allen J, Dunbar E, Plotkin S, Akshintala S, Schneider R, Deng J, Neubert T, Giancotti F, Blakeley J. THER-07. A PHASE 0 PHARMACODYNAMIC AND PHARMACOKINETIC STUDY OF EVEROLIMUS IN VESTIBULAR SCHWANNOMA (VS) AND MENINGIOMA PATIENTS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz036.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Shiyang Wang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Ferner RE, Bakker A, Elgersma Y, Evans DGR, Giovannini M, Legius E, Lloyd A, Messiaen LM, Plotkin S, Reilly KM, Schindeler A, Smith MJ, Ullrich NJ, Widemann B, Sherman LS. From process to progress-2017 International Conference on Neurofibromatosis 1, Neurofibromatosis 2 and Schwannomatosis. Am J Med Genet A 2019; 179:1098-1106. [PMID: 30908866 DOI: 10.1002/ajmg.a.61112] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 02/09/2019] [Indexed: 12/19/2022]
Abstract
The neurofibromatoses are inherited, tumor suppressor disorders that are characterized by multiple, benign peripheral nerve sheath tumors and other nervous system tumors. Each disease is associated with a distinct genetic mutation and with a different pathogenesis and clinical course. Neurofibromatosis 1 (NF1) is common and epitomized by multiple neurofibromas with widespread complications. NF2 and schwannomatosis are rare diseases that are typified by multiple schwannomas that are particularly painful in people with schwannomatosis. Since 1985, the Children's Tumor Foundation (formerly the National Neurofibromatosis Foundation) has hosted an international Neurofibromatosis Conference, bringing together international participants who are focused on NF research and clinical care. The 2017 Conference, held in Washington, DC, was among the largest gatherings of NF researchers to date and included presentations from clinicians and basic scientists, highlighting new data regarding the molecular and cellular mechanisms underlying each of these diseases as well as results from clinical studies and clinical trials. This article summarizes the findings presented at the meeting and represents the current state-of-the art for NF research.
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Affiliation(s)
- Rosalie E Ferner
- Department of Neurology, Neurofibromatosis Centre, Guy's and St. Thomas' NHS Foundation Trust, and King's College London, London, UK
| | | | - Ype Elgersma
- Department of Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - D Gareth R Evans
- Centre for Genomic Medicine, St. Mary's Hospital, Manchester, UK.,Manchester Academic Health Sciences Centre (MAHSC), Division of Evolution and Genomic Science, University of Manchester, Manchester, UK
| | - Marco Giovannini
- Department of Head and Neck Surgery, University of California, Los Angeles
| | - Eric Legius
- Department of Human Genetics, University Hospital Leuven, Leuven, Herestraat, Belgium
| | - Alison Lloyd
- Laboratory for Molecular Cell Biology, University College London, London, UK
| | - Ludwine M Messiaen
- Medical Genomics Laboratory, Department of Genetics, University of Alabama, Birmingham, Alabama
| | - Scott Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Karlyne M Reilly
- Rare Tumors Initiative, Center for Cancer Research, National Institutes of Health, Bethesda, Maryland
| | - Aaron Schindeler
- Orthopaedic Research & Biotechnology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Miriam J Smith
- Centre for Genomic Medicine, St. Mary's Hospital, Manchester, UK.,Manchester Academic Health Sciences Centre (MAHSC), Division of Evolution and Genomic Science, University of Manchester, Manchester, UK
| | - Nicole J Ullrich
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Brigitte Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Larry S Sherman
- Division of Neuroscience, Oregon National Primate Research Center, and Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon
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Plotkin S, Jordan J, Beauchamp R, Muzikansky A, Stemmer-Rachamimov A, Ramesh V. ACTR-36. A SINGLE ARM PHASE 2 STUDY OF THE DUAL mTORC1/mTORC2 INHIBITOR VISTUSERTIB PROVIDED ON AN INTERMITTENT SCHEDULE FOR NEUROFIBROMATOSIS 2 PATIENTS WITH PROGRESSIVE OR SYMPTOMATIC MENINGIOMAS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Justin Jordan
- Department of Neurology and Cancer Center, Boston, MA, USA
| | - Roberta Beauchamp
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Vijaya Ramesh
- Massachusetts General Hospital, Center for Genomic Medicine, Boston, MA, USA
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Tonsgard J, Ullrich N, Blakeley J, Rosser T, Packer R, Korf B, Fisher M, Cutter G, Plotkin S, Karajannis M, Allen J, Wade Clapp D, Thomas C, Campian J. NFM-09. PRELIMINARY REPORT OF A MULTICENTER, PHASE 2 STUDY OF BEVACIZUMAB IN CHILDREN AND ADULTS WITH NEUROFIBROMATOSIS 2 AND PROGRESSIVE VESTIBULAR SCHWANNOMAS: AN NF CLINICAL TRIALS CONSORTIUM STUDY. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- James Tonsgard
- University of Chicago Medicine Comer Children’s Hospital, Chicago, IL, USA
| | | | | | - Tena Rosser
- Children’s Hospital of Los Angeles, Los Angeles, CA, USA
| | - Roger Packer
- Children’s National Health System, Washington, DC, USA
| | - Bruce Korf
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Fisher
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Gary Cutter
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | - D Wade Clapp
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Coretta Thomas
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jian Campian
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Shih CS, Blakely J, Clapp W, Wolters P, Dombi E, Cutter G, Ullrich N, Allen J, Packer R, Goldman S, Gutmann D, Plotkin S, Rosser T, Robertson K, Widemann B, Korf B, Fisher M. NFM-01. NF105: A PHASE II PROSPECTIVE STUDY OF CABOZANTINIB (XL184) FOR PLEXIFORM NEUROFIBROMAS IN SUBJECTS WITH NEUROFIBROMATOSIS TYPE 1: A NEUROFIBROMATOSIS CLINICAL TRIAL CONSORTIUM (NFCTC) STUDY. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - Wade Clapp
- Indiana University, Indianapolis, IN, USA
| | - Pam Wolters
- National Cancer Institute-Pediatric Oncology Branch, Bethesda, MD, USA
| | - Eva Dombi
