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Vivanco RA, Aguirre AS, Montero M, Perez-Davila M, Baehring J. Atypical presentation of dysembryoplastic neuroepithelial tumor in an adult without epilepsy: a case report. Int J Neurosci 2023:1-4. [PMID: 37800586 DOI: 10.1080/00207454.2023.2268269] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023]
Abstract
Aim of the study: Dysembryoplastic neuroepithelial tumor (DNET) is a rare glioneuronal tumor usually found in the temporal lobe of children and young adults. DNETs are commonly associated with drug-resistant partial seizures, with most cases diagnosed before age 20. Asymptomatic brain tumors are rare in the general healthy population, and the frequency of incidental DNETs in adults remains unknown.Materials and methods: We report the case of a 34-year-old healthy man who presented with a facial rash but was incidentally found to have a large T1 hypointense lesion in the left temporal cortex on neuroimaging. The patient opted for surgical removal of the mass, which was subsequently identified as a DNET, positive for a fibroblast growth factor receptor (FGFR) mutation.Results: This case report presents the first incidentally discovered DNET in an adult without epilepsy, highlighting its atypical presentation. In addition, the presence of an FGFR mutation emphasizes its role in DNET pathogenesis and potential therapeutic implications. DNETs exhibit varied behavior based on age, tumor location, and cortical dysplasia.Conclusions: In this case, the absence of seizure onset may be attributed to the lack of cortical dysplasia. Further research is needed to understand the incidence of DNETs and their association with seizure onset and cortical dysplasia.
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Affiliation(s)
- Ricardo A Vivanco
- School of Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Alex S Aguirre
- School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
| | - Marcelo Montero
- School of Medicine, Universidad de las Americas, Quito, Ecuador
| | | | - Joachim Baehring
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, USA
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2
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Hong CS, Marianayagam NJ, Morales-Valero SF, Barak T, Tabor JK, O’Brien J, Huttner A, Baehring J, Gunel M, Erson-Omay EZ, Fulbright RK, Matouk CC, Moliterno J. Vascular steal and associated intratumoral aneurysms in highly vascular brain tumors: illustrative case. J Neurosurg Case Lessons 2023; 5:CASE22512. [PMID: 36880509 PMCID: PMC10550659 DOI: 10.3171/case22512] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/30/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND Intratumoral aneurysms in highly vascular brain tumors can complicate resection depending on their location and feasibility of proximal control. Seemingly unrelated neurological symptoms may be from vascular steal that can help alert the need for additional vascular imaging and augmenting surgical strategies. OBSERVATIONS A 29-year-old female presented with headaches and unilateral blurred vision, secondary to a large right frontal dural-based lesion with hypointense signal thought to represent calcifications. Given these latter findings and clinical suspicion for a vascular steal phenomenon to explain the blurred vision, computed tomography angiography was obtained, revealing a 4 × 2-mm intratumoral aneurysm. Diagnostic cerebral angiography confirmed this along with vascular steal by the tumor from the right ophthalmic artery. The patient underwent endovascular embolization of the intratumoral aneurysm, followed by open tumor resection in the same setting without complication, minimal blood loss, and improvement in her vision. LESSONS Understanding the blood supply of any tumor, but highly vascular ones in particular, and the relationship with normal vasculature is undeniably important in avoiding potentially dangerous situations and optimizing maximal safe resection. Recognition of highly vascular tumors should prompt thorough understanding of the vascular supply and relationship of intracranial vasculature with consideration of endovascular adjuncts when appropriate.
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3
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Omuro A, Brandes AA, Carpentier AF, Idbaih A, Reardon DA, Cloughesy T, Sumrall A, Baehring J, van den Bent M, Bähr O, Lombardi G, Mulholland P, Tabatabai G, Lassen U, Sepulveda JM, Khasraw M, Vauleon E, Muragaki Y, Di Giacomo AM, Butowski N, Roth P, Qian X, Fu AZ, Liu Y, Potter V, Chalamandaris AG, Tatsuoka K, Lim M, Weller M. Radiotherapy combined with nivolumab or temozolomide for newly diagnosed glioblastoma with unmethylated MGMT promoter: An international randomized phase III trial. Neuro Oncol 2023; 25:123-134. [PMID: 35419607 PMCID: PMC9825306 DOI: 10.1093/neuonc/noac099] [Citation(s) in RCA: 137] [Impact Index Per Article: 137.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Addition of temozolomide (TMZ) to radiotherapy (RT) improves overall survival (OS) in patients with glioblastoma (GBM), but previous studies suggest that patients with tumors harboring an unmethylated MGMT promoter derive minimal benefit. The aim of this open-label, phase III CheckMate 498 study was to evaluate the efficacy of nivolumab (NIVO) + RT compared with TMZ + RT in newly diagnosed GBM with unmethylated MGMT promoter. METHODS Patients were randomized 1:1 to standard RT (60 Gy) + NIVO (240 mg every 2 weeks for eight cycles, then 480 mg every 4 weeks) or RT + TMZ (75 mg/m2 daily during RT and 150-200 mg/m2/day 5/28 days during maintenance). The primary endpoint was OS. RESULTS A total of 560 patients were randomized, 280 to each arm. Median OS (mOS) was 13.4 months (95% CI, 12.6 to 14.3) with NIVO + RT and 14.9 months (95% CI, 13.3 to 16.1) with TMZ + RT (hazard ratio [HR], 1.31; 95% CI, 1.09 to 1.58; P = .0037). Median progression-free survival was 6.0 months (95% CI, 5.7 to 6.2) with NIVO + RT and 6.2 months (95% CI, 5.9 to 6.7) with TMZ + RT (HR, 1.38; 95% CI, 1.15 to 1.65). Response rates were 7.8% (9/116) with NIVO + RT and 7.2% (8/111) with TMZ + RT; grade 3/4 treatment-related adverse event (TRAE) rates were 21.9% and 25.1%, and any-grade serious TRAE rates were 17.3% and 7.6%, respectively. CONCLUSIONS The study did not meet the primary endpoint of improved OS; TMZ + RT demonstrated a longer mOS than NIVO + RT. No new safety signals were detected with NIVO in this study. The difference between the study treatment arms is consistent with the use of TMZ + RT as the standard of care for GBM.ClinicalTrials.gov NCT02617589.
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Affiliation(s)
- Antonio Omuro
- Corresponding Author: Antonio Omuro, MD, Yale Cancer Center, 15 York Street, New Haven, CT 06520, USA ()
| | - Alba A Brandes
- Present affiliation: IRCCS Istituto Scienze Neurologiche, Bologna, Italy; Nervous System Medical Oncology Department, Bologna, Italy
| | - Antoine F Carpentier
- Université de Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, Service de Neurologie, Paris, France
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau – Paris Brain Institute – ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Paris, France
| | - David A Reardon
- Dana-Farber Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy Cloughesy
- Department of Neurology, University of California, Los Angeles, California, USA
| | | | - Joachim Baehring
- Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Martin van den Bent
- Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Oliver Bähr
- Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - Ghazaleh Tabatabai
- Department of Neurology and Interdisciplinary Neuro-Oncology, Hertie Institute for Clinical Brain Research, Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Ulrik Lassen
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | | | - Mustafa Khasraw
- The University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | - Nicholas Butowski
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Patrick Roth
- Department of Neurology and Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland
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Horbinski C, Nabors LB, Portnow J, Baehring J, Bhatia A, Bloch O, Brem S, Butowski N, Cannon DM, Chao S, Chheda MG, Fabiano AJ, Forsyth P, Gigilio P, Hattangadi-Gluth J, Holdhoff M, Junck L, Kaley T, Merrell R, Mrugala MM, Nagpal S, Nedzi LA, Nevel K, Nghiemphu PL, Parney I, Patel TR, Peters K, Puduvalli VK, Rockhill J, Rusthoven C, Shonka N, Swinnen LJ, Weiss S, Wen PY, Willmarth NE, Bergman MA, Darlow S. NCCN Guidelines® Insights: Central Nervous System Cancers, Version 2.2022. J Natl Compr Canc Netw 2023; 21:12-20. [PMID: 36634606 DOI: 10.6004/jnccn.2023.0002] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The NCCN Guidelines for Central Nervous System (CNS) Cancers focus on management of the following adult CNS cancers: glioma (WHO grade 1, WHO grade 2-3 oligodendroglioma [1p19q codeleted, IDH-mutant], WHO grade 2-4 IDH-mutant astrocytoma, WHO grade 4 glioblastoma), intracranial and spinal ependymomas, medulloblastoma, limited and extensive brain metastases, leptomeningeal metastases, non-AIDS-related primary CNS lymphomas, metastatic spine tumors, meningiomas, and primary spinal cord tumors. The information contained in the algorithms and principles of management sections in the NCCN Guidelines for CNS Cancers are designed to help clinicians navigate through the complex management of patients with CNS tumors. Several important principles guide surgical management and treatment with radiotherapy and systemic therapy for adults with brain tumors. The NCCN CNS Cancers Panel meets at least annually to review comments from reviewers within their institutions, examine relevant new data from publications and abstracts, and reevaluate and update their recommendations. These NCCN Guidelines Insights summarize the panel's most recent recommendations regarding molecular profiling of gliomas.
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Affiliation(s)
- Craig Horbinski
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | | | | | - Steven Brem
- Abramson Cancer Center at the University of Pennsylvania
| | | | | | - Samuel Chao
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | - Milan G Chheda
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | - Pierre Gigilio
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | | | | | | | | | - Lucien A Nedzi
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | - Kathryn Nevel
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
| | | | | | | | | | - Vinay K Puduvalli
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | | | - Lode J Swinnen
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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5
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Kim L, De Feyter H, de Graaf R, Fulbright R, Liu Y, Rothman D, Baehring J, Blondin N, Kim P, Omuro A, Chiang V, Moliterno J, Omay SB, Piepmeier J, Corbin Z. NIMG-105. DEUTERIUM METABOLIC IMAGING (DMI) DETECTS A LARGER WARBURG EFFECT IN HIGH-GRADE BRAIN TUMORS AND IN IDH WILD TYPE GLIOMAS. Neuro Oncol 2022. [PMCID: PMC9660955 DOI: 10.1093/neuonc/noac209.723] [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
The Warburg Effect (WE) is a metabolic change in which tumors favor glycolysis over oxidative phosphorylation and has been linked to cancer aggressiveness. Mutations in the isocitrate dehydrogenase (IDH) genes in gliomas are associated with improved outcomes. We deployed a magnetic resonance (MR) spectroscopic imaging technique coined Deuterium Metabolic Imaging (DMI) to measure the WE in multiple brain tumor types.
METHODS
Twenty-one patients underwent DMI, acquired on a Bruker 4T MR scanner after oral administration of 0.75g/kg of deuterated glucose. The WE was defined as the ratio of deuterated lactate, representing glycolysis, over deuterated glutamate and glutamine, representing oxidative phosphorylation. We devised an interval scale from 0 to 2 for the WE results. The Wilcoxon rank sum test was performed to detect differences between groups.
