cns cancers

Dutch Study Shows High Prevalence of Early Endocrine Disorders in Survivors of Childhood Brain Tumors

Clement et al found that 25% of survivors of childhood brain tumors were diagnosed with endocrine disorders over 6.6 years of follow-up, based on a Dutch nationwide study reported in the Journal of Clinical Oncology. The study involved data from 718 survivors diagnosed at age ≤ 18 years with a...

cns cancers

Temozolomide vs Radiotherapy in High-Risk Low-Grade Glioma

In the phase III EORTC (European Organisation for Research and Treatment) 22033-26033 intergroup trial reported in The Lancet Oncology, Baumert et al found no progression-free survival difference between temozolomide chemotherapy and radiotherapy alone in patients with high-risk low-grade glioma....

cns cancers

ASTRO 2016: Stereotactic Radiosurgery Decreases Rate of Postoperative Local Recurrence for Brain Metastases

Stereotactic radiosurgery (SRS) for cancer patients who receive the treatment for brain metastases decreases the likelihood of local recurrence, but shows no positive difference in terms of overall survival or distant brain metastases rates when compared to observation alone following surgical...

cns cancers

ASTRO 2016: Reduced Radiation Boost Volume Recommended for Average-Risk Pediatric Medulloblastoma, but Craniospinal Axis Dose Remains Unchanged

In the largest trial conducted for average-risk medulloblastoma, survival rates following reduced radiation therapy boost volumes were comparable to standard treatment volumes for the primary tumor site, but lower doses of craniospinal axis irradiation were associated with higher event rates and...

cns cancers

ASTRO 2016: Postoperative Stereotactic Radiosurgery: New Standard of Care for Patients With Resected Brain Metastases?

For patients who have cancer that has metastasized to the brain, stereotactic radiosurgery (SRS) results in statistically comparable survival rates, reduced cognitive decline, and better quality of life, compared to whole-brain radiotherapy (WBRT), according to research presented at the 58th Annual ...

cns cancers
lung cancer

Little Benefit Reported With WBRT in NSCLC Patients With Brain Metastases Unsuitable for Resection or Stereotactic Radiotherapy

In a UK-based phase III noninferiority trial (QUARTZ) reported in The Lancet, Mulvenna et al found that use of whole-brain radiotherapy in addition to optimal supportive care including dexamethasone was associated with little additional benefit in non–small cell lung cancer (NSCLC) patients...

cns cancers

Is Weekly Vinblastine Active in Chemotherapy-Naive Children With Progressive Low-Grade Glioma?

In a phase II Canadian Pediatric Brain Tumor Consortium Study reported in the Journal of Clinical Oncology, Lassaletta et al found that vinblastine monotherapy was associated with response or stable disease in most children with chemotherapy-naive low-grade glioma. Vinblastine monotherapy has shown ...

cns cancers

Effect of Radiosurgery Alone vs Radiosurgery Plus WBRT on Cognitive Function in Patients With Brain Metastases

Physicians from Carolinas HealthCare System's Neurosciences Institute and Levine Cancer Institute are among the authors of a study published by Brown et al in JAMA. The study showed how among patients with one to three brain metastases, the use of stereotactic radiosurgery (SRS) alone, compared...

cns cancers

Analysis of Cerebrospinal Fluid for D-2-Hydroxyglutarate May Detect Malignant Brain Tumors Nonsurgically

When a brain tumor is suspected, its presence is usually confirmed by anatomic imaging such as computed tomography (CT) or magnetic resonance imaging (MRI). But through imaging, not much about the tumor molecularly can be learned. Surgery and a biopsy are necessary to get a glimpse of the cancer...

cns cancers

Julie R. Park, MD, on Neuroblastoma: Results of a Children’s Oncology Group Study

Julie R. Park, MD, of Seattle Children’s Hospital, discusses findings from this phase III trial of tandem myeloablative autologous stem cell transplant using peripheral blood stem cell as consolidation therapy for high-risk neuroblastoma (Abstract LBA3).

cns cancers

James R. Perry, MD, on Glioblastoma: Study Results on Treating Elderly Patients

James R. Perry, MD, of Sunnybrook Health Sciences Centre, discusses findings of a phase III trial of short-course radiotherapy with or without concomitant and adjuvant temozolomide in older patients with this tumor (Abstract LBA2).