- National Cancer Institute-Pediatric Oncology Branch, Bethesda, MD, USA
| | - Gary Cutter
- University of Alabama-Birmingham, Birmingham, AL, USA
| | | | | | - Roger Packer
- Children’s National Medical Center, Washington, DC, USA
| | | | | | | | - Tena Rosser
- Children’s Hospital of Los Angeles, Los Angeles, CA, USA
| | | | - Brigitte Widemann
- National Cancer Institute-Pediatric Oncology Branch, Bethesda, MD, USA
| | - Bruce Korf
- University of Alabama-Birmingham, Birmingham, AL, USA
| | - Michael Fisher
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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Plotkin S, Tonsgard J, Ullrich N, Allen J, Blakeley J, Rosser T, Campian J, Clapp W, Fisher M, Cutter G, Korf B, Packer R, Thomas C, Karjannis M. RARE-19. MULTICENTER, PHASE 2 STUDY OF BEVACIZUMAB IN CHILDREN AND ADULTS WITH NEUROFIBROMATOSIS 2 AND PROGRESSIVE VESTIBULAR SCHWANNOMAS: AN NF CLINICAL TRIALS CONSORTIUM STUDY. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Williams E, Kim J, Muzikansky A, Shaw M, Iafrate AJ, Plotkin S, Suva M, Stemmer-Rachamimov A. GENE-42. MOLECULAR AND HISTOLOGIC FEATURES OF A SERIES OF SPORADIC AND FAMILIAL SCHWANNOMAS. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Verma S, Wolkenstein P, Le L, Lee J, Widemann B, Brownell I, Jarnagin K, Lavker R, Legius E, Anderson R, Plotkin S, Weinberg H, Casey D, Ko H, LaRosa S, Knight P, Parides M, Bora N, Morris J, Riccardi V, Korf B, Blakeley J. LB951 Establishing a roadmap for therapeutics development for cutaneous neurofibromas. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brastianos PK, Nayyar N, Rosebrock D, Leshchiner I, Gill CM, Livitz D, Bertalan MS, D'Andrea M, Hoang K, Aquilanti E, Chukwueke UN, Kaneb A, Chi A, Plotkin S, Gerstner ER, Frosch MP, Suva ML, Cahill DP, Getz G, Batchelor TT. Resolving the phylogenetic origin of glioblastoma via multifocal genomic analysis of pre-treatment and treatment-resistant autopsy specimens. NPJ Precis Oncol 2017; 1:33. [PMID: 29872714 PMCID: PMC5871833 DOI: 10.1038/s41698-017-0035-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 12/13/2022] Open
Abstract
Glioblastomas are malignant neoplasms composed of diverse cell populations. This intratumoral diversity has an underlying architecture, with a hierarchical relationship through clonal evolution from a common ancestor. Therapies are limited by emergence of resistant subclones from this phylogenetic reservoir. To characterize this clonal ancestral origin of recurrent tumors, we determined phylogenetic relationships using whole exome sequencing of pre-treatment IDH1/2 wild-type glioblastoma specimens, matched to post-treatment autopsy samples (n = 9) and metastatic extracranial post-treatment autopsy samples (n = 3). We identified “truncal” genetic events common to the evolutionary ancestry of the initial specimen and later recurrences, thereby inferring the identity of the precursor cell population. Mutations were identified in a subset of cases in known glioblastoma genes such as NF1(n = 3), TP53(n = 4) and EGFR(n = 5). However, by phylogenetic analysis, there were no protein-coding mutations as recurrent truncal events across the majority of cases. In contrast, whole copy-loss of chromosome 10 (12 of 12 cases), copy-loss of chromosome 9p21 (11 of 12 cases) and copy-gain in chromosome 7 (10 of 12 cases) were identified as shared events in the majority of cases. Strikingly, mutations in the TERT promoter were also identified as shared events in all evaluated pairs (9 of 9). Thus, we define four truncal non-coding genomic alterations that represent early genomic events in gliomagenesis, that identify the persistent cellular reservoir from which glioblastoma recurrences emerge. Therapies to target these key early genomic events are needed. These findings offer an evolutionary explanation for why precision therapies that target protein-coding mutations lack efficacy in GBM. Non-coding and structural alterations may be early drivers of brain cancer development. A team led by Priscilla Brastianos and Tracy Batchelor from Massachusetts General Hospital, Boston, USA, analyzed the genetic landscape of glioblastoma by comparing pre-treatment and autopsy tumor specimens from 12 patients who died of the aggressive brain cancer. They identified a common set of four genetic events that occurred early in the evolution of nearly every patient’s cancer: three losses or gains of chromosome regions or entire chromosomes, and mutations in the gene-activating promoter of TERT, which encodes an enzyme implicated in the cancer’s growth. The findings help explain why therapies that target protein-coding mutations don’t work in brain cancer when they do in other tumor types. They also point to new drug targets.
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Affiliation(s)
- Priscilla K Brastianos
- 1Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,2Broad Institute of MIT and Harvard, Boston, Massachusetts USA.,3Harvard Medical School, Boston, Massachusetts USA.,4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Naema Nayyar
- 2Broad Institute of MIT and Harvard, Boston, Massachusetts USA.,4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | | | | | - Corey M Gill
- 4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Dimitri Livitz
- 2Broad Institute of MIT and Harvard, Boston, Massachusetts USA
| | - Mia S Bertalan
- 4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Megan D'Andrea
- 4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Kaitlin Hoang
- 4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Elisa Aquilanti
- 1Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,2Broad Institute of MIT and Harvard, Boston, Massachusetts USA.,3Harvard Medical School, Boston, Massachusetts USA.,4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Ugonma N Chukwueke
- 4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Andrew Kaneb
- 4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Andrew Chi
- 6Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY USA
| | - Scott Plotkin
- 1Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,3Harvard Medical School, Boston, Massachusetts USA.,4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Elizabeth R Gerstner