RESULTS
The WE measurements for the largest groups, by diagnosis, showed: glioblastoma (n= 9, mean= 1.67); astrocytoma, IDH-mutant, WHO grade 3 (n= 2, mean= 0.25); oligodendroglioma, WHO grade 3 (n= 3, mean= 0.5); low grade glioma, IDH-mutant (n= 2, mean= 0); and meningioma, WHO grade 2 (n= 2, mean= 0). The WE for high-grade tumors (n= 15, mean= 1.27) was significantly different from the WE for low-grade tumors (n= 5, mean= 0), with p= 0.010. The WE for IDH wild type gliomas (n= 9, mean= 1.67) was significantly different from the WE for IDH-mutant gliomas (n= 9, mean= 0.44), with p= 0.007. Analysis is ongoing.
CONCLUSIONS
DMI successfully and non-invasively detects the WE in many types of brain tumors. The WE was larger in high-grade tumors as compared to low-grade tumors, and the WE was larger in IDH wild type gliomas as compared to IDH-mutant gliomas. If validated with future studies, our results suggest that DMI is a useful tool to measure differences in the metabolism of brain tumors with different clinical behaviors.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Peter Kim
- Yale School of Medicine , New Haven , USA
| | | | - Veronica Chiang
- Yale School of Medicine, Department of Neurosurgery , New Haven, CT , USA
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6
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Lim M, Weller M, Idbaih A, Steinbach J, Finocchiaro G, Raval RR, Ansstas G, Baehring J, Taylor JW, Honnorat J, Petrecca K, De Vos F, Wick A, Sumrall A, Sahebjam S, Mellinghoff IK, Kinoshita M, Roberts M, Slepetis R, Warad D, Leung D, Lee M, Reardon DA, Omuro A. Phase III trial of chemoradiotherapy with temozolomide plus nivolumab or placebo for newly diagnosed glioblastoma with methylated MGMT promoter. Neuro Oncol 2022; 24:1935-1949. [PMID: 35511454 PMCID: PMC9629431 DOI: 10.1093/neuonc/noac116] [Citation(s) in RCA: 151] [Impact Index Per Article: 75.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Nearly all patients with newly diagnosed glioblastoma experience recurrence following standard-of-care radiotherapy (RT) + temozolomide (TMZ). The purpose of the phase III randomized CheckMate 548 study was to evaluate RT + TMZ combined with the immune checkpoint inhibitor nivolumab (NIVO) or placebo (PBO) in patients with newly diagnosed glioblastoma with methylated MGMT promoter (NCT02667587). METHODS Patients (N = 716) were randomized 1:1 to NIVO [(240 mg every 2 weeks × 8, then 480 mg every 4 weeks) + RT (60 Gy over 6 weeks) + TMZ (75 mg/m2 once daily during RT, then 150-200 mg/m2 once daily on days 1-5 of every 28-day cycle × 6)] or PBO + RT + TMZ following the same regimen. The primary endpoints were progression-free survival (PFS) and overall survival (OS) in patients without baseline corticosteroids and in all randomized patients. RESULTS As of December 22, 2020, median (m)PFS (blinded independent central review) was 10.6 months (95% CI, 8.9-11.8) with NIVO + RT + TMZ vs 10.3 months (95% CI, 9.7-12.5) with PBO + RT + TMZ (HR, 1.1; 95% CI, 0.9-1.3) and mOS was 28.9 months (95% CI, 24.4-31.6) vs 32.1 months (95% CI, 29.4-33.8), respectively (HR, 1.1; 95% CI, 0.9-1.3). In patients without baseline corticosteroids, mOS was 31.3 months (95% CI, 28.6-34.8) with NIVO + RT + TMZ vs 33.0 months (95% CI, 31.0-35.1) with PBO + RT + TMZ (HR, 1.1; 95% CI, 0.9-1.4). Grade 3/4 treatment-related adverse event rates were 52.4% vs 33.6%, respectively. CONCLUSIONS NIVO added to RT + TMZ did not improve survival in patients with newly diagnosed glioblastoma with methylated or indeterminate MGMT promoter. No new safety signals were observed.
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Affiliation(s)
- Michael Lim
- Corresponding Author: Michael Lim, MD, Center for Academic Medicine, Stanford University School of Medicine, 453 Quarry Road, Neurosurgery 5327, Palo Alto, CA 94304, USA ()
| | | | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, Paris, France
| | - Joachim Steinbach
- Frankfurt Cancer Institute, Goethe University, Frankfurt, Germany
- Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany
| | - Gaetano Finocchiaro
- Present affiliation: Department of Neurology, San Raffaele Research Hospital, Milan, Italy (G.F.)
| | - Raju R Raval
- Translational Therapeutics Program, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - George Ansstas
- Department of Medicine, Oncology Division, Washington University Medical School, St. Louis, Missouri, USA
| | - Joachim Baehring
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jennie W Taylor
- Departments of Neurology and Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Jerome Honnorat
- Neuro-Oncology Department, Hospices Civils de Lyon, SynatAc Team, Institute MeLis, INSERM U1314/CNRS UMR 5284, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Kevin Petrecca
- Department of Neurology and Neurosurgery, Brain Tumour Research Centre, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Filip De Vos
- Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Antje Wick
- Neurology Clinic, University of Heidelberg, National Center for Tumor Diseases, Heidelberg, Germany
| | - Ashley Sumrall
- Neuro-Oncology Department, Levine Cancer Institute, Charlotte, North Carolina, USA
| | - Solmaz Sahebjam
- Present affiliation: Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA (S.S.)
| | - Ingo K Mellinghoff
- Department of Neurology and Human Oncology & Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | | | - Deepti Warad
- Bristol Myers Squibb, Princeton, New Jersey, USA
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7
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Barden M, Baehring J. P11.58.A Case of a complex neurocutaneous syndrome characterized by extensive peripheral nerve sheath tumors and somatic ERBB2 mutation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.247] [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
Schwannomatosis is a rare genetic tumor predisposition syndrome characterized by the presence of multiple non-intradermal schwannomas and the definitive absence of vestibular nerve involvement. Though considered benign, the burden of tumors can cause significant morbidity in the form of motor dysfunction and refractory neuropathic pain. Treatment is focused on mitigating these symptoms, which includes resection of offending tumors when feasible and anti-angiogenesis therapy with bevacizumab. Options for targeted medical therapies are lacking. Schwannomatosis is molecularly distinct from the other neurofibromatoses and by definition lacks constitutional mutations in NF1 and NF2. Instead, constitutional mutations in SMARCB1 or LZTR1 are often the “first hit” in tumorigenesis. Activating mutations in ERBB2 (also designated HER2) have been identified as oncogenic drivers in peripheral nerve sheath tumors in patients who lack these typical constitutional tumor suppressor gene mutations.
Here we report a case of extensive peripheral nerve sheath tumors in the setting of apparent somatic mosaicism of an ERBB2 mutation. A 48-year-old man with history of chronic back pain presented with diffuse enlarging soft tissues masses primarily involving the left neck and occiput. Examination revealed areas of cutaneous heterogeneous hyperpigmentation, decreased muscle bulk and dorsiflexor weakness in the bilateral lower extremities, and steppage gait. Neuroimaging showed extensive T2 hyperintense, mildly enhancing masses within the bilateral thoracic and lumbar spine neuroforamina, intercostal nerves, paraspinal musculature, and lumbosacral plexus. Tissue from two separate tumor sites was morphologically consistent with schwannoma with some features of neurofibroma. Immunohistochemistry revealed partial loss of staining for SMARCB1. Whole exome sequencing (WES) on blood and tumor tissue did not show pathogenic germline or somatic variants for NF1, NF2, SMARCB1, LZTR1, or an array of tumor predisposition syndromes. WES on tumor tissue from both sites however did reveal a somatic ERBB2 variant (p.D769Y), suggesting mosaicism. ERBB2 D769Y has previously been classified as an activating mutation that confers sensitivity to some small molecule receptor tyrosine kinase inhibitors. Patients with ERRB2-mutated peripheral nerve sheath tumors may have broader therapeutic options in the variety of available tyrosine kinase inhibitors studied in other cancers.
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Affiliation(s)
- M Barden
- Yale School of Medicine , New Haven, CT , United States
| | - J Baehring
- Yale School of Medicine , New Haven, CT , United States
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8
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Brastianos PK, Kim AE, Giobbie-Hurder A, Lee EQ, Wang N, Eichler AF, Chukwueke U, Forst DA, Arrillaga-Romany IC, Dietrich J, Corbin Z, Moliterno J, Baehring J, White M, Lou KW, Larson J, de Sauvage MA, Evancic K, Mora J, Nayyar N, Loeffler J, Oh K, Shih HA, Curry WT, Cahill DP, Barker FG, Gerstner ER, Santagata S. Phase 2 study of pembrolizumab in patients with recurrent and residual high-grade meningiomas. Nat Commun 2022; 13:1325. [PMID: 35289329 PMCID: PMC8921328 DOI: 10.1038/s41467-022-29052-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/16/2022] [Indexed: 01/16/2023] Open
Abstract
High-grade meningiomas are associated with neuro-cognitive morbidity and have limited treatments. High-grade meningiomas harbor an immunosuppressive tumor microenvironment (TME) and programmed death-ligand 1 (PD-L1) expression may contribute to their aggressive phenotype. Here, we present the results of a single-arm, open-label phase 2 trial (NCT03279692) evaluating the efficacy of pembrolizumab, a PD-1 inhibitor, in a cohort of 25 evaluable patients with recurrent and progressive grade 2 and 3 meningiomas. The primary endpoint is the proportion of patients alive and progression-free at 6 months (PFS-6). Secondary endpoints include progression-free and overall survival, best intracranial response, and toxicity. Our study has met its primary endpoint and achieved a PFS-6 rate of 0.48 (90% exact CI: 0.31-0.66) and a median PFS of 7.6 months (90% CI: 3.4-12.9 months). Twenty percent of patients have experienced one (or more) grade-3 or higher treatment-related adverse events. These results suggest that pembrolizumab exerts promising efficacy on a subset of these tumors. Further studies are needed to identify the biological facets within the meningioma TME that may drive response to immune-based therapies.
