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cns cancers

Does Postoperative Conformal Radiotherapy Improve Survival in Pediatric Patients With Ependymoma?

Treatment with conformal radiation therapy immediately following surgery in children with ependymoma may greatly improve survival. The findings were published by Merchant et al in the Journal of Clinical Oncology. “Historically, children under the age of 3 with ependymoma have a worse...

cns cancers
survivorship

Late Morbidity and Mortality in Survivors of Medulloblastoma

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Salloum et al found that changes in medulloblastoma therapy over 3 decades that have improved survival have also increased risk for subsequent neoplasms and debilitating health conditions. As noted...

cns cancers

Addition of Lomustine to Temozolomide and Radiotherapy in Newly Diagnosed Glioblastoma With Methylated MGMT Promoter

In a German phase III trial (CeTeG/NOA–09) reported in The Lancet, Herrlinger et al found that the addition of adjuvant lomustine to temozolomide and radiotherapy improved overall survival in newly diagnosed glioblastoma with methylated MGMT promoter. The researchers noted that findings...

cns cancers
immunotherapy

Madhav V. Dhodapkar, MBBS, on Cancer Vaccines: Emerging Trends

Madhav V. Dhodapkar, MBBS, of Emory University, summarizes a session he co-chaired on emerging approaches for vaccines, personalized/neoantigen vaccines, and mutation-targeted immunotherapy for diffuse midline gliomas.

cns cancers

Buparlisib in PI3K Pathway–Activated Recurrent Glioblastoma

In a phase II trial reported in the Journal of Clinical Oncology, Wen et al found minimal activity of the phosphatidylinositol 3-kinase (PI3K) inhibitor buparlisib in patients with recurrent glioblastoma with PI3K pathway activation. The study included 2 cohorts. In cohort 1, 14 evaluable patients ...

cns cancers
issues in oncology

Implementation of a Hospital Pathway for Patients With a Newly Identified Single Brain Mass

In a study reported by Arrillaga-Romany et al in the Journal of Oncology Practice, a team at Massachusetts General Hospital found that implementation of a hospital pathway consisting of a dedicated admission protocol for patients with newly identified single brain masses and no history of cancer...

cns cancers

Higher Incidence of Brain and CNS Tumors Among People Living in Appalachia

A recent study published by Ostrom et al in the Journal of Neuro-Oncology showed that compared to the rest of the United States, the Appalachian region has a 5% higher incidence of malignant primary brain tumors and other central nervous system (CNS) tumors, a higher mortality rate due to ...

cns cancers

Risk of Intracranial Malignancy After Stereotactic Radiosurgery for Nonmalignant Conditions

In a retrospective cohort study reported in The Lancet Oncology, Wolf et al found that patients undergoing Gamma Knife stereotactic radiosurgery for nonmalignant neurosurgical conditions did not appear to be at long-term increased risk of radiation-associated secondary intracranial malignancy or...

cns cancers

Regorafenib vs Lomustine in Relapsed Glioblastoma

In the Italian phase II REGOMA trial reported in The Lancet Oncology, Lombardi et al found that regorafenib was associated with improved overall survival vs lomustine in patients with relapsed glioblastoma. In the open-label trial, 119 patients from 10 Italian sites were randomly assigned between...

cns cancers
immunotherapy

Addition of Interleukin-2 to Dinutuximab Beta in High-Risk Neuroblastoma

In an international phase III trial (HR-NBL1/SIOPEN) reported in The Lancet Oncology, Ladenstein et al found that the addition of interleukin (IL)-2 to dinutuximab beta did not improve event-free survival in children and young people with high-risk neuroblastoma. Study Details The current report...

cns cancers

Molecular and Clinical Heterogeneity in Histologically Diagnosed CNS-PNET

As reported by Hwang et al in the Journal of Clinical Oncology, subsequent molecular profiling of histologically diagnosed central nervous system supratentorial primitive neuroectodermal tumors (CNS-PNET) in patients showed molecular and clinical heterogeneity that strongly affected prognosis. The ...

cns cancers

Activity of Vemurafenib in BRAF V600–Mutant Gliomas

In a multicohort study (VE-BASKET study) in patients with BRAF V600–mutant nonmelanoma cancers in the Journal of Clinical Oncology, Kaley et al found evidence of activity of vemurafenib (Zelboraf) in gliomas that appeared to vary by glioma subtype.   Study Details In the study, 24...