- 1Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,3Harvard Medical School, Boston, Massachusetts USA.,4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Mathew P Frosch
- 3Harvard Medical School, Boston, Massachusetts USA.,7Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Mario L Suva
- 3Harvard Medical School, Boston, Massachusetts USA.,7Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Daniel P Cahill
- 3Harvard Medical School, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA.,8Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Gad Getz
- 2Broad Institute of MIT and Harvard, Boston, Massachusetts USA.,3Harvard Medical School, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA.,7Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts USA
| | - Tracy T Batchelor
- 1Division of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,3Harvard Medical School, Boston, Massachusetts USA.,4Division of Neuro-Oncology, Massachusetts General Hospital, Boston, Massachusetts USA.,5Cancer Center, Massachusetts General Hospital, Boston, Massachusetts USA
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Lassman AB, Bent MJD, Wen PY, Walenkamp A, Plotkin S, Kung A, Gardner H, Shacham S, Chudnovsky A, Mau-Sorensen PM. OS07.5 Interim analysis data from Phase 2 study on efficacy, safety & intratumoral pharmacokinetics of oral Selinexor (KPT-330) in patients with recurrent glioblastoma (GBM). Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Colman H, Raizer J, Walbert T, Plotkin S, Chamberlain M, Wong E, Puduvalli V, Reardon D, Iwamoto F, Johnson B, Sonty K, Welbourn B, Karlin D, Pelayo M, Hutchinson M, Hsu H. ACTR-20. INITIAL RESULTS OF PLX108-08: AN OPEN LABEL PHASE 1B/2 STUDY OF ORALLY ADMINISTERED PEXIDARTINIB (PLX3397) IN COMBINATION WITH RADIATION THERAPY AND TEMOZOLOMIDE IN PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Eisele S, Gill C, Jones S, Pisapia M, Batchelor T, Plotkin S, Dietrich J. NTOX-03. HIGH RATE OF METHOTREXATE-INDUCED LEUKOENCEPHALOPATHY IN ADULT PATIENTS WITH CNS LYMPHOMA CARRYING MTHFR SINGLE GENE POLYMORPHISMS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jordan J, Smith M, Merker V, Cai W, Harris G, Bredella M, Erdin S, Gusella J, Plotkin S. NIMG-64. NOVEL METHODS FOR GENOTYPE-PHENOTYPE CORRELATION IN SCHWANNOMATOSIS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Korf B, Ahmadian R, Allanson J, Aoki Y, Bakker A, Wright EB, Denger B, Elgersma Y, Gelb BD, Gripp KW, Kerr B, Kontaridis M, Lazaro C, Linardic C, Lozano R, MacRae CA, Messiaen L, Mulero-Navarro S, Neel B, Plotkin S, Rauen KA, Roberts A, Silva AJ, Sittampalam SG, Zhang C, Schoyer L. The third international meeting on genetic disorders in the RAS/MAPK pathway: towards a therapeutic approach. Am J Med Genet A 2015; 167A:1741-6. [PMID: 25900621 DOI: 10.1002/ajmg.a.37089] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 03/15/2015] [Indexed: 12/15/2022]
Abstract
"The Third International Meeting on Genetic Disorders in the RAS/MAPK Pathway: Towards a Therapeutic Approach" was held at the Renaissance Orlando at SeaWorld Hotel (August 2-4, 2013). Seventy-one physicians and scientists attended the meeting, and parallel meetings were held by patient advocacy groups (CFC International, Costello Syndrome Family Network, NF Network and Noonan Syndrome Foundation). Parent and patient advocates opened the meeting with a panel discussion to set the stage regarding their hopes and expectations for therapeutic advances. In keeping with the theme on therapeutic development, the sessions followed a progression from description of the phenotype and definition of therapeutic endpoints, to definition of genomic changes, to identification of therapeutic targets in the RAS/MAPK pathway, to preclinical drug development and testing, to clinical trials. These proceedings will review the major points of discussion.
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Affiliation(s)
- Bruce Korf
- University of Alabama at Birmingham, Alabama
| | | | - Judith Allanson
- (Retired) Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Yoko Aoki
- Tohoku University School of Medicine, Sendai, Japan
| | | | - Emma Burkitt Wright
- Manchester Centre for Genomic Medicine, UK.,Manchester Academic Health Science Center, Manchester, UK
| | - Brian Denger
- Parent Project Muscular Dystrophy, Hackensack, New Jersey
| | | | - Bruce D Gelb
- Icahn School of Medicine at Mount Sinai, New York
| | - Karen W Gripp
- A.I. duPont Hospital for Children, Wilmington, Delaware
| | - Bronwyn Kerr
- Manchester Centre for Genomic Medicine, Manchester, UK
| | - Maria Kontaridis
- Harvard Medical School and Beth Israel Deaconess Medical Cancer Center, Boston, Massachusetts
| | - Conxi Lazaro
- Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | | | | | - Calum A MacRae
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Benjamin Neel
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Scott Plotkin
- Massachusetts General Hospital, Boston, Massachusetts
| | - Katherine A Rauen
- University of California, Davis MIND Institute, Sacramento, California
| | - Amy Roberts
- Boston Children's Hospital, Massachusetts.,Harvard Medical School, Massachusetts
| | | | - Sitta G Sittampalam
- National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, Maryland
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Beauchamp R, James M, Wagh V, DeSouza P, Zhao W, Stemmer‐Rachamimov A, Plotkin S, Gusella J, Haggarty S, Ramesh V. Kinome Screen Reveals SGK1 as a Therapeutic Target for NF2: Inhibition of mTORC1/2 is More Effective than Rapamycin. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.889.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Roberta Beauchamp
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - Marianne James
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - Vilas Wagh
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - Patrick DeSouza
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - Wen‐Ning Zhao
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | | | - Scott Plotkin
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - James Gusella