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Affiliation(s)
| | - Albert E Kim
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | - Eudocia Quant Lee
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Nancy Wang
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - April F Eichler
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Ugonma Chukwueke
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Deborah A Forst
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | - Jorg Dietrich
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Zachary Corbin
- The Chenevert Family Brain Tumor Center, Smilow Cancer Hospital and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Moliterno
- The Chenevert Family Brain Tumor Center, Smilow Cancer Hospital and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Joachim Baehring
- The Chenevert Family Brain Tumor Center, Smilow Cancer Hospital and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Michael White
- Wilmot Cancer Center, University of Rochester, Division of Neuro-Oncology, Rochester, NY, USA
| | - Kevin W Lou
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Juliana Larson
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Magali A de Sauvage
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Kathryn Evancic
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Joana Mora
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Naema Nayyar
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Jay Loeffler
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Kevin Oh
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Helen A Shih
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - William T Curry
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Daniel P Cahill
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Fred G Barker
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Elizabeth R Gerstner
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Sandro Santagata
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Department of Pathology, Harvard Medical School, Boston, MA, USA
- Ludwig Center at Harvard, Boston, MA, USA
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9
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Omuro A, Reardon DA, Sampson JH, Baehring J, Sahebjam S, Cloughesy TF, Chalamandaris AG, Potter V, Butowski N, Lim M. Nivolumab plus radiotherapy with or without temozolomide in newly diagnosed glioblastoma: results from exploratory phase 1 cohorts of CheckMate 143. Neurooncol Adv 2022; 4:vdac025. [PMID: 35402913 PMCID: PMC8989388 DOI: 10.1093/noajnl/vdac025] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The phase 1 cohorts (1c+1d) of CheckMate 143 (NCT02017717) evaluated the safety/tolerability and efficacy of nivolumab plus radiotherapy (RT) ± temozolomide (TMZ) in newly diagnosed glioblastoma.
Methods
In total, 136 patients were enrolled. In part A (safety lead-in), 31 patients (n=15, methylated/unknown MGMT promoter; n=16, unmethylated MGMT promoter) received nivolumab and RT+TMZ (NIVO+RT+TMZ) and 30 patients with unmethylated MGMT promoter received NIVO+RT. In part B (expansion), patients with unmethylated MGMT promoter were randomized to NIVO+RT+TMZ (n=29) or NIVO+RT (n=30). Primary endpoint was safety/tolerability; secondary endpoint was overall survival (OS).
Results
NIVO+RT±TMZ was tolerable; grade 3/4 treatment-related adverse events occurred in 51.6% (NIVO+RT+TMZ) and 30.0% (NIVO+RT) of patients in part A and 46.4% (NIVO+RT+TMZ) and 28.6% (NIVO+RT) in part B. No new safety signals were detected. In part A, median OS (mOS) with NIVO+RT+TMZ was 33.38 months (95% CI, 16.2 to not estimable) in patients with methylated MGMT promoter. In patients with unmethylated MGMT promoter, mOS was 16.49 months (12.94-22.08) with NIVO+RT+TMZ and 14.41 months (12.55-17.31) with NIVO+RT. In part B, mOS was 14.75 months (10.01-18.6) with NIVO+RT+TMZ and 13.96 months (10.81-18.14) with NIVO+RT in patients with unmethylated MGMT promoter.
Conclusions
CheckMate 143 was the first trial evaluating immune checkpoint inhibition with first-line treatment of glioblastoma. Results showed that NIVO can be safely combined with RT±TMZ, with no new safety signals. Toxicities, including lymphopenia, were more frequent with NIVO+RT+TMZ. OS was similar with or without TMZ in patients with unmethylated MGMT promoter, and differences by MGMT methylation status were observed.
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Affiliation(s)
- Antonio Omuro
- Yale School of Medicine, New Haven, Connecticut, USA
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - David A Reardon
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Solmaz Sahebjam
- Moffitt Cancer Center, University of South Florida, Tampa, Florida, USA
| | | | | | - Von Potter
- Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Nicholas Butowski
- University of California, San Francisco, San Francisco, California, USA
| | - Michael Lim
- The Johns Hopkins Hospital, Baltimore, Maryland, USA
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Reardon DA, Brandes AA, Omuro A, Mulholland P, Lim M, Wick A, Baehring J, Ahluwalia MS, Roth P, Bähr O, Phuphanich S, Sepulveda JM, De Souza P, Sahebjam S, Carleton M, Tatsuoka K, Taitt C, Zwirtes R, Sampson J, Weller M. Effect of Nivolumab vs Bevacizumab in Patients With Recurrent Glioblastoma: The CheckMate 143 Phase 3 Randomized Clinical Trial. JAMA Oncol 2021; 6:1003-1010. [PMID: 32437507 PMCID: PMC7243167 DOI: 10.1001/jamaoncol.2020.1024] [Citation(s) in RCA: 727] [Impact Index Per Article: 242.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Question Does programmed cell death 1 immune checkpoint inhibition with nivolumab improve overall survival compared with bevacizumab treatment for patients with recurrent glioblastoma? Findings In this randomized phase 3 clinical trial of 369 patients diagnosed with recurrent glioblastoma treated with nivolumab, an improved survival benefit was not observed in patients who received nivolumab compared with bevacizumab-treated control patients. Meaning Additional research is needed; nivolumab monotherapy did not improve overall survival compared with bevacizumab in the treatment of recurrent glioblastoma. A study of nivolumab in combination with radiotherapy and temozolomide in patients with newly diagnosed glioblastoma with methylated MGMT promoter is ongoing. Importance Clinical outcomes for glioblastoma remain poor. Treatment with immune checkpoint blockade has shown benefits in many cancer types. To our knowledge, data from a randomized phase 3 clinical trial evaluating a programmed death-1 (PD-1) inhibitor therapy for glioblastoma have not been reported. Objective To determine whether single-agent PD-1 blockade with nivolumab improves survival in patients with recurrent glioblastoma compared with bevacizumab. Design, Setting, and Participants In this open-label, randomized, phase 3 clinical trial, 439 patients with glioblastoma at first recurrence following standard radiation and temozolomide therapy were enrolled, and 369 were randomized. Patients were enrolled between September 2014 and May 2015. The median follow-up was 9.5 months at data cutoff of January 20, 2017. The study included 57 multicenter, multinational clinical sites. Interventions Patients were randomized 1:1 to nivolumab 3 mg/kg or bevacizumab 10 mg/kg every 2 weeks until confirmed disease progression, unacceptable toxic effects, or death. Main Outcomes and Measures The primary end point was overall survival (OS). Results A total of 369 patients were randomized to nivolumab (n = 184) or bevacizumab (n = 185). The MGMT promoter was methylated in 23.4% (43/184; nivolumab) and 22.7% (42/185; bevacizumab), unmethylated in 32.1% (59/184; nivolumab) and 36.2% (67/185; bevacizumab), and not reported in remaining patients. At median follow-up of 9.5 months, median OS (mOS) was comparable between groups: nivolumab, 9.8 months (95% CI, 8.2-11.8); bevacizumab, 10.0 months (95% CI, 9.0-11.8); HR, 1.04 (95% CI, 0.83-1.30); P = .76. The 12-month OS was 42% in both groups. The objective response rate was higher with bevacizumab (23.1%; 95% CI, 16.7%-30.5%) vs nivolumab (7.8%; 95% CI, 4.1%-13.3%). Grade 3/4 treatment-related adverse events (TRAEs) were similar between groups (nivolumab, 33/182 [18.1%]; bevacizumab, 25/165 [15.2%]), with no unexpected neurological TRAEs or deaths due to TRAEs. Conclusions and Relevance Although the primary end point was not met in this randomized clinical trial, mOS was comparable between nivolumab and bevacizumab in the overall patient population with recurrent glioblastoma. The safety profile of nivolumab in patients with glioblastoma was consistent with that in other tumor types. Trial Registration ClinicalTrials.gov Identifier: NCT02017717
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Affiliation(s)
| | - Alba A Brandes
- AUSL-IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Antonio Omuro
- Department of Neurology and Yale Cancer Center, Yale University, New Haven, Connecticut
| | | | - Michael Lim
- The Johns Hopkins Hospital, Baltimore, Maryland
| | - Antje Wick
- Neurology Clinic, University of Heidelberg, National Center for Tumor Diseases, Heidelberg, Germany
| | | | | | - Patrick Roth
- Department of Neurology and Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Oliver Bähr
- Dr Senckenberg Institute of Neurooncology, Goethe University Hospital, Frankfurt, Germany
| | - Surasak Phuphanich
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Paul De Souza
- University of Wollongong School of Medicine, Wollongong, NSW, Australia
| | - Solmaz Sahebjam
- Moffitt Cancer Center, University of South Florida, Tampa, Florida
| | | | | | | | | | - John Sampson
- Duke University Hospital, Durham, North Carolina
| | - Michael Weller
- Department of Neurology and Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland
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11
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Nabors LB, Portnow J, Ahluwalia M, Baehring J, Brem H, Brem S, Butowski N, Campian JL, Clark SW, Fabiano AJ, Forsyth P, Hattangadi-Gluth J, Holdhoff M, Horbinski C, Junck L, Kaley T, Kumthekar P, Loeffler JS, Mrugala MM, Nagpal S, Pandey M, Parney I, Peters K, Puduvalli VK, Robins I, Rockhill J, Rusthoven C, Shonka N, Shrieve DC, Swinnen LJ, Weiss S, Wen PY, Willmarth NE, Bergman MA, Darlow SD. Central Nervous System Cancers, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:1537-1570. [PMID: 33152694 DOI: 10.6004/jnccn.2020.0052] [Citation(s) in RCA: 210] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The NCCN Guidelines for Central Nervous System (CNS) Cancers focus on management of adult CNS cancers ranging from noninvasive and surgically curable pilocytic astrocytomas to metastatic brain disease. The involvement of an interdisciplinary team, including neurosurgeons, radiation therapists, oncologists, neurologists, and neuroradiologists, is a key factor in the appropriate management of CNS cancers. Integrated histopathologic and molecular characterization of brain tumors such as gliomas should be standard practice. This article describes NCCN Guidelines recommendations for WHO grade I, II, III, and IV gliomas. Treatment of brain metastases, the most common intracranial tumors in adults, is also described.
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Affiliation(s)
| | | | - Manmeet Ahluwalia
- 3Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Henry Brem
- 5The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | - Steven Brem
- 6Abramson Cancer Center at the University of Pennsylvania
| | | | - Jian L Campian
- 8Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | | | | | - Craig Horbinski
- 13Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | - Larry Junck
- 14University of Michigan Rogel Cancer Center
| | | | - Priya Kumthekar
- 13Robert H. Lurie Comprehensive Cancer Center of Northwestern University
| | | | | | | | - Manjari Pandey
- 19St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | - Vinay K Puduvalli
- 21The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Ian Robins
- 22University of Wisconsin Carbone Cancer Center
| | - Jason Rockhill
- 23Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | | | - Lode J Swinnen
- 5The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
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12
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McAlpine LS, Zubair AS, Moeller J, Baehring J, Spudich S. Lessons from a neurology consult service for patients with COVID-19. Lancet Neurol 2020; 19:806-807. [PMID: 32949536 PMCID: PMC7494315 DOI: 10.1016/s1474-4422(20)30316-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 10/28/2022]
Affiliation(s)
- Lindsay S McAlpine
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Adeel S Zubair
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Jeremy Moeller
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Joachim Baehring
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Serena Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA.