cns cancers

2018 ASTRO: Impact of MGMT Gene Expression on Overall Survival in Patients With Anaplastic Glioma

A phase III trial revealed that elevated MGMT gene expression is independently associated with worse overall survival for patients with anaplastic grade III gliomas. These findings were presented by Fleming et al at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO) and...

cns cancers
issues in oncology

Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors

In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...

cns cancers
lung cancer

CNS Activity of First-Line Osimertinib in EGFR-Mutant Advanced NSCLC

In a subgroup analysis of the phase III FLAURA trial reported in the Journal of Clinical Oncology, Reungwetwattana et al found evidence of greater central nervous system (CNS) activity of osimertinib (Tagrisso) vs standard EGFR tyrosine kinase inhibitors in patients with previously untreated...

cns cancers
skin cancer
immunotherapy

Immunotherapy Combination in Melanoma Brain Metastases

In the phase II CheckMate 204 study reported in The New England Journal of Medicine, Tawbi et al found that combined nivolumab (Opdivo) and ipilimumab (Yervoy) produced a high rate of intracranial clinical benefit in patients with melanoma brain metastases. Study Details The study included 94...

cns cancers

Oncology Organizations Remember Senator John McCain

United States Senator from Arizona John McCain passed away on August 25 of the brain cancer glioblastoma multiforme (GBM). Numerous medical societies issued statements in light of his death, reprinted below. ASCO  ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, issued the following...

cns cancers
issues in oncology

Memory Issues in Children With Medulloblastoma Undergoing Radiation Therapy

Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of events they experienced after radiation than to remember pretreatment happenings, according to a Baylor University study comparing them to children with healthy brains. These...

cns cancers
immunotherapy

Bevacizumab and Temozolomide in First Recurrence of Glioma Without 1p/19q Codeletion

In a phase II trial funded by the European Organisation for Research and Treatment of Cancer and reported in The Lancet Oncology, van den Bent et al found no evidence of a survival benefit with the addition of bevacizumab (Avastin) to temozolomide in patients with a first recurrence of World Health ...

cns cancers
survivorship

Functional and Social Independence in Survivors of Pediatric CNS Tumors

In a report from the St. Jude Lifetime Cohort Study published in the Journal of Clinical Oncology, Brinkman et al found that 60% of adult survivors of pediatric central nervous system (CNS) tumors do not achieve full functional or social independence in adult life. In the study, functional and...

cns cancers
lymphoma

Philip J. Bierman, MD, on DLBCL: Managing Patients at Risk of CNS Involvement and Systemic Disease

Philip J. Bierman, MD, of the University of Nebraska Medical Center, discusses how to identify and treat the 1% to 2% of patients with diffuse large B-cell lymphoma who have central nervous system involvement as well as systemic sites at the time of diagnosis.

cns cancers
issues in oncology

Pediatric CT Scans and Subsequent Malignancy Risk

A new study by Meulepas et al in the Journal of the National Cancer Institute suggests that computed tomography (CT) scans may increase the risk of brain tumors. The use of CT scans has increased dramatically over the past 2 decades. CT scans greatly improve diagnostic capabilities,...

cns cancers
skin cancer
immunotherapy

First-Line Treatment With Checkpoint Inhibitors in Patients With Melanoma Brain Metastases

An analysis of newly diagnosed patients with cutaneous melanoma brain metastases treated with checkpoint blockade immunotherapy has found the treatment was associated with an increase in median overall survival of 12.4 months compared with 5.2 months—a 1.4-fold improvement. The benefit was...

cns cancers

Intratumoral Recombinant Poliovirus in Grade IV Glioblastoma

In a study reported in The New England Journal of Medicine, Desjardins and colleagues found that convection-enhanced intratumoral delivery of a recombinant nonpathogenic polio–rhinovirus chimera (PVSRIPO) was not associated with neurovirulence in patients with recurrent grade IV glioma and...

cns cancers

Surgery Followed by Salvage Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Four or Fewer Brain Metastases

In a Japanese phase III noninferiority trial (JCOG0504) reported in the Journal of Clinical Oncology, Kayama et al found that salvage stereotactic radiosurgery (SRS) was noninferior to whole brain radiation therapy (WBRT) for survival in patients with 1 to 4 resected brain metastases. In the...

cns cancers

Risk-Adapted Treatment for Young Children With Medulloblastoma

In a phase II trial (SJYC07) reported in The Lancet Oncology, Robinson et al found that risk-adapted treatment did not improve event-free survival in young children with medulloblastoma. Analysis by methylation status showed superior outcome in the sonic hedgehog (SHH) subgroup. Study Details The ...