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - Stephen Haggarty
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
| | - Vijaya Ramesh
- Center for Human Genetic Research Massachusetts General HospitalBostonMAUnited States
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Affiliation(s)
- Justin T Jordan
- Pappas Center for Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Boston
| | - Scott Plotkin
- Pappas Center for Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Boston
| | - Jorg Dietrich
- Pappas Center for Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Boston
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Brognaro E, Chang S, Cha J, Choi K, Choi C, DePetro J, Binding C, Blough M, Kelly J, Lawn S, Chan J, Weiss S, Cairncross G, Eisenbeis A, Goldbrunner R, Timmer M, Gabrusiewicz K, Cortes-Santiago N, Fan X, Hossain MB, Kaminska B, Heimberger A, Rao G, Yung WKA, Marini F, Fueyo J, Gomez-Manzano C, Halle B, Marcusson E, Aaberg-Jessen C, Jensen SS, Meyer M, Schulz MK, Andersen C, Bjarne, Kristensen W, Hashizume R, Ihara Y, Ozawa T, Parsa A, Clarke J, Butowski N, Prados M, Perry A, McDermott M, James D, Jensen R, Gillespie D, Martens T, Zamykal M, Westphal M, Lamszus K, Monsalves E, Jalali S, Tateno T, Ezzat S, Zadeh G, Nedergaard MK, Kristoffersen K, Poulsen HS, Stockhausen MT, Lassen U, Kjaer A, Ohka F, Natsume A, Zong H, Liu C, Hatanaka A, Katsushima K, Shinjo K, Wakabayashi T, Kondo Y, Picotte K, Li L, Westerhuis B, Zhao H, Plotkin S, James M, Kalamarides M, Zhao WN, Kim J, Stemmer-Rachamimov A, Haggarty S, Gusella J, Ramesh V, Nunes F, Rao G, Doucette T, Yang Y, Fuller G, Rao A, Schmidt NO, Humke N, Meissner H, Mueller FJ, Westphal M, Schnell O, Jaehnert I, Albrecht V, Fu P, Tonn JC, Schichor C, Shackleford G, Swanson K, Shi XH, D'Apuzzo M, Gonzalez-Gomez I, Sposto R, Seeger R, Erdreich-Epstein A, Moats R, Sirianni RW, Heffernan JM, Overstreet DJ, Sleire L, Skeie BS, Netland IA, Heggdal J, Pedersen PH, Enger PO, Stiles C, Sun Y, Mehta S, Taylor C, Alberta J, Sundstrom T, Wendelbo I, Daphu I, Hodneland E, Lundervold A, Immervoll H, Skaftnesmo KO, Babic M, Jendelova P, Sykova E, Lund-Johansen M, Bjerkvig R, Thorsen F, Synowitz M, Ku MC, Wolf SA, Respondek D, Matyash V, Pohlmann A, Waiczies S, Waiczies H, Niendorf T, Glass R, Kettenmann H, Thompson N, Elder D, Hopkins K, Iyer V, Cohen N, Tavare J, Thorsen F, Fite B, Mahakian LM, Seo JW, Qin S, Harrison V, Sundstrom T, Harter PN, Johnson S, Ingham E, Caskey C, Meade T, Skaftnesmo KO, Ferrara KW, Tschida BR, Lowy AR, Marek CA, Ringstrom T, Beadnell TJ, Wiesner SM, Largaespada DA, Wenger C, Miranda PC, Mekonnen A, Salvador R, Basser P, Yoon J, Shin H, Choi K, Choi C. TUMOR MODELS (IN VIVO/IN VITRO). Neuro Oncol 2013. [DOI: 10.1093/neuonc/not193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fayad LM, Blakeley J, Plotkin S, Widemann B, Jacobs MA. Whole Body MRI at 3T with Quantitative Diffusion Weighted Imaging and Contrast-Enhanced Sequences for the Characterization of Peripheral Lesions in Patients with Neurofibromatosis Type 2 and Schwannomatosis. ISRN Radiol 2013; 2013:627932. [PMID: 24967287 PMCID: PMC4045550 DOI: 10.5402/2013/627932] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 08/13/2013] [Indexed: 12/15/2022]
Abstract
Purpose. WB-MRI is mainly used for tumor detection and surveillance. The purpose of this study is to establish the feasibility of WB-MRI at 3T for lesion characterization, with DWI/ADC-mapping and contrast-enhanced sequences, in patients with neurofibromatosis type 2 (NF-2) and schwannomatosis. Materials and Methods. At 3T, WB-MRI was performed in 11 subjects (10 NF-2 and 1 schwannomatosis) with STIR, T1, contrast-enhanced T1, and DWI/ADC mapping (b = 50, 400, 800 s/mm(2)). Two readers reviewed imaging for the presence and character of peripheral lesions. Lesion size and features (signal intensity, heterogeneity, enhancement characteristics, and ADC values) were recorded. Descriptive statistics were reported. Results. Twenty-three lesions were identified, with average size of 4.6 ± 2.8 cm. Lesions were characterized as tumors (21/23) or cysts (2/23) by contrast-enhancement properties (enhancement in tumors, no enhancement in cysts). On T1, tumors were homogeneously isointense (5/21) or hypointense (16/21); on STIR, tumors were hyperintense and homogeneous (10/21) or heterogeneous (11/21); on postcontrast T1, tumors enhanced homogeneously (14/21) or heterogeneously (7/21); on DWI, tumor ADC values were variable (range 0.8-2.7), suggesting variability in intrinsic tumor properties. Conclusion. WB-MRI with quantitative DWI and contrast-enhanced sequences at 3T is feasible and advances the utility of WB-MRI not only to include detection, but also to provide additional metrics for lesion characterization.
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Affiliation(s)
- Laura M. Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Jaishri Blakeley
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- The Johns Hopkins Hospital Comprehensive Neurofibromatosis Center, Department of Neurology, The Johns Hopkins Hospital, CRB II, Suite 1M16, 1550 Orleans Street, Baltimore, MD 21231, USA
| | - Scott Plotkin
- Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston, MA, USA
- Neurofibromatosis Clinic, Pappas Center for Neuro-Oncology, Massachusetts General Hospital, 55 Fruit Street, YAW 9, Boston, MA 02114, USA
| | - Brigitte Widemann
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
- Pharmacology & Experimental Therapeutics Section, Pediatric Oncology Branch, NCI, CCR, Room 1-5750, 10 Center Drive, 10-CRC, MSC 1101, Bethesda, MD 20892, USA
| | - Michael A. Jacobs