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Rattray Z, Deng G, Zhang S, Shirali A, May C, Liu J, Zou P, Cuffari B, Rattray N, Johnson C, Dubljevic V, Campbell J, Huttner A, Baehring J, Zhou J, Hansen J. 64. AN ENT2-DEPENDENT, CELL-PENETRATING, AND DNA-DAMAGING LUPUS AUTOANTIBODY CROSSES THE BLOOD-BRAIN BARRIER TO TARGET BRAIN TUMORS. Neurooncol Adv 2020. [PMCID: PMC7401412 DOI: 10.1093/noajnl/vdaa073.051] [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: 11/14/2022] Open
Abstract
Abstract
The blood-brain barrier (BBB) limits conventional antibody-based approaches to brain tumors. ENT2, an equilibrative nucleoside transporter, facilitates penetration of autoantibodies into live cells and is expressed in the BBB. PAT-DX1 (also known as Deoxymab-1 or DX1) is an ENT2-dependent, cell-penetrating, and DNA-damaging lupus autoantibody that is synthetically lethal to cancer cells with defects in the DNA damage response. PTEN loss renders sensitivity to DX1 and is common in primary and metastatic brain tumors. We show that DX1 is toxic to spheroids derived from primary PTEN-deficient glioblastoma (GBM), and crosses the BBB to suppress the growth of orthotopic GBM and breast cancer brain metastases. Mechanistically, we find the ENT2 inhibitor dipyridamole blocks DX1 penetration into brain endothelial cells and transport across the BBB in vitro and in vivo, consistent with ENT2-mediated uptake of DX1 into brain tumors. Autoantibodies that hijack nucleoside transporters to cross cell membranes may open new frontiers in brain tumor therapy.
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Affiliation(s)
| | - Gang Deng
- Yale School of Medicine, New Haven, CT, USA
| | | | | | | | - Jun Liu
- Yale School of Medicine, New Haven, CT, USA
| | - Pan Zou
- Yale School of Medicine, New Haven, CT, USA
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Mohammadi AM, Sharma M, Beaumont TL, Juarez KO, Kemeny H, Dechant C, Seas A, Sarmey N, Lee BS, Jia X, Fecci PE, Baehring J, Moliterno J, Chiang VL, Ahluwalia MS, Kim AH, Barnett GH, Leuthardt EC. Upfront Magnetic Resonance Imaging-Guided Stereotactic Laser-Ablation in Newly Diagnosed Glioblastoma: A Multicenter Review of Survival Outcomes Compared to a Matched Cohort of Biopsy-Only Patients. Neurosurgery 2020; 85:762-772. [PMID: 30476325 DOI: 10.1093/neuros/nyy449] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/21/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Laser ablation (LA) is used as an upfront treatment in patients with deep seated newly diagnosed Glioblastoma (nGBM). OBJECTIVE To evaluate the outcomes of LA in patients with nGBM and compare them with a matched biopsy-only cohort. METHODS Twenty-four nGBM patients underwent upfront LA at Cleveland clinic, Washington University in St. Louis, and Yale University (6/2011-12/2014) followed by chemo/radiotherapy. Also, 24 out of 171 nGBM patients with biopsy followed by chemo/radiotherapy were matched based on age (< 70 vs ≥ 70), gender, tumor location (deep vs lobar), and volume (<11 cc vs ≥11 cc). Progression-free survival (PFS), overall survival (OS), and disease-specific PFS and OS were outcome measures. Three prognostic groups were identified based on extent of tumor ablation by thermal-damage-threshold (TDT)-lines. RESULTS The median tumor volume in LA (n = 24) and biopsy only (n = 24) groups was 9.3 cm3 and 8.2 cm3 respectively. Overall, median estimate of OS and PFS in LA cohort was 14.4 and 4.3 mo compared to 15.8 mo and 5.9 mo for biopsy only cohort. On multivariate analysis, favorable TDT-line prognostic groups were associated with lower incidence of disease specific death (P = .03) and progression (P = .05) compared to other groups including biopsy only cohort. Only age (<70 yr, P = .02) and tumor volume (<11 cc, P = .03) were favorable prognostic factors for OS. CONCLUSION The maximum tumor coverage by LA followed by radiation/chemotherapy is an effective treatment modality in patients with nGBM, compared to biopsy only cohort. The TDT-line prognostic groups were independent predictor of disease specific death and progression after LA.
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Affiliation(s)
- Alireza M Mohammadi
- The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Mayur Sharma
- The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Thomas L Beaumont
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | - Kevin O Juarez
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Hanna Kemeny
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Cosette Dechant
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Andreas Seas
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Nehaw Sarmey
- The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Bryan S Lee
- The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Xuefei Jia
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Peter E Fecci
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Joachim Baehring
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Jennifer Moliterno
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Veronica L Chiang
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Manmeet S Ahluwalia
- The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Albert H Kim
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
| | - Gene H Barnett
- The Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Neurosurgery, Neurological Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
| | - Eric C Leuthardt
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri
- Department of Biomedical Engineering, Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, Missouri
- Department of Mechanical Engineering and Material Science, Center for Innovation in Neuroscience and Technology, Washington University, School of Medicine, St. Louis, Missouri
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Hong C, Barbiero F, Chiang V, Moliterno J, Piepmeier J, Corbin Z, Baehring J. SURG-03. A COMPARISON OF SURVIVAL OUTCOMES AFTER BIOPSY VERSUS RESECTION IN PRIMARY CNS LYMPHOMA: A SINGLE INSTITUTION EXPERIENCE. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.1039] [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)
- Christopher Hong
- Yale University School of Medicine Department of Neurosurgery, New Haven, CT, USA
| | - Frank Barbiero
- Yale University School of Medicine Department of Neurology, New Haven, CT, USA
| | - Veronica Chiang
- Yale University School of Medicine Department of Neurosurgery, New Haven, CT, USA
| | - Jennifer Moliterno
- Yale University School of Medicine Department of Neurosurgery, New Haven, CT, USA
| | - Joseph Piepmeier
- Yale University School of Medicine Department of Neurosurgery, New Haven, CT, USA
| | - Zachary Corbin
- Yale University School of Medicine Department of Neurology, New Haven, CT, USA
| | - Joachim Baehring
- Yale University School of Medicine Department of Neurology, New Haven, CT, USA
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Mohammadi A, Sharma M, Beaumont T, Juarez K, Kemeny H, Dechant C, Seas A, Sarmey N, Lee B, Jia X, Fecci P, Baehring J, Moliterno J, Chiang V, Ahluwalia M, Kim A, Barnett G, Leuthardt E. SURG-15. UPFRONT MRI-GUIDED STEREOTACTIC LASER-ABLATION IN NEWLY DIAGNOSED GLIOBLASTOMA: A MULTICENTER REVIEW OF SURVIVAL OUTCOMES COMPARED TO A MATCHED COHORT OF BIOPSY-ONLY PATIENTS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.1051] [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: 11/14/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Bryan Lee
- Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Joachim Baehring
- Yale University School of Medicine Department of Neurology, New Haven, CT, USA
| | | | - Veronica Chiang
- Yale University School of Medicine Department of Neurosurgery, New Haven, CT, USA
| | | | - Albert Kim
- Washington University in St. Louis, St. Louis, MO, USA
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Roque A, Galluzzo D, Barbiero F, Fulbright R, Baehring J. NIMG-20. DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING FINDINGS IN PATIENTS WITH CENTRAL NERVOUS SYSTEM INVOLVEMENT OF SYSTEMIC LYMPHOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.746] [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)
| | | | - Frank Barbiero
- Yale University School of Medicine Department of Neurology, New Haven, CT, USA
| | | | - Joachim Baehring
- Yale University School of Medicine Department of Neurology, New Haven, CT, USA
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18
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Nabors LB, Portnow J, Ammirati M, Baehring J, Brem H, Butowski N, Fenstermaker RA, Forsyth P, Hattangadi-Gluth J, Holdhoff M, Howard S, Junck L, Kaley T, Kumthekar P, Loeffler JS, Moots PL, Mrugala MM, Nagpal S, Pandey M, Parney I, Peters K, Puduvalli VK, Ragsdale J, Rockhill J, Rogers L, Rusthoven C, Shonka N, Shrieve DC, Sills AK, Swinnen LJ, Tsien C, Weiss S, Wen PY, Willmarth N, Bergman MA, Engh A. NCCN Guidelines Insights: Central Nervous System Cancers, Version 1.2017. J Natl Compr Canc Netw 2018; 15:1331-1345. [PMID: 29118226 DOI: 10.6004/jnccn.2017.0166] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For many years, the diagnosis and classification of gliomas have been based on histology. Although studies including large populations of patients demonstrated the prognostic value of histologic phenotype, variability in outcomes within histologic groups limited the utility of this system. Nonetheless, histology was the only proven and widely accessible tool available at the time, thus it was used for clinical trial entry criteria, and therefore determined the recommended treatment options. Research to identify molecular changes that underlie glioma progression has led to the discovery of molecular features that have greater diagnostic and prognostic value than histology. Analyses of these molecular markers across populations from randomized clinical trials have shown that some of these markers are also predictive of response to specific types of treatment, which has prompted significant changes to the recommended treatment options for grade III (anaplastic) gliomas.
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Omuro A, Vlahovic G, Lim M, Sahebjam S, Baehring J, Cloughesy T, Voloschin A, Ramkissoon SH, Ligon KL, Latek R, Zwirtes R, Strauss L, Paliwal P, Harbison CT, Reardon DA, Sampson JH. Nivolumab with or without ipilimumab in patients with recurrent glioblastoma: results from exploratory phase I cohorts of CheckMate 143. Neuro Oncol 2018; 20:674-686. [PMID: 29106665 PMCID: PMC5892140 DOI: 10.1093/neuonc/nox208] [Citation(s) in RCA: 320] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Immunotherapies have demonstrated efficacy across a diverse set of tumors supporting further evaluation in glioblastoma. The objective of this study was to evaluate the safety/tolerability and describe immune-mediated effects of nivolumab ± ipilimumab in patients with recurrent glioblastoma. Exploratory efficacy outcomes are also reported. Methods Patients were randomized to receive nivolumab 3 mg/kg every 2 weeks (Q2W; NIVO3) or nivolumab 1 mg/kg + ipilimumab 3 mg/kg every 3 weeks (Q3W) for 4 doses, then nivolumab 3 mg/kg Q2W (NIVO1+IPI3). An alternative regimen of nivolumab 3 mg/kg + ipilimumab 1 mg/kg Q3W for 4 doses, then nivolumab 3 mg/kg Q2W (NIVO3+IPI1) was investigated in a nonrandomized arm. Results Forty patients were enrolled (NIVO3, n = 10; NIVO1+IPI3, n = 10; NIVO3+IPI1, n = 20). The most common treatment-related adverse events (AEs) were fatigue (NIVO3, 30%; NIVO1+IPI3, 80%; NIVO3+IPI1, 55%) and diarrhea (10%, 70%, 30%, respectively). AEs leading to discontinuation occurred in 10% (NIVO3), 30% (NIVO1+IPI3), and 20% (NIVO3+IPI1) of patients. Three patients achieved a partial response (NIVO3, n = 1; NIVO3+IPI1, n = 2) and 8 had stable disease for ≥12 weeks (NIVO3, n = 2; NIVO1+IPI3, n = 2; NIVO3+IPI1, n = 4 [Response Assessment in Neuro-Oncology criteria]). Most patients (68%) had tumor-cell programmed death ligand-1 expression ≥1%. Immune-mediated effects mimicking radiographic progression occurred in 2 patients. Conclusions Nivolumab monotherapy was better tolerated than nivolumab + ipilimumab; the tolerability of the combination was influenced by ipilimumab dose. These safety and exploratory findings merit further investigation of immunotherapies in glioblastoma.