cns cancers

Characteristics of Long-Term Survivors of Diffuse Intrinsic Pontine Glioma

In a report from the diffuse intrinsic pontine glioma (DIPG) registries of the International and European Societies for Pediatric Oncology, published in the Journal of Clinical Oncology, Hoffman et al identified characteristics of long-term survivors among pediatric and young adult...

cns cancers
immunotherapy

Treating Pediatric Glioma With Bevacizumab and Standard Treatment

Children with nonbrainstem high-grade glioma could benefit from potentially life-extending treatment if genetic testing was used to personalize therapy as it is in many adults, new research published by Mackay et al in Cancer Cell reported.  Scientists analyzed the DNA of children taking an...

cns cancers

Genetic Counseling and Testing for Patients With Medulloblastoma

Researchers have identified six genes that predispose carriers to develop medulloblastoma and have used the discovery to craft genetic counseling and screening guidelines. The study was published by Waszak et al in The Lancet Oncology. St. Jude Children’s Research Hospital,...

cns cancers

Early-Phase Trial of Carboxyamidotriazole Orotate and Temozolomide in Glioblastoma

In a phase Ib trial reported in the Journal of Clinical Oncology, Omuro et al found evidence of activity of carboxyamidotriazole orotate plus temozolomide in patients with recurrent anaplastic gliomas or glioblastoma and previously untreated glioblastoma. Carboxyamidotriazole orotate is an...

cns cancers
skin cancer
immunotherapy

Nivolumab/Ipilimumab or Nivolumab Alone in Melanoma Brain Metastases

In an Australian phase II trial reported in The Lancet Oncology, Long et al found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) and nivolumab alone showed intracranial activity in patients with melanoma brain metastases. Study Details In the open-label trial, 76 evaluable...

cns cancers

Genomic Copy Number Aberrations and Extremely Poor Survival in High-Risk Neuroblastoma

In a study reported in the Journal of the National Cancer Institute, Depuydt et al identified two genomic copy number aberrations associated with risk of extremely poor survival in patients with high-risk neuroblastoma. Study Details The international collaborative study included normalized...

cns cancers
immunotherapy

Monoclonal Antibody Treatment in Newly Diagnosed Pediatric High-Grade Glioma

In a phase II study reported in the Journal of Clinical Oncology, Grill et al found that the addition of bevacizumab (Avastin) to radiotherapy plus temozolomide (RT + TMZ) did not improve event-free survival in pediatric patients with newly diagnosed high-grade glioma. Study Details In the...

cns cancers

Does Treatment With Tumor-Treating Fields Plus Temozolomide Influence Quality of Life in Patients With Newly Diagnosed Glioblastoma?

A detailed quality-of-life analysis of the phase III EF-14 trial of tumor-treating fields (Optune) in combination with temozolomide for the treatment of newly diagnosed glioblastoma was published by Taphoorn et al in JAMA Oncology. This secondary endpoint analysis demonstrated that the...

cns cancers

Addition of Tumor-Treating Fields to Maintenance Temozolomide in Glioblastoma

Final results of a phase III trial reported by Stupp and colleagues in JAMA indicate that adding antimitotic treatment with tumor-treating fields to maintenance temozolomide is associated with improved progression-free and overall survival in patients with previously treated glioblastoma. The...

cns cancers

FDA Grants Bevacizumab Full Approval in Recurrent Glioblastoma

On December 5, the U.S. Food and Drug Administration (FDA) granted full approval of bevacizumab (Avastin) for the treatment of adults with recurrent glioblastoma that has progressed following prior therapy. Bevacizumab was previously granted provisional approval in this setting under the FDA's ...

cns cancers

Phase III Trial of Combination Therapy for Progressive Glioblastoma

In a phase III trial reported in The New England Journal of Medicine, Wick et al found that adding bevacizumab (Avastin) to lomustine at first disease progression did not improve overall survival in patients with progressive glioblastoma. Study Details In the trial, 437 patients with disease...

cns cancers

AACR-NCI-EORTC: Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

More than a quarter of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 (vocimagene amiretrorepvec) combined with Toca FC (an extended-release formulation of fluorocytosine, a prodrug of fluorouracil [5-FU]) were alive more than 3 years after...