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Terry A, Barker F, Leffert L, Bateman B, Souter I, Plotkin S. Outcomes of Hospitalization in Pregnant Women with Brain Tumors: A Population-Based Study (P07.112). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Merker V, Esparza S, Smith M, Stemmer-Rachamimov A, Plotkin S. Clinical Features of the Schwannomatosis Tumor Suppressor Syndrome: A Retrospective Analysis of 87 Patients (S45.003). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s45.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hagel C, Stemmer-Rachamimov AO, Bornemann A, Schuhmann M, Nagel C, Huson S, Evans DG, Plotkin S, Matthies C, Kluwe L, Mautner VF. Clinical presentation, immunohistochemistry and electron microscopy indicate neurofibromatosis type 2-associated gliomas to be spinal ependymomas. Neuropathology 2012; 32:611-6. [DOI: 10.1111/j.1440-1789.2012.01306.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hu YL, De Lay M, Rose SD, Carbonell WS, Aghi MK, Rose SD, Carbonell WS, De Lay M, Hu YL, Paquette J, Tokuyasu T, Tsao S, Chaumeil M, Ronen S, Aghi MK, Matlaf LA, Soroceanu L, Cobbs C, Soroceanu L, Matlaf L, Harkins L, Cobbs C, Garzon-Muvdi T, Rhys CA, Smith C, Kim DH, Kone L, Farber H, An S, Levchenko A, Quinones-Hinojosa A, Lemke D, Pfenning PN, Sahm F, Klein AC, Kempf T, Schnolzer M, Platten M, Wick W, Smith SJ, Rahman R, Rahman C, Barrow J, Macarthur D, Rose F, Grundy RG, Kaley TJ, Huse J, Karimi S, Rosenblum M, Omuro A, DeAngelis LM, de Groot JF, Kong LY, Wei J, Wang T, Piao Y, Liang J, Fuller GN, Qiao W, Heimberger AB, Jhaveri N, Cho H, Torres S, Wang W, Schonthal A, Petasis N, Louie SG, Hofman F, Chen TC, Yamada R, Sumual S, Buljan V, Bennett MR, McDonald KL, Weiler M, Pfenning PN, Thiepold AL, Jestaedt L, Gronych J, Dittmann LM, Jugold M, Kosch M, Combs SE, von Deimling A, Weller M, Bendszus M, Platten M, Wick W, Kwiatkowska A, Paulino V, Tran NL, Symons M, Stockham AL, Borden E, Peereboom D, Hu Y, Chaturbedi A, Hamamura M, Mark E, Zhou YH, Abbadi S, Guerrero-Cazares H, Pistollato F, Smith CL, Ruff W, Puppa AD, Basso G, Quinones-Hinojosa A, Monje M, Freret ME, Masek M, Fisher PG, Haddix T, Vogel H, Kijima N, Hosen N, Kagawa N, Hashimoto N, Fujimoto Y, Kinoshita M, Sugiyama H, Yoshimine T, Anneke N, Bob H, Pieter W, Arend H, William L, Eoli M, Calleri A, Cuppini L, Anghileri E, Pellegatta S, Prodi E, Bruzzone MG, Bertolini F, Finocchiaro G, Zhu D, Hunter SB, Vertino PM, Van Meir EG, Cork SM, Kaur B, Cooper L, Saltz JH, Sandberg EM, Van Meir EG, Burrell K, Hill R, Zadeh G, Parker JJ, Dionne K, Massarwa R, Klaassen M, Niswander L, Kleinschmidt-DeMasters BK, Waziri A, Jalali S, Wataya T, Salehi F, Croul S, Gentili F, Zadeh G, Jalali S, Foltz W, Burrell K, Lee JI, Agnihorti S, Menard C, Chung C, Zadeh G, Torres S, Jhaveri N, Wang W, Schonthal AH, Louie SG, Hofman FM, Chen TC, Elena P, Faivre G, Demopoulos A, Taillibert S, Rosenblum M, Omuro A, Kirsch M, Martin KD, Bertram A, uckermann O, Leipnitz E, Weigel P, Temme A, Schackert G, Geiger K, Gerstner E, Jennings D, Chi AS, Plotkin S, Kwon SJ, Pinho M, Polaskova P, Batchelor TT, Sorensen AG, Hossain MB, Gururaj AE, Cortes-Santiago N, Gabrusiewicz K, Yung WKA, Fueyo J, Gomez-Manzano C, Gil OD, Noticewala S, Ivkovic S, Esencay M, Zagzagg D, Rosenfeld S, Bruce JN, Canoll P, Chang JH, Seol HJ, Weeks A, Smith CA, Rutka JT, Georges J, Samuelson G, Misra A, Joy A, Huang Y, McQuilkin M, Yoshihiro A, Carpenter D, Butler L, Feuerstein B, Murphy SF, Vaghaiwalla T, Wotoczek-Obadia M, Albright R, Mack D, Lawn S, Henderson F, Jung M, Dakshanamurthy S, Brown M, Forsyth P, Brem S, Sadr MS, Maret D, Sadr ES, Siu V, Alshami J, Trinh G, Denault JS, Faury D, Jabado N, Nantel A, Del Maestro R. ANGIOGENESIS AND INVASION. Neuro Oncol 2011; 13:iii1-iii9. [PMCID: PMC3222963 DOI: 10.1093/neuonc/nor147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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Prithviraj GK, Sommers SR, Jump RL, Halmos B, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Hunter K, Chamberlain MC, Le EM, Lee ELT, Chamberlain MC, Sadighi ZS, Pearlman ML, Slopis JM, Vats TS, Khatua S, DeVito NC, Yu M, Chen R, Pan E, Cloughesy T, Raizer J, Drappatz J, Gerena-Lewis M, Rogerio J, Yacoub S, Desjardin A, Groves MD, DeGroot J, Loghin M, Conrad CA, Hess K, Ni J, Ictech S, Hunter K, Yung WA, Porter AB, Dueck AC, Karlin NJ, Chamberlain MC, Olson J, Silber J, Reiner AS, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Shiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Cachia D, Alderson L, Moser R, Smith T, Yunus S, Saito K, Mukasa A, Narita Y, Tabei Y, Shinoura N, Shibui S, Saito N, Flechl B, Ackerl M, Sax C, Dieckmann K, Crevenna R, Widhalm G, Preusser M, Marosi C, Marosi C, Ay C, Preusser M, Dunkler D, Widhalm G, Pabinger I, Dieckmann K, Zielinski C, Belongia M, Jogal S, Schlingensiepen KH, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine V, Parfenov V, Poverennova I, Hau P, Jachimczak P, Heinrichs H, Mammoser AG, Shonka NA, de Groot JF, Shibahara I, Sonoda Y, Kumabe T, Saito R, Kanamori M, Yamashita Y, Watanabe M, Ishioka C, Tominaga T, Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Broggi G, Fariselli L, Solero CL, Salmaggi A, Green RM, Woyshner EA, Cloughesy TF, Shu F, Oh YS, Iganej S, Singh G, Vemuri SL, Theeler BJ, Ellezam B, Gilbert MR, Aoki T, Kobayashi H, Takano S, Nishikawa R, Shinoura N, Nagane M, Narita Y, Muragaki Y, Sugiyama K, Kuratsu J, Matsutani M, Sadighi ZS, Khatua S, Langford LA, Puduvalli VK, Shen D, Chen ZP, Zhang JP, Chen ZP, Bedekar D, Rand S, Connelly J, Malkin M, Paulson E, Mueller W, Schmainda K, Gallego O, Benavides M, Segura PP, Balana C, Gil M, Berrocal A, Reynes G, Garcia JL, Murata P, Bague S, Quintana MJ, Vasishta VG, Nagane M, Kobayashi K, Tanaka M, Tsuchiya K, Shiokawa Y, Bavle AA, Ayyanar K, Puduvalli VK, Prado MP, Hess KR, Hunter K, Ictech S, Groves MD, Gilbert MR, Liu V, Conrad CA, de Groot J, Loghin ME, Colman H, Levin VA, Alfred Yung WK, Hackney JR, Palmer CA, Markert JM, Cure J, Riley KO, Fathallah-Shaykh H, Nabors LB, Saria MG, Corle C, Hu J, Rudnick J, Phuphanich S, Mrugala MM, Lee LK, Fu BD, Bota DA, Kim RY, Brown T, Feely H, Hu A, Drappatz J, Wen PY, Lee JW, Carter B, Kesari S, Fu BD, Kong XT, Bota DA, Fu BD, Bota DA, Sparagana S, Belousova E, Jozwiak S, Korf B, Frost M, Kuperman R, Kohrman M, Witt O, Wu J, Flamini R, Jansen A, Curtalolo P, Thiele E, Whittemore V, De Vries P, Ford J, Shah G, Cauwel H, Edrich P, Sahmoud T, Franz D, Khasraw M, Brown C, Ashley DM, Rosenthal MA, Jiang X, Mou YG, Chen ZP, Oh M, kim E, Chang J, Juratli TA, Kirsch M, Schackert G, Krex D, Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi M, Jaeckle KA, Armstrong TS, Wefel JS, Won M, Blumenthal