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Affiliation(s)
- Antonio Omuro
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Michael Lim
- The Johns Hopkins Hospital, Baltimore, Maryland
| | - Solmaz Sahebjam
- Moffitt Cancer Center, University of South Florida, Tampa, Florida
| | | | | | | | - Shakti H Ramkissoon
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | - Keith L Ligon
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | | | - David A Reardon
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
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20
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Chan AM, Huttner A, Baehring J. Disappearing Leukoencephalopathy : A Case of Relapsing-Remitting Intravascular Large B‑Cell Lymphoma with Transient Spontaneous Radiographic Regression. Clin Neuroradiol 2017; 28:455-459. [PMID: 29196778 DOI: 10.1007/s00062-017-0650-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/14/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Amy M Chan
- Department of Neurology, Medicine and Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 1137, 10029, New York, USA.
| | - Anita Huttner
- Department of Pathology, Yale School of Medicine, 310 Cedar Street, 06520, New Haven, CT, USA
| | - Joachim Baehring
- Department of Neurology and Neurosurgery, Yale School of Medicine, 15 York Street, LLCI Room 920, 06520, New Haven, CT, USA
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Kaulen L, Galluzzo D, Hui P, Huttner A, Fulbright R, Baehring J. RARE-05. PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA IN IMMUNOCOMPROMISED HOSTS – A SINGLE INSTITUTION RETROSPECTIVE STUDY (2002-2017). Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox168.858] [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: 11/13/2022] Open
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Parikh R, Materin MA, Lesser R, Baehring J, Sznol M, Galvin JA. A 71-year-old woman with decreased vision, nyctalopia, and peripheral vision loss. Digit J Ophthalmol 2017; 22:85-90. [PMID: 28924411 DOI: 10.5693/djo.02.2016.06.001] [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: 11/20/2022]
Affiliation(s)
- Ravi Parikh
- Department of Ophthalmology and Visual Science, Yale University, New Haven, Connecticut
| | - Miguel A Materin
- Department of Ophthalmology and Visual Science, Yale University, New Haven, Connecticut.,Smilow Hospital at Yale New Haven Hospital
| | | | - Joachim Baehring
- Smilow Hospital at Yale New Haven Hospital.,Department of Neurology, Yale University
| | - Mario Sznol
- Smilow Hospital at Yale New Haven Hospital.,Department of Internal Medicine, Yale University
| | - Jennifer A Galvin
- Department of Ophthalmology and Visual Science, Yale University, New Haven, Connecticut
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Lim M, Omuro A, Vlahovic G, Reardon D, Sahebjam S, Cloughesy T, Baehring J, Butowski N, Potter V, Zwirtes R, Paliwal P, Carleton M, Sampson J, Brandes A. Nivolumab (nivo) in combination with radiotherapy (RT) ± temozolomide (TMZ): Updated safety results from CheckMate 143 in pts with methylated or unmethylated newly diagnosed glioblastoma (GBM). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx366] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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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Omuro A, Vlahovic G, Baehring J, Butowski N, Reardon D, Cloughesy T, Sahebjam S, Lim M, Zwirtes R, Sampson J. OS07.3 Nivolumab in Combination With Radiotherapy With or Without Temozolomide in Patients With Newly Diagnosed Glioblastoma: Updated Results From CheckMate 143. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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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Omuro A, Vlahovic G, Baehring J, Butowski NA, Reardon DA, Cloughesy T, Sahebjam S, Lim M, Strauss L, Latek R, Zwirtes R, Paliwal P, Harbison C, Sampson J. ATIM-16. NIVOLUMAB COMBINED WITH RADIOTHERAPY WITH OR WITHOUT TEMOZOLOMIDE IN PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA: RESULTS FROM PHASE 1 SAFETY COHORTS IN CHECKMATE 143. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now212.081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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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Kann B, Lester-Coll N, Park H, Yeboa D, Bindra R, Becker K, Baehring J, Roberts K. Addition of Chemotherapy to Adjuvant Radiation Therapy is Associated With Improved Overall Survival in Adult Medulloblastoma. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.080] [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: 11/28/2022]
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Lester-Coll N, Kluytenaar J, Pavlik K, Yu J, Contessa J, Moliterno J, Piepmeier J, Becker K, Baehring J, Huttner A, Vortmeyer A, Ramani R, Lampert R, Yao X, Bindra R. Mibefradil Dihydrochloride With Hypofractionated Radiation for Recurrent Glioblastoma: Preliminary Results of a Phase 1 Dose Expansion Trial. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.233] [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: 10/20/2022]
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Nabors LB, Portnow J, Ammirati M, Baehring J, Brem H, Brown P, Butowski N, Chamberlain MC, Fenstermaker RA, Friedman A, Gilbert MR, Hattangadi-Gluth J, Holdhoff M, Junck L, Kaley T, Lawson R, Loeffler JS, Lovely MP, Moots PL, Mrugala MM, Newton HB, Parney I, Raizer JJ, Recht L, Shonka N, Shrieve DC, Sills AK, Swinnen LJ, Tran D, Tran N, Vrionis FD, Weiss S, Wen PY, McMillian N, Engh AM. Central Nervous System Cancers, Version 1.2015. J Natl Compr Canc Netw 2016; 13:1191-202. [PMID: 26483059 DOI: 10.6004/jnccn.2015.0148] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Central Nervous System (CNS) Cancers provide interdisciplinary recommendations for managing adult CNS cancers. Primary and metastatic brain tumors are a heterogeneous group of neoplasms with varied outcomes and management strategies. These NCCN Guidelines Insights summarize the NCCN CNS Cancers Panel's discussion and highlight notable changes in the 2015 update. This article outlines the data and provides insight into panel decisions regarding adjuvant radiation and chemotherapy treatment options for high-risk newly diagnosed low-grade gliomas and glioblastomas. Additionally, it describes the panel's assessment of new data and the ongoing debate regarding the use of alternating electric field therapy for high-grade gliomas.
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Sampson J, Omuro A, Vlahovic G, Sahebjam S, Baehring J, Hafler DA, Voloschin A, Simon J, Latek R, Coric V, Cloughesy T, Lim M, Reardon D. IMCT-03SAFETY AND ACTIVITY OF NIVOLUMAB MONOTHERAPY AND NIVOLUMAB IN COMBINATION WITH IPILIMUMAB IN RECURRENT GLIOBLASTOMA: UPDATED RESULTS FROM CHECKMATE-143. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov218.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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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Lowther DE, Weinhold K, Reap E, Vlahovic G, Omuro A, Sahebjam S, Baehring J, Voloschin A, Cloughesy T, Lim M, Coric V, Latek R, Simon J, Lerner B, Raddassi K, Hafler DA, Sampson J. CBM-06IMMUNE BIOMARKER RESULTS FROM A TRIAL OF NIVOLUMAB ± IPILIMUMAB IN PATIENTS WITH RECURRENT GLIOBLASTOMA: CHECKMATE-143. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov211.06] [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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Ramkissoon S, Sampson J, Vlahovic G, Sahebjam S, Omuro A, Baehring J, Latek R, Vandeloise E, Coric V, Cloughesy T, Lim M, Reardon D, Ligon K. NIMG-17CENTRAL NEUROPATHOLOGY REVIEW TO ASSIST IN THE EVALUATION OF IMMUNE-RELATED TREATMENT CHANGES VERSUS DISEASE PROGRESSION IN CHECKMATE-143. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov225.17] [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: 11/12/2022] Open
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Sahebjam S, Omuro A, Baehring J, Sampson J, Vlahovic G, Voloschin A, Hayes W, Latek R, Coric V, Cloughesy T, Lim M, Reardon DA. NIMG-16PSEUDOPROGRESSION AND IMMUNOTHERAPY IN GLIOBLASTOMA: A CASE SERIES FROM COHORT 1 OF CHECKMATE-143 (NCT02017717). Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov225.16] [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: 11/12/2022] Open