cns cancers

ASCO 2016: Tandem Autologous Stem-Cell Transplant Improves Outcomes for Children With High-Risk Neuroblastoma

Historically, less than 50% of children with high-risk neuroblastoma live 5 or more years after diagnosis. A National Cancer Institute (NCI)-funded phase III trial performed by the Children’s Oncology Group found that adding a second autologous stem-cell transplant to standard therapy...

cns cancers

ASCO 2016: Temozolomide Chemotherapy Plus Short-Course Radiotherapy Improves Survival in Elderly Patients With Glioblastoma

A Canadian-led randomized phase III trial found that adding temozolomide chemotherapy during short-course radiation therapy, followed by monthly maintenance doses of temozolomide, significantly improved survival of elderly patients with glioblastoma, reducing the risk of death by 33%. These data...

cns cancers

Martin J. Van Den Bent, MD, PhD, on Anaplastic Glioma: Results from the CATNON Trial

Martin J. Van Den Bent, MD, PhD, of the Daniel den Hoed Cancer Center, discusses the interim analysis of the EORTC phase III study on concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q co-deletion (Abstract LBA2000).

cns cancers
solid tumors

Retroviral Replicating Vector That Delivers Cytosine Deaminase to Cancer Cells Active in Recurrent Glioblastoma

A phase I study by Cloughesy et al published in Science Translational Medicine investigating the effectiveness of vocimagene amiretrorepvec (Toca 511), an experimental nonlytic, retroviral replicating vector that delivers cytosine deaminase to cancer cells, and an investigational...

cns cancers

Play-Based Procedural Preparation May Aid Children Undergoing Cranial Radiation Therapy

Play-based procedural preparation not only helps children cope with the stress and anxiety of radiation therapy, but can also help reduce the amount of sedation used and cut costs, according to a study from the Child Life Program at St. Jude Children’s Research Hospital. The study was...

cns cancers

Clinically Relevant Mutations Identified Through Sequencing of Cerebrospinal Fluid of Patients With CNS Cancers

Next-generation sequencing identified clinically relevant somatic alterations in cancer-associated genes in the cerebrospinal fluid of patients with central nervous system (CNS) cancers, according to a report by Pentsova et al in the Journal of Clinical Oncology. Somatic Alterations The study...

cns cancers

Study Explores Differential Localization of Glioblastoma Subtypes and Pathogenesis

Researchers at the University of California San Diego School of Medicine have demonstrated that distinct types of glioblastoma tend to develop in different regions of the brain. This finding provides an explanation for how the same cancer-causing mutation can give rise to different types of brain...

cns cancers

KIR3DL1 and HLA-B Allele Combinations May Impact Response to Treatment in Neuroblastoma

In a study reported in the Journal of Clinical Oncology, Forlenza et al found that noninteracting KIR3DL1 and HLA-B subtypes were associated with better response to anti-GD2 antibody treatment in neuroblastoma. Study Details Treatment of neuroblastoma with anti-GD2 monoclonal antibody (eg, the...

cns cancers

Improved Overall Survival With Addition of Chemotherapy to Radiation in Low-Grade Glioma

The addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall survival in patients with low-grade glioma, according to the final results of the phase III RTOG 9802 trial reported in The New England Journal of Medicine by Buckner et al. A...

cns cancers

Louis Burt Nabors, MD, on Primary and Recurrent Gliomas: Notable Developments in Management

Louis Burt Nabors, MD, of the University of Alabama at Birmingham Comprehensive Cancer Center, discusses improvements in the 2016 NCCN Guidelines for glioma, anaplastic oligodendroglioma, and glioblastoma.

cns cancers

Glioblastoma Multiforme With Mismatch Repair Deficiency May Be Target for Immune Checkpoint Inhibition

Glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency was characterized by hypermutation and elevated neoantigen load—characteristics associated with response to immune checkpoint inhibitors in other settings—according to a study reported in the Journal of ...

cns cancers

Finnish Study Identifies Increased Cancer Risks in Patients With Neurofibromatosis Type 1

In a Finnish study reported in the Journal of Clinical Oncology, Uusitalo et al found that patients with neurofibromatosis type 1 (NF1) were at increased risk of other cancers in addition to nervous system disease. The study included data from a population-based series of patients with...

cns cancers

Alisertib Shows Activity With Irinotecan/Temozolomide in Relapsed or Refractory Neuroblastoma