DT, Mahajan A, Schultz CJ, Erridge SC, Brown PD, Chakravarti A, Curran WJ, Mehta MP, Hofland KF, Hansen S, Sorensen M, Schultz H, Muhic A, Engelholm S, Ask A, Kristiansen C, Thomsen C, Poulsen HS, Lassen UN, Zalatimo O, Weston C, Zoccoli C, Glantz M, Rahmanuddin S, Shiroishi MS, Cen SY, Jones J, Chen T, Pagnini P, Go J, Lerner A, Gomez J, Law M, Ram Z, Wong ET, Gutin PH, Bobola MS, Alnoor M, Silbergeld DL, Rostomily RC, Chamberlain MC, Silber JR, Martha N, Jacqueline S, Thaddaus G, Daniel P, Hans M, Armin M, Eugen T, Gunther S, Hutterer M, Tseng HM, Zoccoli CM, Glantz M, Zalatimo O, Patel A, Rizzo K, Sheehan JM, Sumrall AL, Vredenburgh JJ, Desjardins A, Reardon DA, Friiedman HS, Peters KB, Taylor LP, Stewart M, Blondin NA, Baehring JM, Foote T, Laack N, Call J, Hamilton MG, Walling S, Eliasziw M, Easaw J, Shirsat NV, Kundar R, Gokhale A, Goel A, Moiyadi AA, Wang J, Mutlu E, Oyan A, Yan T, Tsinkalovsky O, Jacobsen HK, Talasila KM, Sleire L, Pettersen K, Miletic H, Andersen S, Mitra S, Weissman I, Li X, Kalland KH, Enger PO, Sepulveda J, Belda C, Balana C, Segura PP, Reynes G, Gil M, Gallego O, Berrocal A, Blumenthal DT, Sitt R, Phishniak L, Bokstein F, Philippe M, Carole C, Andre MDP, Marylin B, Olivier C, L'Houcine O, Dominique FB, Philippe M, Isabelle NM, Olivier C, Frederic F, Stephane F, Henry D, Marylin B, L'Houcine O, Dominique FB, Errico MA, Kunschner LJ, Errico MA, Kunschner LJ, Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I, Jalali R, Julka PK, Anand AK, Bhavsar D, Singhal N, Naik R, John S, Mathew BS, Thaipisuttikul I, Graber J, DeAngelis LM, Shirinian M, Fontebasso AM, Jacob K, Gerges N, Montpetit A, Nantel A, Albrecht S, Jabado N, Mammoser AG, Shah K, Conrad CA, Di K, Linskey M, Bota DA, Thon N, Eigenbrod S, Kreth S, Lutz J, Tonn JC, Kretzschmar H, Peraud A, Kreth FW, Muggeri AD, Alderuccio JP, Diez BD, Jiang P, Chao Y, Gallagher M, Kim R, Pastorino S, Fogal V, Kesari S, Rudnick JD, Bresee C, Rogatko A, Sakowsky S, Franco M, Hu J, Lim S, Lopez A, Yu L, Ryback K, Tsang V, Lill M, Steinberg A, Sheth R, Grimm S, Helenowski I, Rademaker A, Raizer J, Nunes FP, Merker V, Jennings D, Caruso P, Muzikansky A, Stemmer-Rachamimov A, Plotkin S, Spalding AC, Vitaz TW, Sun DA, Parsons S, Welch MR, Omuro A, DeAngelis LM, Omuro A, Beal K, Correa D, Chan T, DeAngelis L, Gavrilovic I, Nolan C, Hormigo A, Lassman AB, Kaley T, Mellinghoff I, Grommes C, Panageas K, Reiner A, Barradas R, Abrey L, Gutin P, Lee SY, Slagle-Webb B, Glantz MJ, Sheehan JM, Connor JR, Schlimper CA, Schlag H, Stoffels G, Weber F, Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Byars A, Sahmoud T, Franz DN, Raizer J, Rice L, Rademaker A, Chandler J, Levy R, Muro K, Grimm S, Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Omuro A, Kaley TJ, Thomas AA, Fadul CE, Meyer LP, Lallana EC, Colman H, Gilbert M, Alfred Yung WK, Aldape K, De Groot J, Conrad C, Levin V, Groves M, Loghin M, Chris P, Puduvalli V, Nagpal S, Feroze A, Recht L, Rangarajan HG, Kieran MW, Scott RM, Lew SM, Firat SY, Segura AD, Jogal SA, Kumthekar PU, Grimm SA, Avram M, Patel J, Kaklamani V, McCarthy K, Cianfrocca M, Gradishar W, Mulcahy M, Von Roenn J, Helenowski I, Rademaker A, Raizer J, Galanis E, Anderson SK, Lafky JM, Kaufmann TJ, Uhm JH, Giannini C, Kumar SK, Northfelt DW, Flynn PJ, Jaeckle KA, Buckner JC, Omar AI, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Schiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Delios A, Jakubowski A, DeAngelis L, Grommes C, Lassman AB, Theeler BJ, Melguizo-Gavilanes I, Shonka NA, Qiao W, Wang X, Mahajan A, Puduvalli V, Hashemi-Sadraei N, Bawa H, Rahmathulla G, Patel M, Elson P, Stevens G, Peereboom D, Vogelbaum M, Weil R, Barnett G, Ahluwalia MS, Alvord EC, Rockne RC, Rockhill JK, Mrugala MM, Rostomily R, Lai A, Cloughesy T, Wardlaw J, Spence AM, Swanson KR, Zadeh G, Alahmadi H, Wilson J, Gentili F, Lassman AB, Wang M, Gilbert MR, Aldape KD, Beumer JJ, Wright J, Takebe N, Puduvalli VK, Hormigo A, Gaur R, Werner-Wasik M, Mehta MP, Gupta AJ, Campos-Gines A, Le K, Arango C, Richards M, Landeros M, Juan H, Chang JH, Kim JS, Cho JH, Seo CO, Baldock AL, Rockne R, Canoll P, Born D, Yagle K, Swanson KR, Alexandru D, Bota D, Linskey ME, Nabeel S, Raval SN, Raizer J, Grimm S, Rice L, Rosenow J, Levy R, Bredel M, Chandler J, New PZ, Plotkin SR, Supko JG, Curry WT, Chi AS, Gerstner ER, Stemmer-Rachamimov A, Batchelor TT, Ahluwalia MS, Hashemi N, Rahmathulla G, Patel M, Chao ST, Peereboom D, Weil RJ, Suh JH, Vogelbaum MA, Stevens GH, Barnett GH, Corwin D, Holdsworth C, Stewart R, Rockne R, Swanson K, Graber JJ, Kaley T, Rockne RC, Anderson AR, Swanson KR, Jeyapalan S, Goldman M, Boxerman J, Donahue J, Elinzano H, Evans D, O'Connor B, Puthawala MY, Oyelese A, Cielo D, Blitstein M, Dargush M, Santaniello A, Constantinou M, DiPetrillo T, Safran H, Plotkin SR, Halpin C, Merker V, Barker FG, Maher EA, Ganji S, DeBerardinis R, Hatanpaa K, Rakheja D, Yang XL, Mashimo T, Raisanen J, Madden C, Mickey B, Malloy C, Bachoo R, Choi C, Ranjan T, Yono N, Zalatimo O, Zoccoli C, Glantz M, Han SJ, Sun M, Berger MS, Aghi M, Gupta N, Parsa AT. MEDICAL AND NEURO-ONCOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shen Y, Nunes F, Stemmer-Rachamimov A, James M, Mohapatra G, Plotkin S, Betensky RA, Engler DA, Roy J, Ramesh V, Gusella JF. Genomic profiling distinguishes familial multiple and sporadic multiple meningiomas. BMC Med Genomics 2009; 2:42. [PMID: 19589153 PMCID: PMC2716362 DOI: 10.1186/1755-8794-2-42] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2009] [Accepted: 07/09/2009] [Indexed: 11/27/2022] Open
Abstract