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Omuro A, Baehring J, Sahebjam S, Vlahovic G, Voloschin A, Young R, Hayes W, Latek R, Coric V, Cloughesy T, Lim M, Sampson J, Reardon DA. NIMG-18EVALUATING TUMOR PROGRESSION AND IMMUNOLOGIC REACTIONS DURING IMMUNOTHERAPY: NEUROIMAGING OBSERVATIONS FROM A MULTICENTER STUDY OF NIVOLUMAB MONOTHERAPY AND NIVOLUMAB IN COMBINATION WITH IPILIMUMAB IN RECURRENT GLIOBLASTOMA (CHECKMATE-143). Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov225.18] [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: 11/13/2022] Open
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Nayak L, Brandes A, Omuro A, Rieger J, Wick A, Phuphanich S, Sumrall A, Sahebjam S, Ahluwalia M, de Souza P, Sepulveda JM, Maio M, Grauer O, Vlahovic G, Baehring J, Dastani H, Latek R, Coric V, Reardon D. QOL-07DESCRIPTION OF CLINICAL AND PATIENT REPORTED OUTCOMES ASSESSMENTS FROM A PHASE 3, MULTICENTER, RANDOMIZED TRIAL EVALUATING NIVOLUMAB MONOTHERAPY VERSUS BEVACIZUMAB IN RECURRENT GLIOBLASTOMA: CHECKMATE-143. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov230.07] [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: 11/13/2022] Open
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Adachi K, Sasaki H, Nagahisa S, Yoshida K, Hattori N, Nishiyama Y, Kawase T, Hasegawa M, Abe M, Hirose Y, Alentorn A, Marie Y, Poggioli S, Alshehhi H, Boisselier B, Carpentier C, Mokhtari K, Capelle L, Figarella-Branger D, Hoang-Xuan K, Sanson M, Delattre JY, Idbaih A, Yust-Katz S, Anderson M, Olar A, Eterovic A, Ezzeddine N, Chen K, Zhao H, Fuller G, Aldape K, de Groot J, Andor N, Harness J, Lopez SG, Fung TL, Mewes HW, Petritsch C, Arivazhagan A, Somasundaram K, Thennarasu K, Pandey P, Anandh B, Santosh V, Chandramouli B, Hegde A, Kondaiah P, Rao M, Bell R, Kang R, Hong C, Song J, Costello J, Bell R, Nagarajan R, Zhang B, Diaz A, Wang T, Song J, Costello J, Bie L, Li Y, Li Y, Liu H, Luyo WFC, Carnero MH, Iruegas MEP, Morell AR, Figueiras MC, Lopez RL, Valverde CF, Chan AKY, Pang JCS, Chung NYF, Li KKW, Poon WS, Chan DTM, Wang Y, Ng HAK, Chaumeil M, Larson P, Yoshihara H, Vigneron D, Nelson S, Pieper R, Phillips J, Ronen S, Clark V, Omay ZE, Serin A, Gunel J, Omay B, Grady C, Youngblood M, Bilguvar K, Baehring J, Piepmeier J, Gutin P, Vortmeyer A, Brennan C, Pamir MN, Kilic T, Krischek B, Simon M, Yasuno K, Gunel M, Cohen AL, Sato M, Aldape KD, Mason C, Diefes K, Heathcock L, Abegglen L, Shrieve D, Couldwell W, Schiffman JD, Colman H, D'Alessandris QG, Cenci T, Martini M, Ricci-Vitiani L, De Maria R, Larocca LM, Pallini R, de Groot J, Theeler B, Aldape K, Lang F, Rao G, Gilbert M, Sulman E, Luthra R, Eterovic K, Chen K, Routbort M, Verhaak R, Mills G, Mendelsohn J, Meric-Bernstam F, Yung A, MacArthur K, Hahn S, Kao G, Lustig R, Alonso-Basanta M, Chandrasekaran S, Wileyto EP, Reyes E, Dorsey J, Fujii K, Kurozumi K, Ichikawa T, Onishi M, Ishida J, Shimazu Y, Kaur B, Chiocca EA, Date I, Geisenberger C, Mock A, Warta R, Schwager C, Hartmann C, von Deimling A, Abdollahi A, Herold-Mende C, Gevaert O, Achrol A, Gholamin S, Mitra S, Westbroek E, Loya J, Mitchell L, Chang S, Steinberg G, Plevritis S, Cheshier S, Gevaert O, Mitchell L, Achrol A, Xu J, Steinberg G, Cheshier S, Napel S, Zaharchuk G, Plevritis S, Gevaert O, Achrol A, Chang S, Harsh G, Steinberg G, Cheshier S, Plevritis S, Gutman D, Holder C, Colen R, Dunn W, Jain R, Cooper L, Hwang S, Flanders A, Brat D, Hayes J, Droop A, Thygesen H, Boissinot M, Westhead D, Short S, Lawler S, Bady P, Kurscheid S, Delorenzi M, Hegi ME, Crosby C, Faulkner C, Smye-Rumsby T, Kurian K, Williams M, Hopkins K, Faulkner C, Palmer A, Williams H, Wragg C, Haynes HR, Williams M, Hopkins K, Kurian KM, Haynes HR, Crosby C, Williams H, White P, Hopkins K, Williams M, Kurian KM, Ishida J, Kurozumi K, Ichikawa T, Onishi M, Fujii K, Shimazu Y, Oka T, Date I, Jalbert L, Elkhaled A, Phillips J, Chang S, Nelson S, Jensen R, Salzman K, Schabel M, Gillespie D, Mumert M, Johnson B, Mazor T, Hong C, Barnes M, Yamamoto S, Ueda H, Tatsuno K, Aihara K, Jalbert L, Nelson S, Bollen A, Hirst M, Marra M, Mukasa A, Saito N, Aburatani H, Berger M, Chang S, Taylor B, Costello J, Popov S, Mackay A, Ingram W, Burford A, Jury A, Vinci M, Jones C, Jones DTW, Hovestadt V, Picelli S, Wang W, Northcott PA, Kool M, Reifenberger G, Pietsch T, Sultan M, Lehrach H, Yaspo ML, Borkhardt A, Landgraf P, Eils R, Korshunov A, Zapatka M, Radlwimmer B, Pfister SM, Lichter P, Joy A, Smirnov I, Reiser M, Shapiro W, Mills G, Kim S, Feuerstein B, Jungk C, Mock A, Geisenberger C, Warta R, Friauf S, Unterberg A, Herold-Mende C, Juratli TA, McElroy J, Meng W, Huebner A, Geiger KD, Krex D, Schackert G, Chakravarti A, Lautenschlaeger T, Kim BY, Jiang W, Beiko J, Prabhu S, DeMonte F, Lang F, Gilbert M, Aldape K, Sawaya R, Cahill D, McCutcheon I, Lau C, Wang L, Terashima K, Yamaguchi S, Burstein M, Sun J, Suzuki T, Nishikawa R, Nakamura H, Natsume A, Terasaka S, Ng HK, Muzny D, Gibbs R, Wheeler D, Lautenschlaeger T, Juratli TA, McElroy J, Meng W, Huebner A, Geiger KD, Krex D, Schackert G, Chakravarti A, Zhang XQ, Sun S, Lam KF, Kiang KMY, Pu JKS, Ho ASW, Leung GKK, Loebel F, Curry WT, Barker FG, Lelic N, Chi AS, Cahill DP, Lu D, Yin J, Teo C, McDonald K, Madhankumar A, Weston C, Slagle-Webb B, Sheehan J, Patel A, Glantz M, Connor J, Maire C, Francis J, Zhang CZ, Jung J, Manzo V, Adalsteinsson V, Homer H, Blumenstiel B, Pedamallu CS, Nickerson E, Ligon A, Love C, Meyerson M, Ligon K, Mazor T, Johnson B, Hong C, Barnes M, Jalbert LE, Nelson SJ, Bollen AW, Smirnov IV, Song JS, Olshen AB, Berger MS, Chang SM, Taylor BS, Costello JF, Mehta S, Armstrong B, Peng S, Bapat A, Berens M, Melendez B, Mollejo M, Mur P, Hernandez-Iglesias T, Fiano C, Ruiz J, Rey JA, Mock A, Stadler V, Schulte A, Lamszus K, Schichor C, Westphal M, Tonn JC, Unterberg A, Herold-Mende C, Morozova O, Katzman S, Grifford M, Salama S, Haussler D, Nagarajan R, Zhang B, Johnson B, Bell R, Olshen A, Fouse S, Diaz A, Smirnov I, Kang R, Wang T, Costello J, Nakamizo S, Sasayama T, Tanaka H, Tanaka K, Mizukawa K, Yoshida M, Kohmura E, Northcott P, Hovestadt V, Jones D, Kool M, Korshunov A, Lichter P, Pfister S, Otani R, Mukasa A, Takayanagi S, Saito K, Tanaka S, Shin M, Saito N, Ozawa T, Riester M, Cheng YK, Huse J, Helmy K, Charles N, Squatrito M, Michor F, Holland E, Perrech M, Dreher L, Rohn G, Goldbrunner R, Timmer M, Pollo B, Palumbo V, Calatozzolo C, Patane M, Nunziata R, Farinotti M, Silvani A, Lodrini S, Finocchiaro G, Lopez E, Rioscovian A, Ruiz R, Siordia G, de Leon AP, Rostomily C, Rostomily R, Silbergeld D, Kolstoe D, Chamberlain M, Silber J, Roth P, Keller A, Hoheisel J, Codo P, Bauer A, Backes C, Leidinger P, Meese E, Thiel E, Korfel A, Weller M, Saito K, Mukasa A, Nagae G, Nagane M, Aihara K, Takayanagi S, Tanaka S, Aburatani H, Saito N, Salama S, Sanborn JZ, Grifford M, Brennan C, Mikkelsen T, Jhanwar S, Chin L, Haussler D, Sasayama T, Tanaka K, Nakamizo S, Nishihara M, Tanaka H, Mizukawa K, Kohmura E, Schliesser M, Grimm C, Weiss E, Claus R, Weichenhan D, Weiler M, Hielscher T, Sahm F, Wiestler B, Klein AC, Blaes J, Weller M, Plass C, Wick W, Stragliotto G, Rahbar A, Soderberg-Naucler C, Sulman E, Won M, Ezhilarasan R, Sun P, Blumenthal D, Vogelbaum M, Colman H, Jenkins R, Chakravarti A, Jeraj R, Brown P, Jaeckle K, Schiff D, Dignam J, Atkins J, Brachman D, Werner-Wasik M, Gilbert M, Mehta M, Aldape K, Terashima K, Shen J, Luan J, Yu A, Suzuki T, Nishikawa R, Matsutani M, Liang Y, Man TK, Lau C, Trister A, Tokita M, Mikheeva S, Mikheev A, Friend S, Rostomily R, van den Bent M, Erdem L, Gorlia T, Taphoorn M, Kros J, Wesseling P, Dubbink H, Ibdaih A, Sanson M, French P, van Thuijl H, Mazor T, Johnson B, Fouse S, Heimans J, Wesseling P, Ylstra B, Reijneveld J, Taylor B, Berger M, Chang S, Costello J, Prabowo A, van Thuijl H, Scheinin I, van Essen H, Spliet W, Ferrier C, van Rijen P, Veersema T, Thom M, Meeteren ASV, Reijneveld J, Ylstra B, Wesseling P, Aronica E, Kim H, Zheng S, Mikkelsen T, Brat DJ, Virk S, Amini S, Sougnez C, Chin L, Barnholtz-Sloan J, Verhaak RGW, Watts C, Sottoriva A, Spiteri I, Piccirillo S, Touloumis A, Collins P, Marioni J, Curtis C, Tavare S, Weiss E, Grimm C, Schliesser M, Hielscher T, Claus R, Sahm F, Wiestler B, Klein AC, Blaes J, Tews B, Weiler M, Weichenhan D, Hartmann C, Weller M, Plass C, Wick W, Yeung TPC, Al-Khazraji B, Morrison L, Hoffman L, Jackson D, Lee TY, Yartsev S, Bauman G, Zheng S, Fu J, Vegesna R, Mao Y, Heathcock LE, Torres-Garcia W, Ezhilarasan R, Wang S, McKenna A, Chin L, Brennan CW, Yung WKA, Weinstein JN, Aldape KD, Sulman EP, Chen K, Koul D, Verhaak RGW. OMICS AND PROGNSTIC MARKERS. Neuro Oncol 2013; 15:iii136-iii155. [PMCID: PMC3823898 DOI: 10.1093/neuonc/not183] [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: 09/21/2023] Open