cns cancers
survivorship

Predicting Risk of Subsequent CNS Tumors in Survivors of Childhood Cancer

As reported in the Journal of Clinical Oncology, Wang et al have developed a model for predicting risk of subsequent central nervous system (CNS) tumors in survivors of childhood cancer. Study Details In the study, matched childhood cancer survivors with (n = 82) and without (n = 228) subsequent...

cns cancers
gynecologic cancers
kidney cancer
lung cancer
gastroesophageal cancer

FDA Approves First Biosimilar for the Treatment of Cancer

The U.S. Food and Drug Administration today approved bevacizumab-awwb (Mvasi) as a biosimilar to bevacizumab (Avastin) for the treatment of multiple types of cancer. Bevacizumab-awwb is the first biosimilar approved in the U.S. for the treatment of cancer. “Bringing new biosimilars to...

cns cancers

Zika Virus Shows Oncolytic Activity Against Glioblastoma Stem Cells in Preclinical Trial

Although Zika virus causes devastating damage to the brains of developing fetuses, it someday may prove to be an effective treatment for glioblastoma. New research from Washington University School of Medicine in St. Louis and the University of California San Diego School of Medicine showed that...

cns cancers

Addition of EGFR-Targeting Vaccine to Temozolomide in EGFRvIII-Expressing Glioblastoma

The phase III ACT IV study has shown no survival benefit of adding rindopepimut, a vaccine targeting the epidermal growth factor receptor (EGFR) deletion mutation EGFRvIII, to temozolomide in patients with newly diagnosed EGFRvIII-positive glioblastoma. These findings were reported by Weller et al...

cns cancers

Adjuvant Temozolomide in 1p/19q Non-Codeleted Anaplastic Glioma

Interim results of the phase III CATNON trial (EORTC study 26053-22054) indicate a survival benefit of adjuvant temozolomide in 1p/19q non-codeleted anaplastic glioma. These findings were reported in The Lancet by van den Bent et al. Study Details In the open-label 2 x 2 factorial trial, 745...

cns cancers
survivorship

Study Maps Mutation That May Drive Meningioma Development in Childhood Cancer Survivors

Neuroscientists may have uncovered the genetic basis for why many long-term survivors of childhood cancer develop meningiomas, the most common adult brain tumor, decades after their treatment with cranial radiation. The findings, published by Agnihotri et al in Nature Communications, show that...

cns cancers

Effect of BRAF V600E Mutation on Outcome in Pediatric Low-Grade Gliomas

An analysis reported by Lassaletta et al in the Journal of Clinical Oncology showed that BRAF V600E mutation is associated with a poor outcome in pediatric low-grade gliomas treated with standard adjuvant therapy. Study Details The study involved patients with low-grade gliomas with long-term...

cns cancers

Analysis Reveals Genomic Alterations, Oncogenes Driving Medulloblastoma Subtypes

The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75% of the brain tumors, including two new suspected cancer genes that were found exclusively in the least understood disease subgroups. The study from an international research...

cns cancers

Single-Center Trial of Stereotactic Radiosurgery for Completely Resected Brain Metastases

In a U.S. single-institution study reported in The Lancet Oncology, Mahajan et al found that stereotactic radiosurgery to the surgical cavity reduced local recurrence vs observation in patients with completely resected brain metastases. Study Details In the trial, 128 evaluable patients at MD...

cns cancers

Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Resected Metastatic Brain Disease

In the phase III NCCTG N107C/CEC.3 trial, stereotactic radiosurgery to the surgical cavity reduced cognitive deterioration and was associated with similar overall survival vs whole-brain radiotherapy in patients with resected brain metastasis. These results were reported by Brown et al in The...

cns cancers
issues in oncology

Study Demonstrates Potential for Artificial Intelligence and Whole-Genome Sequencing to Scale Access to Precision Medicine

In a study published by Wrzeszczynski et al in Neurology: Genetics, researchers at the New York Genome Center (NYGC), The Rockefeller University, and IBM illustrated the potential of IBM Watson for Genomics to analyze complex genomic data from state-of-the-art sequencing of whole genomes. The study ...

cns cancers

FDA Approves Aminolevulinic Acid Hydrochloride as an Optical Imaging Agent Indicated in Gliomas

On June 6, the U.S. Food and Drug Administration (FDA) approved aminolevulinic acid hydrochloride, known as ALA HCl (Gleolan), as an optical imaging agent indicated in patients with gliomas (suspected World Health Organization [WHO] Grades III or IV) for preoperative imaging, as an adjunct for the...

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