Background Meningiomas may occur either as familial tumors in two distinct disorders, familial multiple meningioma and neurofibromatosis 2 (NF2), or sporadically, as either single or multiple tumors in individuals with no family history. Meningiomas in NF2 and approximately 60% of sporadic meningiomas involve inactivation of the NF2 locus, encoding the tumor suppressor merlin on chromosome 22q. This study was undertaken to establish whether genomic profiling could distinguish familial multiple meningiomas from sporadic solitary and sporadic multiple meningiomas. Methods We compared 73 meningiomas presenting as sporadic solitary (64), sporadic multiple (5) and familial multiple (4) tumors using genomic profiling by array comparative genomic hybridization (array CGH). Results Sporadic solitary meningiomas revealed genomic rearrangements consistent with at least two mechanisms of tumor initiation, as unsupervised cluster analysis readily distinguished tumors with chromosome 22 deletion (associated with loss of the NF2 tumor suppressor) from those without chromosome 22 deletion. Whereas sporadic meningiomas without chromosome 22 loss exhibited fewer chromosomal imbalance events overall, tumors with chromosome 22 deletion further clustered into two major groups that largely, though not perfectly, matched with their benign (WHO Grade I) or advanced (WHO Grades II and III) histological grade, with the latter exhibiting a significantly greater degree of genomic imbalance (P < 0.001). Sporadic multiple meningiomas showed a frequency of genomic imbalance events comparable to the atypical grade solitary tumors. By contrast, familial multiple meningiomas displayed no imbalances, supporting a distinct mechanism for the origin for these tumors. Conclusion Genomic profiling can provide an unbiased adjunct to traditional meningioma classification and provides a basis for exploring the different genetic underpinnings of tumor initiation and progression. Most importantly, the striking difference observed between sporadic and familial multiple meningiomas indicates that genomic profiling can provide valuable information for differential diagnosis of subjects with multiple meningiomas and for considering the risk for tumor occurrence in their family members.
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Affiliation(s)
- Yiping Shen
- Molecular Neurogenetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, 02114, USA.
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Gurunathan S, Habib RE, Baglyos L, Meric C, Plotkin S, Dodet B, Corey L, Tartaglia J. Use of predictive markers of HIV disease progression in vaccine trials. Vaccine 2009; 27:1997-2015. [DOI: 10.1016/j.vaccine.2009.01.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 12/19/2008] [Accepted: 01/08/2009] [Indexed: 10/21/2022]
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Reardon DA, Fink KL, Mikkelsen T, Cloughesy TF, O'Neill A, Plotkin S, Glantz M, Ravin P, Raizer JJ, Rich KM, Schiff D, Shapiro WR, Burdette-Radoux S, Dropcho EJ, Wittemer SM, Nippgen J, Picard M, Nabors LB. Randomized Phase II Study of Cilengitide, an Integrin-Targeting Arginine-Glycine-Aspartic Acid Peptide, in Recurrent Glioblastoma Multiforme. J Clin Oncol 2008; 26:5610-7. [DOI: 10.1200/jco.2008.16.7510] [Citation(s) in RCA: 412] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PurposeCilengitide, an inhibitor of αvβ3 and αvβ5 integrin receptors, demonstrated minimal toxicity and durable activity across a wide range of doses administered to adults with recurrent glioblastoma multiforme (GBM) in a prior phase I study. The current multicenter phase II study was conducted to evaluate the activity and safety of cilengitide in GBM patients at first recurrence.Patients and MethodsEligible patients were randomly assigned to receive either 500 or 2,000 mg of cilengitide twice weekly on a continuous basis. Patients were assessed every 4 weeks. The primary end point was 6-month progression-free survival (PFS) rate. Secondary end points included PFS, overall survival (OS), and radiographic response, as well as quality-of-life and pharmacokinetic assessments.ResultsEighty-one patients were enrolled, including 41 on the 500-mg arm and 40 on the 2,000-mg arm. The safety profile of cilengitide was excellent, with no significant reproducible toxicities observed on either arm. Antitumor activity was observed in both treatment cohorts but trended more favorably among patients treated with 2,000 mg, including a 6-month PFS of 15% and a median OS of 9.9 months.ConclusionCilengitide monotherapy is well tolerated and exhibits modest antitumor activity among recurrent GBM patients. Additional studies integrating cilengitide into combinatorial regimens for GBM are warranted.
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Affiliation(s)
- David A. Reardon
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Karen L. Fink
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Tom Mikkelsen
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Timothy F. Cloughesy
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Alison O'Neill
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Scott Plotkin
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Michael Glantz
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Paula Ravin
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Jeffrey J. Raizer
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Keith M. Rich
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - David Schiff
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - William R. Shapiro
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Susan Burdette-Radoux
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Edward J. Dropcho
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Sabine M. Wittemer
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Johannes Nippgen
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - Martin Picard
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
| | - L. Burt Nabors
- From the Duke University Medical Center, Durham, NC; Baylor University Medical Center, Dallas, TX; Henry Ford Hospital, Detroit, MI; University of California, Los Angeles Medical Center, Los Angeles, CA; TransMolecular, Inc, Cambridge; Massachusetts General Hospital, Boston; University of Massachusetts Medical Center, Worcester, MA; Northwestern University Medical Center, Chicago, IL; Washington University, St Louis, MO; University of Virginia Health Science Center, Charlottesville, VA; Barrow
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Plotkin S. [Tropical vaccinology at the dawn of the 21st century]. Med Trop (Mars) 2007; 67:320. [PMID: 17926787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- S Plotkin
- L'Université de Pennsylvanie, Philadelphie, USA.