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Adachi JI, Totake K, Shirahata M, Mishima K, Suzuki T, Yanagisawa T, Fukuoka K, Nishikawa R, Arimappamagan A, Manoj N, Mahadevan A, Bhat D, Arvinda H, Indiradevi B, Somanna S, Chandramouli B, Petterson SA, Hermansen SK, Dahlrot RH, Hansen S, Kristensen BW, Carvalho F, Jalali S, Singh S, Croul S, Aldape K, Zadeh G, Choi J, Park SH, Khang SK, Suh YL, Kim SP, Lee YS, Kim SH, Coberly S, Samayoa K, Liu Y, Kiaei P, Hill J, Patterson S, Damore M, Dahiya S, Emnett R, Phillips J, Haydon D, Leonard J, Perry A, Gutmann D, Epari S, Ahmed S, Gurav M, Raikar S, Moiyadi A, Shetty P, Gupta T, Jalali R, Georges J, Zehri A, Carlson E, Martirosyan N, Elhadi A, Nichols J, Ighaffari L, Eschbacher J, Feuerstein B, Anderson T, Preul M, Jensen K, Nakaji P, Girardi H, Monville F, Carpentier S, Giry M, Voss J, Jenkins R, Boisselier B, Frayssinet V, Poggionovo C, Catteau A, Mokhtari K, Sanson M, Peyro-Saint-Paul H, Giannini C, Hide T, Nakamura H, Makino K, Yano S, Anai S, Shinojima N, Kuroda JI, Takezaki T, Kuratsu JI, Higuchi F, Matsuda H, Iwata K, Ueki K, Kim P, Kong J, Cooper L, Wang F, Gao J, Teodoro G, Scarpace L, Mikkelsen T, Schniederjan M, Moreno C, Saltz J, Brat D, Cho U, Hong YK, Lee YS, Lober R, Lu L, Gephart MH, Fisher P, Miyazaki M, Nishihara H, Itoh T, Kato M, Fujimoto S, Kimura T, Tanino M, Tanaka S, Nguyen N, Moes G, Villano JL, Nishihara H, Kanno H, Kato Y, Tanaka S, Ohnishi T, Harada H, Ohue S, Kouno S, Inoue A, Yamashita D, Okamoto S, Nitta M, Muragaki Y, Maruyama T, Sawada T, Komori T, Saito T, Okada Y, Omay SB, Gunel JM, Clark VE, Li J, Omay EZE, Serin A, Kolb LE, Hebert RM, Bilguvar K, Ozduman K, Pamir MN, Kilic T, Baehring J, Piepmeier JM, Brennan CW, Huse J, Gutin PH, Yasuno K, Vortmeyer A, Gunel M, Perry A, Pugh S, Rogers CL, Brachman D, McMillan W, Jenrette J, Barani I, Shrieve D, Sloan A, Mehta M, Prabowo A, Iyer A, Veersema T, Anink J, Meeteren ASV, Spliet W, van Rijen P, Ferrier T, Capper D, Thom M, Aronica E, Chharchhodawala T, Sable M, Sharma MC, Sarkar C, Suri V, Singh M, Santosh V, Thota B, Srividya M, Sravani K, Shwetha S, Arivazhagan A, Thennarasu K, Chandramouli B, Hegde A, Kondaiah P, Somasundaram K, Rao M, Santosh V, Kumar VP, Thota B, Shastry A, Arivazhagan A, Thennarasu K, Kondaiah P, Shastry A, Narayan R, Thota B, Somanna S, Thennarasu K, Arivazhagan A, Santosh V, Shastry A, Naz S, Thota B, Thennarasu K, Arivazhagan A, Somanna S, Santosh V, Kondaiah P, Venneti S, Garimella M, Sullivan L, Martinez D, Huse J, Heguy A, Santi M, Thompson C, Judkins A, Voronovich Z, Chen L, Clark K, Walsh M, Mannas J, Horbinski C, Wiestler B, Capper D, Holland-Letz T, Korshunov A, von Deimling A, Pfister SM, Platten M, Weller M, Wick W, Zieman G, Dardis C, Ashby L, Eschbacher J. PATHOLOGY. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not184] [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: 11/13/2022] Open
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Taylor JW, Flanagan EP, O'Neill BP, Siegal T, Omuro A, Deangelis L, Baehring J, Nishikawa R, Pinto F, Chamberlain M, Hoang-Xuan K, Gonzalez-Aguilar A, Batchelor T, Blay JY, Korfel A, Betensky RA, Lopes MBS, Schiff D. Primary leptomeningeal lymphoma: International Primary CNS Lymphoma Collaborative Group report. Neurology 2013; 81:1690-6. [PMID: 24107866 DOI: 10.1212/01.wnl.0000435302.02895.f3] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [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
OBJECTIVE To evaluate clinical presentation, optimal diagnostic evaluation and treatment, and outcome in primary leptomeningeal lymphoma, a rare form of primary CNS lymphoma without parenchymal or systemic involvement. METHODS The International Primary CNS Lymphoma Collaborative Group, a multidisciplinary group of physicians with a particular interest in primary CNS lymphoma, retrospectively identified cases of lymphoma isolated to the leptomeninges as diagnosed by CSF cytology, flow cytometry, or biopsy, without systemic or parenchymal brain/spinal cord lymphoma or immunodeficiency. RESULTS Forty-eight patients were identified, with median age at diagnosis of 51 years and median Eastern Cooperative Oncology Group performance status of 2. Presenting symptoms were multifocal in 68%. Leptomeningeal enhancement was seen in 74% and CSF profile was abnormal in all cases. CSF cytology detected malignant lymphocytes in 67%. Flow cytometry identified monoclonal population in 80%, as did receptor gene rearrangement studies in 71%. Sixty-two percent had B-cell lymphoma, 19% T-cell, and 19% unclassified. Treatment varied and included fractionated radiotherapy (36%), systemic chemotherapy (78%), and intra-CSF chemotherapy (66%), with 66% receiving ≥ 2 modalities. Seventy-one percent had a favorable clinical response; ultimately, 44% received salvage treatment. Median overall survival was 24 months, with 11 patients still alive at 50 months follow-up. CONCLUSION Primary leptomeningeal lymphoma is a rare form of primary CNS lymphoma. Patients usually present with multifocal symptoms, with evidence of leptomeningeal enhancement and diagnostic CSF analysis. Although treatment is highly variable, patients have a better prognosis than previously reported and a subset may be cured.
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Affiliation(s)
- Jennie W Taylor
- From the Massachusetts General Hospital (J.W.T., T.B., R.A.B.), Boston; Mayo Clinic (E.P.F., B.P.O.), Rochester, MN; Hadassah Hebrew University Medical Center (T.S.), Jerusalem, Israel; Memorial Sloan-Kettering (A.O., L.D.), New York, NY; Yale University (J.B.), New Haven, CT; Saitama Medical University (R.N.), Japan; Kings College Hospital (F.P.), London, UK; University of Washington (M.C.), Seattle; LOC National Expert Center (K.H.-X., A.G.-A.), APHP, UPMC, Pitie-Salpetriere, Paris; Centre Leon Berard (J.-Y.B.), Lyon, France; Campus Benjamin Franklin (A.K.), Charite Universitätsmedizin Berlin, Germany; Department of Biostatistics (R.A.B.), Harvard School of Public Health, Boston, MA; and University of Virginia (M.-B.S.L., D.S.), Charlottesville
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G, Karamoutsios A, Voulgaris S, Shen D, Wang J, Qiu Z, Chen F, Chen Z, Miwa K, Shinoda J, Ito T, Yokoyama K, Yamada M, Yamada J, Yano H, Iwama T, Brokinkel B, Schober O, Heindel W, Hargus G, Paulus W, Stummer W, Woelfer J, Aoki T, Arakawa Y, Ueba T, Miyatake S, Nozaki K, Taki W, Tsukahara T, Miyamoto S, Matsutani M, Satou K, Ito T, Takanashi M, Oikawa M, Ozaki Y, Sugio H, Nakamura H. Abstracts of the 10th Congress of the European Association of NeuroOncology. Marseille, France. September 6-9, 2012. Neuro Oncol 2012; 14 Suppl 3:iii1-109. [PMID: 22977921 DOI: 10.1093/neuonc/nos183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abla O, Weitzman S, Blay JY, O'Neill BP, Abrey LE, Neuwelt E, Doolittle ND, Baehring J, Pradhan K, Martin SE, Guerrera M, Shah S, Ghesquieres H, Silver M, Betensky RA, Batchelor T. Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG). Clin Cancer Res 2011; 17:346-52. [PMID: 21224370 DOI: 10.1158/1078-0432.ccr-10-1161] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To describe the demographic and clinical features and outcomes for children and adolescents with primary CNS lymphoma (PCNSL). EXPERIMENTAL DESIGN A retrospective series of children and adolescents with PCNSL was assembled from 10 cancer centers in 3 countries. RESULTS Twenty-nine patients with a median age of 14 years were identified. Sixteen (55%) had Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 1 or greater. Frontline therapy consisted of chemotherapy only in 20 patients (69%), while 9 (31%) had chemotherapy plus cranial radiotherapy. Most patients received methotrexate (MTX)-based regimens. Overall response rate was 86% (complete remission 69%, partial remission 17%). The 2-year progression-free survival (PFS) and overall survival (OS) rates were 61% and 86%, respectively; the 3-year OS was 82%. Univariate analyses were conducted for age (≤ 14 vs. >14 years), PS (0 or 1 vs. >1), deep brain lesions, MTX dose, primary treatment with chemotherapy alone, intrathecal chemotherapy, and high-dose therapy. Primary treatment with chemotherapy alone was associated with better overall response rates with an odds ratio (OR) of 0.125 (P = 0.02). There was a marginally significant relationship between higher doses of MTX and response (OR = 1.5, P = 0.06). ECOG-PS of 0 to 1 was the only factor associated with better outcome with hazard ratios of 0.136 (P = 0.017) and 0.073 (P = 0.033) for PFS and OS, respectively. CONCLUSION This is the largest series collected of pediatric PCNSL. The outcome of children and adolescents seems to be better than in adults. PS of 0 to 1 is associated with better survival.
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Affiliation(s)
- Oussama Abla
- Division of Haematology/Oncology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.