The oral Aurora A kinase inhibitor alisertib was active in combination with irinotecan/temozolomide in patients with relapsed or refractory neuroblastoma, in a phase I dose-escalation trial reported in the Journal of Clinical Oncology by DuBois et al. The maximum tolerated dose of alisertib was 60...

cns cancers

Combination Therapy May Be Better Than Radiotherapy Alone to Treat Aggressive Brain Cancer, According to Early Study

Radiotherapy effectively damages brain tumors, but the cancer cells can repair themselves in order to live on. Now, researchers at Sidney Kimmel Cancer Center at Thomas Jefferson University have tested a strategy that combines radiotherapy with a drug that shuts down the ability of tumor to mend...

cns cancers

Hyperthermic Laser Surgery Disrupts Blood-Brain-Barrier in Glioblastoma, Opening Path for Chemotherapy

Neurosurgeons at Washington University School of Medicine in St. Louis used hyperthermic laser ablation to shrink tumors in patients with recurrent glioblastoma and noted a temporary disruption of the blood-brain barrier, thereby enabling them to deliver chemotherapy to the peritumoral region....

cns cancers

Two Forms of Radiosurgery for Brain Metastases Are Equally Effective

While two advanced radiosurgery approaches—Gamma Knife and RapidArc—offer different strengths, they are equally effective at eradicating cancer in the brain, say researchers at Sidney Kimmel Cancer Center at Jefferson. Their study, published by Liu et al in Frontiers in Oncology,...

cns cancers

Malignant Brain Tumors Most Common Cause of Cancer Deaths in Adolescents and Young Adults

A new report published by Ostrom et al in the journal Neuro-Oncology sponsored by the American Brain Tumor Association (ABTA) found that malignant brain tumors are the most common cause of cancer-related deaths in adolescents and young adults aged 15 to 39, and the most common cancer occurring...

cns cancers

Single-Center Study Evaluates Proton Radiotherapy for Pediatric Medulloblastoma

In a phase II study reported in The Lancet Oncology by Yock et al, use of proton radiotherapy for pediatric medulloblastoma was associated with acceptable long-term toxic effects and good survival outcomes. Study Details In the study, 59 patients aged 3 to 21 years were treated at...

survivorship
cns cancers
issues in oncology

Increased Risk of Severe Neurocognitive Impairment in Adult Survivors of Pediatric CNS Tumors

As reported in the Journal of Clinical Oncology by Brinkman et al, a study in the St. Jude Lifetime Cohort showed that adult survivors of pediatric central nervous system (CNS) tumors are at increased risk of severe neurocognitive impairment. Study Details The study involved 224 survivors of CNS...

cns cancers
issues in oncology

Abnormal Fused Gene Is a Triple Threat in Driving Pediatric Brain Tumors

Oncology researchers have discovered that an abnormal fused gene that drives pediatric brain tumors poses a triple threat, operating simultaneously through three distinct biologic mechanisms—the first such example in cancer biology. The study was published by Bandopadhayay et al in Nature...

survivorship
cns cancers

Gregory T. Armstrong, MD, MSCE, on Late Mortality in Childhood Cancer Survivors

Gregory T. Armstrong, MD, MSCE, of St. Jude Children's Research Hospital, discusses the findings of a landmark survivorship study (Abstract LBA2).

cns cancers

Jan C. Buckner, MD, on Whole-Brain Radiation and Radiosurgery in Patients With Brain Metastases

Jan C. Buckner, MD, of the Mayo Clinic discusses adjuvant whole-brain radiotherapy and the need for initial treatment with radiosurgery and close monitoring to preserve cognitive function in patients with brain metastases (Abstract LBA4).

solid tumors
cns cancers

Priscilla K. Brastianos, MD, on Genetic Screening of Brain Metastases

Priscilla K. Brastianos, MD, of Massachusetts General Hospital, discusses genomic characterization of brain metastases and paired primary tumors, which could reveal potential therapeutic targets (Abstract 2905).

cns cancers
gastroesophageal cancer

Anita Mahajan, MD, on Radiotherapy Advances in the CNS and Aerodigestive Tract

Anita Mahajan, MD, of MD Anderson Cancer Center, summarizes results from three clinical trials on radiation therapy for ependymoma, locally advanced thoracic esophageal squamous cell carcinoma, and meningioma (Abstracts 31, 1, 7).