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Williams Z, Coumans JV, Bredella MA, Torriani M, Hornicek F, Ouellette H, Palmer W, Fischman A, Plotkin S. Role of Positron Emission Tomography Imaging in the Surgical Management of Peripheral Nerve Sheath Tumors in Patients with Neurofibromatosis Type 1. Neurosurgery 2007. [DOI: 10.1227/01.neu.0000279902.76570.1d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Reardon D, Fink K, Nabors B, Cloughesy T, Plotkin S, Schiff D, Raizer J, Krueger S, Picard M, Mikkelsen T. Phase IIa trial of cilengitide (EMD121974) single-agent therapy in patients (pts) with recurrent glioblastoma (GBM): EMD 121974-009. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.2002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2002 Background: Our phase IIa study evaluated the safety, toxicity, and clinical activity of the cyclic RGD pentapeptide cilengitide (EMD121974), an inhibitor of integrins avβ3 and avβ5, as a single agent at doses of 500 and 2000 mg in pts with recurrent GBM. Methods: In this multicenter, open-label, randomized, uncontrolled study, pts with GBM and measurable disease that had relapsed after previous temozolomide and radiotherapy were randomized to receive cilengitide at either 500 mg or 2000 mg i.v., 2x/week, until progression. Neurologic exams were performed after every cycle (4 weeks) and MRIs were performed every other cycle. Central, blinded pathology and radiology reviews were performed. The primary endpoint was Progression Free Survival (PFS) at 6 months (6-mth PFS). Secondary endpoints included response, survival, time to disease progression, safety, tolerability and pharmacokinetics (PK). Results: 81 pts accrued (median Karnofsky Performance Status 80%; median age 57 yrs) at 15 sites including 41 at the 500 mg and 40 at the 2000 mg dose levels. Demographic and pretreatment variables were comparable between dose level cohorts. The median number of infusions was 16 [range, 4–179]. PK studies revealed significantly greater exposures among the 2000 mg cohort. Treatment related NCI CTC grade 3 adverse events (AEs) included elevated transaminases (at 500 mg), arthralgia/ myalgia (at 500 mg), and weight increase/ edema (at 2000 mg) in 1 patient, respectively. No grade 4 therapy related AEs were reported. One CTC grade 2 cerebral hemorrhage was reported in a pt at progression. The 6- mth PFS was 16.1% (n=13/81 pts). 10 pts (12.3 %, n=4 with 500 mg, n=6 with 2000 mg) received 12 or more cycles. Six pts (7.4%) remain progression-free and on treatment. Median Overall Survival (mOS) was 6.5 mths [95% CI: 5.2–9.3 mths] in the 500 mg arm and 9.9 mths [95% CI, 6.3–15.7 mths] in the 2000 mg arm. Although not statistically significant, there was a trend towards better tumor control in pts receiving 2000 mg 2x/week. Conclusions: Cilengitide was well tolerated and demonstrated single agent activity in recurrent GBM, with long term disease stabilization in a subset of pts. [Table: see text]
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Affiliation(s)
- D. Reardon
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - K. Fink
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - B. Nabors
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - T. Cloughesy
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - S. Plotkin
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - D. Schiff
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - J. Raizer
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - S. Krueger
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - M. Picard
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
| | - T. Mikkelsen
- Duke University Medical Center, Durham, NC; Neuro-Oncology Associates, Dallas, TX; University of Alabama, Birmingham, AL; University of California, Los Angeles, CA; Massachusetts General Hospital, Boston, MA; University of Virginia, Charlottesville, VA; Northwestern University, Chicago, IL; Merck KGaA, Darmstadt, Germany; Henry Ford Health System, Detroit, MI
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Batchelor TT, Sorensen AG, di Tomaso E, Zhang WT, Duda DG, Cohen KS, Kozak KR, Cahill DP, Chen PJ, Zhu M, Ancukiewicz M, Mrugala MM, Plotkin S, Drappatz J, Louis DN, Ivy P, Scadden DT, Benner T, Loeffler JS, Wen PY, Jain RK. AZD2171, a pan-VEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients. Cancer Cell 2007; 11:83-95. [PMID: 17222792 PMCID: PMC2748664 DOI: 10.1016/j.ccr.2006.11.021] [Citation(s) in RCA: 1325] [Impact Index Per Article: 77.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Revised: 10/16/2006] [Accepted: 11/30/2006] [Indexed: 02/08/2023]
Abstract
Using MRI techniques, we show here that normalization of tumor vessels in recurrent glioblastoma patients by daily administration of AZD2171-an oral tyrosine kinase inhibitor of VEGF receptors-has rapid onset, is prolonged but reversible, and has the significant clinical benefit of alleviating edema. Reversal of normalization began by 28 days, though some features persisted for as long as four months. Basic FGF, SDF1alpha, and viable circulating endothelial cells (CECs) increased when tumors escaped treatment, and circulating progenitor cells (CPCs) increased when tumors progressed after drug interruption. Our study provides insight into different mechanisms of action of this class of drugs in recurrent glioblastoma patients and suggests that the timing of combination therapy may be critical for optimizing activity against this tumor.
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Affiliation(s)
- Tracy T. Batchelor
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - A. Gregory Sorensen
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- MGH-HST A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and Division of Health Sciences and Technology, Harvard Medical School, Boston, MA 02114, and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Emmanuelle di Tomaso
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Wei-Ting Zhang
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- MGH-HST A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and Division of Health Sciences and Technology, Harvard Medical School, Boston, MA 02114, and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Dan G. Duda
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Kenneth S. Cohen
- Center for Regenerative Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Kevin R. Kozak
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Daniel P. Cahill
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Poe-Jou Chen
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- MGH-HST A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and Division of Health Sciences and Technology, Harvard Medical School, Boston, MA 02114, and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Mingwang Zhu
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- MGH-HST A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, and Division of Health Sciences and Technology, Harvard Medical School, Boston, MA 02114, and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Marek Ancukiewicz
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Maciej M. Mrugala
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Scott Plotkin
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jan Drappatz
- Department of Adult Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA 02115, USA
| | - David N. Louis
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Percy Ivy
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD 20892, USA
| | - David T. Scadden
- Center for Regenerative Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Thomas Benner
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jay S. Loeffler
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Patrick Y. Wen
- Department of Adult Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA 02115, USA
| | - Rakesh K. Jain
- Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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