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Kautzky-Willer A, Preusser M, Elandt K, Widhalm G, Dieckmann K, Torcuator RG, Opinaldo P, Chua E, Barredo C, Cuanang J, Grimm S, Phuphanich S, Recht LD, Rosenfeld SS, Chamberlain MC, Zhu JJ, Fadul CE, Swabb EA, Pope C, Beelen AP, Raizer JJ, Kim IH, Park CK, Han JH, Lee SH, Kim CY, Kim TM, Kim DW, Kim JE, Paek SH, Kim IA, Kim YJ, Kim JH, Nam DH, Rhee CH, Lee SH, Park BJ, Kim DG, Heo DS, Jung HW, Desjardins A, Peters KB, Vredenburgh JJ, Friedman HS, Reardon DA, Becker K, Baehring J, Hammond SN, Norden AD, Fisher DC, Wong ET, Cote GM, Ciampa AS, Doherty LM, Ruland SF, LaFrankie DC, Wen PY, Drappatz J, Brandes AA, Franceschi E, Tosoni A, Poggi R, Agati R, Bartolini S, Spagnolli F, Pozzati E, Marucci G, Ermani M, Taillibert S, Guillevin R, Dehais C, Bellanger A, Delattre JY, Omuro A, Taillibert S, Hoang-Xuan K, Barrie M, Guiu S, Chauffert B, Cartalat-Carel S, Taillandier L, Fabbro M, Laigre M, Guillamo JS, Geffrelot J, Rouge TDLM, Bonnetain F, Chinot O, Gil MJ, de las Penas R, Reynes G, Balana C, Perez-Segura P, Garcia-Velasco A, Gallego O, Herrero A, de Lucas CFC, Benavides M, Perez-Martin X, Mesia C, Martinez-Garcia M, Muggeri AD, Cervio A, Rojas M, Arakaki N, Sevlever GE, Diez BD, Muggeri AD, Cerrato S, Martinetto H, Diez BD, Peereboom DM, Brewer CJ, Suh JH, Chao ST, Parsons MW, Elson PJ, Vogelbaum MA, Sade B, Barnett GH, Shonka NA, Yung WKA, Bekele N, Gilbert MR, Kobyakov G, Absalyamova O, Amanov R, Rauschkolb PK, Drappatz J, Batchelor TT, Meyer LP, Fadul CE, Lallana EC, Nghiemphu PL, Kohanteb P, Lai A, Green RM, Cloughesy TF, Mrugala MM, Lee LK, Graham CA, Fink JR, Spence AM, Portnow J, Badie B, Liu X, Frankel P, Chen M, Synold TW, Al Jishi AA, Golan J, Polley MYC, Lamborn KR, Chang SM, Butowski N, Clarke JL, Prados M, Grommes C, Oxnard GR, Kris MG, Miller VA, Pao W, Lassman AB, Renfrow J, DeTroye A, Chan M, Tatter S, Ellis T, McMullen K, Johnson A, Mott R, Lesser GJ, Cavaliere R, Abrey LE, Mason WP, Lassman AB, Perentesis J, Ivy P, Villalona M, Nayak L, Fleisher M, Gonzalez-Espinoza R, Reiner A, Panageas K, Lin O, Liu CM, Deangelis LM, Omuro A, Taylor LP, Ammirati M, Lamki T, Zarzour H, Grecula J, Dudley RW, Kavan P, Garoufalis E, Guiot MC, Del Maestro RF, Maurice C, Belanger K, Moumdjian R, Dufresne S, Fortin C, Fortin MA, Berthelet F, Renoult E, Belair M, Rouleau D, Gallego O, Benavides M, Segura PP, Balana C, Gil MJG, Berrocal A, Reynes G, Garcia JL, Mazarico J, Bague S. Medical and Neuro-Oncology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s6] [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: 11/13/2022] Open
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Tasdemiroglu E, Kaya M, Yildirim CH, Lucas KG, Bao L, Bruggeman R, Specht C, Murray JC, Donahue DJ, Galliani CA, Blondin NA, Hui P, Vortmeyer A, Hasbani J, Baehring J, Jensen RL, Lee J, Lake WB, Baskaya MK, Salamat MS, Kennedy T, Abraham S, Jensen RL, Lusis EA, Scheithauer B, Yachnis AT, Chicoine MR, Paulus W, Perry A, Chan DT, Kam MK, Ma BB, Ng SC, Siu DY, Ng HK, Poon WS, Dunbar EM, Dong HJ, Liu C, Chi YY, Keeling C, Yachnis AT, Stephen JH, Sievert AJ, Resnick AC, Storm PB, Judkins AR, Santi M, Kirsch M, Stelling A, Koch E, Salzer R, Schackert G, Steiner G, Pollo B, Maderna E, Valletta L, Guzzetti S, Eoli M, Calatozzolo C, Nunziata R, Salmaggi A, Finocchiaro G, Kastenhuber ER, Campos C, Brennan CW, Mellinghoff IK, Huse JT, Zhang H, Sergey M, Estrada DK, Kay AB, Wagner AS, Khanlou N, Vinters HV, Cloughesy TF, Yong WH. Pathology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s10] [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: 11/13/2022] Open
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Baehring J, Hui P, Piepmeier J, Bannykh SI. Anaplastic oligoastrocytoma in Turcot syndrome. J Neurooncol 2009; 95:293-298. [PMID: 19495563 DOI: 10.1007/s11060-009-9928-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 05/24/2009] [Indexed: 10/20/2022]
Abstract
Turcot syndrome (TS), a rare variant of hereditary non-polyposis colorectal cancer (HNPCC), is characterized by familial clustering of cancer of the large bowel, extracolonic body sites and brain. It is caused by germline mutations in genes encoding for components of the DNA mismatch repair system. We report a 72 year old woman with anaplastic oligoastrocytoma in the setting of TS. Careful analysis of tumor DNA is required to exclude the chance occurrence of a brain tumor in HNPCC kindreds and increase our understanding of the pathogenesis of the disease. Our case adds to the handful of cases published with detailed molecular data previously.
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Affiliation(s)
- Joachim Baehring
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, TMP412, New Haven, CT, 06510, USA. .,Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA.
| | - Pei Hui
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - Joseph Piepmeier
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA
| | - Serguei I Bannykh
- Department of Pathology, Cedars Sinai Medical Center, Los Angeles, CA, USA
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Mayer T, Lacy J, Baehring J. A Single Institution's Experience with Bevacizumab in Combination with Cytotoxic Chemotherapy in Progressive Malignant Glioma. Clin Med Oncol 2008; 2:455-9. [PMID: 21892317 PMCID: PMC3161684 DOI: 10.4137/cmo.s827] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Bevacizumab and irinotecan may represent one of the most active treatments in progressive malignant glioma. Limited published experience with bevacizumab in patients with CNS tumors raises concerns regarding toxicity, particularly in regards to hemorrhage and thromboembolism. METHODS We retrospectively reviewed 36 patients with progressive malignant glioma after prior resection, chemotherapy and radiation who were treated with bevacizumab at our institution. Patients were evaluated for bevacizumab-related adverse events, time to treatment failure (TTF) and overall survival (OS). Two patients who progressed or died prior to completion of 4 cycles of therapy were analyzed for adverse events only. RESULTS Patients were treated with bevacizumab alone (1), bevacizumab plus irinotecan (31), or bevacizumab plus carboplatin (4). In 34 patients who received >4 cycles of bevacizumab, median TTF and OS were 16 and 32 weeks, respectively. Toxicities included 1 arterial thrombosis, 4 venous thromboses, and 3 clinically significant CNS hemorrhages. CONCLUSION Overall, our results confirm the efficacy and safety of bevacizumab in combination with chemotherapy in patients with progressive malignant glioma. Although the TTF and OS were less than previously reported with the combination of bevacizumab and irinotecan, this was an unselected patient population with 50% of patients having received >1 prior chemotherapy regimen.
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Affiliation(s)
- Tina Mayer
- Medical Oncology, Yale University School of Medicine, New Haven, CT; Yale Medical Oncology, Yale University School of Medicine, New Haven, CT; Neurology, Yale University School of Medicine, New Haven, CT
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Mayer TM, Lacy J, Baehring J. A single institution’s experience with bevacizumab and cytoxic chemotherapy in progressive malignant glioma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.13010] [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: 11/20/2022] Open
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Eisenbarth SC, Colegio OR, Iyer A, Cooper D, Bannykh S, Baehring J. Images in neuro-oncology: a case of POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes) in a patient with multicentric Castleman's disease. J Neurooncol 2006; 81:163-5. [PMID: 17086436 DOI: 10.1007/s11060-006-9253-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Accepted: 08/17/2006] [Indexed: 11/30/2022]
Affiliation(s)
- Stephanie C Eisenbarth
- Department of Laboratory Medicine, Yale University School of Medicine, 333 Cedar St., TMP 410, Box 208082, New Haven, CT 06510, USA.
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Dotto JE, Baehring J, Piepmeier JM, Bannykh SI. 21-year-old woman with a cystic brain lesion. Brain Pathol 2006; 16:239-41. [PMID: 16911483 PMCID: PMC8095829 DOI: 10.1111/j.1750-3639.2006.00014_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Baehring J, Sutter C, Kadmon M, Doeberitz MVK, Gebert J. A ‘Nonsense’ Mutation Leads to Aberrant Splicing of hMLH1 in a German Hereditary Non-polyposis Colorectal Cancer Family. Fam Cancer 2006; 5:195-9. [PMID: 16736291 DOI: 10.1007/s10689-006-6988-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2005] [Accepted: 01/26/2006] [Indexed: 10/24/2022]
Abstract
Hereditary Non-polyposis Colorectal Cancer (HNPCC) is an autosomal dominant cancer predisposition syndrome caused by germline mutations in at least four genes encoding integral components of the cellular DNA mismatch repair (MMR) system. The spectrum of genetic alterations encompasses missense- and nonsense mutations, intronic mutations affecting splice donor or acceptor sites as well as small-scale deletions and insertions. We have identified a 'nonsense' mutation that activates a cryptic splice site generating an in frame deletion of the last 17 codons of exon1 of the hMLH1 gene causing HNPCC in a German family. We present a comprehensive genetic analysis of this family that demonstrates important aspects of HNPCC pathogenesis.
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Affiliation(s)
- J Baehring
- Department of General Surgery, University of Heidelberg, INF 110, Heidelberg, Germany
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Noronha V, Berliner N, Ballen KK, Lacy J, Kracher J, Baehring J, Henson JW. Treatment-related myelodysplasia/AML in a patient with a history of breast cancer and an oligodendroglioma treated with temozolomide: case study and review of the literature. Neuro Oncol 2006; 8:280-3. [PMID: 16728498 PMCID: PMC1871950 DOI: 10.1215/15228517-2006-003] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The emergence of temozolomide as an effective alkylating agent with little acute toxicity or cumulative myelosuppression has led to protracted courses of chemotherapy for many patients with gliomas. Secondary, or treatment-related, myelodysplasia (t-MDS) and acute myelogenous leukemia (t-AML) are life-threatening complications of alkylating chemotherapy and have been reported in patients with primary brain tumors. We describe a case of temozolomide-related t-MDS/AML and discuss the clinical features of this condition. Administration of an alkylating agent in patient populations with long median survivals must be undertaken with an understanding of the potential for this treatment complication.
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Affiliation(s)
| | | | | | | | | | | | - John W. Henson
- Address correspondence to John W. Henson, Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Yawkey 9 East, Fruit Street, Boston, MA 02114 (
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Affiliation(s)
- Serguei Bannykh
- Department of Pathology, Yale University School of Medicine, New Haven, CT
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Bannykh S, Ogle E, Duncan CC, Baehring J. Images in neuro-oncology. J Neurooncol 2005; 73:135. [PMID: 15981103 DOI: 10.1007/s11060-005-5545-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Serguei Bannykh
- Department of Pathology, Yale Brain Tumor Center, Yale University School of Medicine, UK
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