cns cancers

2016 GI Symposium: Everolimus Slows Growth of Neuroendocrine Tumors

Researchers report the results of a new analysis from a phase III trial of patients with neuroendocrine tumors that begin in the gastrointestinal (GI) tract or have an unknown origin. Compared to placebo, everolimus (Afinitor) was associated with a 6- to 8-month longer time period before the cancer ...

cns cancers

2016 GI Symposium: New Targeted Hormone-Radiation Treatment Slows Growth of Midgut Neuroendocrine Tumors

Early results from the NETTER-1 phase III study of patients with previously treated, advanced midgut neuroendocrine tumors show that a novel therapy, lutetium (177Lu)-DOTATATE (Lutathera), may substantially slow tumor growth. Patients treated with the experimental drug had a 79% lower risk of...

solid tumors
lung cancer
cns cancers

Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract

In a phase III RADIANT-4 trial reported in The Lancet, Yao et al found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with advanced nonfunctional neuroendocrine tumors of the lung or gastrointestinal tract. ...

cns cancers

Early Surgical Treatment of Low-grade Glioma Improves Survival vs Watchful Waiting

In a comparison of surgical treatment strategies for low-grade gliomas, patients in Norway treated at a hospital that generally favored early surgical resection had better overall survival than patients treated at a hospital that favored diagnostic biopsy and watchful waiting, according to a study...

cns cancers

Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma

On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...

cns cancers

Bevacizumab Added to Radiation and Chemotherapy Improved Progression-free Survival in Newly Diagnosed Glioblastoma

Recently announced results of the phase III AVAglio study showed that bevacizumab (Avastin) in combination with radiation and temozolomide chemotherapy increased progression-free survival (a co-primary endpoint) by 36% compared to radiation and temozolomide chemotherapy plus placebo (hazard ratio...

cns cancers
supportive care

Memantine Provides Modest Improvement in Cognition after Cranial Irradiation

Memantine, a drug used to treat Alzheimer’s disease, slowed cognitive decline in patients with brain cancer treated with whole-brain radiation therapy in a phase III trial reported at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), held recently in Boston. Cognitive ...

cns cancers

Management of Brain Metastases

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

cns cancers

Surgery of Primary Tumor Site Has No Impact on Local Control and Outcome in Patients ≥ 18 Months with Stage IV Disease 

“In intensively treated patients with stage IV neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome,” according to findings from the German prospective clinical trial NB97. “The results of the study,” the researchers...

cns cancers

The Challenges and Rewards of Neuro-oncology 

Despite the extremely difficult clinical challenges posed by brain tumors, mortality rates in this disease have decreased somewhat over the past several decades due, in part, to advances in surgical techniques and therapies. The ASCO Post recently discussed contemporary issues in neuro-oncology...

cns cancers

Neurosurgeon Eric Holland, MD, PhD, joins Fred Hutchinson and University of Washington Medicine; Plans to Develop Brain Cancer Program

Neurosurgeon and brain cancer researcher Eric Holland, MD, PhD, will be joining Fred Hutchinson Cancer Research Center and the University of Washington in summer 2013.  Dr. Holland will be Senior Vice President and Director of the Human Biology Division at Fred Hutchinson Cancer Research Center,...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

cns cancers

Studies Explore Role of Bevacizumab in Combination Therapies for Glioblastoma

At the 2013 ASCO Annual Meeting, studies evaluating the addition of bevacizumab (Avastin) to standard therapy in newly diagnosed glioblastoma multiforme patients did not meet their primary endpoints. When paired with irinotecan, however, bevacizumab showed activity in MGMT-unmethylated tumors....

cns cancers

No Event-Free Survival Difference With Chemotherapy Before vs After Radiotherapy in Children With High-Risk Medulloblastoma 

A number of different strategies for combining chemotherapy and radiation therapy have been evaluated in the effort to improve survival in patients with high-risk medulloblastoma. In a trial (POG 9031) reported in Journal of Clinical Oncology, Nancy J. Tarbell, MD, of Massachusetts General...

cns cancers

Postresection Adenovirus-Mediated Gene Therapy Improves Time to Death/Reintervention but Not Survival in Adult Glioblastoma 

In an open-label phase III trial (ASPECT) reported in Lancet Oncology, Manfred Westphal, MD, of University Hospital Eppendorf in Hamburg, and colleagues assessed the effects of locally applied adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir after surgical...

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