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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

Bevacizumab in Glioblastoma: Another Perspective 

Given the results of the AVAglio trial, we feel that a more balanced discussion about the role of bevacizumab (Avastin) in patients with newly diagnosed glioblastoma is in order. The accompanying article in The ASCO Post suggests that bevacizumab has no benefit in newly diagnosed glioblastoma; data ...

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...

cns cancers

Resistance to Anti-VEGF Drugs in Glioblastoma Is Linked to Mesenchymal Transition 

Antiangiogenic therapy reduces tumor vascular permeability and delays tumor progression but may ultimately promote an aggressive treatment-resistant phenotype. In a study reported in Clinical Cancer Research, Piao and colleagues attempted to identify factors responsible for glioblastoma resistance...

cns cancers

Protecting Hippocampus During Whole-Brain Radiation Substantially Reduces Rate of Cognitive Decline 

Protecting the stem cells that reside in and around the hippocampus substantially reduces the rate of cognitive decline in patients during whole-brain radiotherapy without a significant risk of recurrence in that area of the brain, a new study shows. Results of the phase II clinical trial of...

cns cancers
head and neck cancer

Tumor-Infiltrating Lymphocytes in Glioblastoma Are Related to Specific Genomic Alterations

The role of tumor-infiltrating lymphocytes in glioblastoma has not been fully defined. In a study reported in Clinical Cancer Research, Rutledge and colleagues assessed the association between tumor-infiltrating lymphocytes and molecular alterations, histologies, and survival in glioblastoma. In...

cns cancers

Investigators Report Valganciclovir May Increase Survival in Glioblastoma

In a letter to The New England Journal of Medicine, Cecilia Söderberg-­Nauclér, MD, PhD, and colleagues from the Karolinska Institutet, Stockholm, described experience with the anti-cytomegalovirus (CMV) agent valganciclovir (Valcyte) in the treatment of glioblastoma, citing dramatically improved...

cns cancers

An Overview of the REGAL Trial and Anti-VEGF Therapies in Recurrent Glioblastoma

As published in the Journal of Clinical Oncology by Batchelor and colleagues1 and reviewed in a recent issue of The ASCO Post (November 15, 2013, page 106), the REGAL trial was a randomized, phase III, placebo-controlled, partially blinded trial evaluating the efficacy of cediranib, an...

cns cancers

Neuro-Oncology Community Convenes in Workshop to Advance Imaging-Related Endpoints in Clinical Trials

Leaders from key cross-sections of the neuro-oncology community came together at a recent Brain Tumor Clinical Trial Endpoints Workshop to confront a critical challenge in developing and testing treatments for glioblastoma multiforme. Participants were able to adjourn the workshop with the...

cns cancers

Mutation Predicts Benefit From Alkylating Chemotherapy in Oligodendroglial Tumors

Patients in the Radiation Therapy Oncology Group (RTOG) 9402 study with 1p/19q codeleted anaplastic oligodendroglial tumors had markedly prolonged overall survival after chemoradiotherapy (with procarbazine, lomustine, and vincristine) compared with radiation therapy alone. Some patients with...

cns cancers

Surgical Resection of Newly Diagnosed Glioblastoma: What Is the Standard of Care?

The neurosurgeon is often the gateway provider when patients present with what on magnetic resonance imaging (MRI) appears to be a new glioblastoma. Because histology-based diagnosis is a prerequisite for initiating standard therapy with radiation and chemotherapy, the first question that the...

cns cancers

Glioblastoma: Can We Make This Intractable Disease Tractable?

In the clinical array of brain tumors, glioblastoma is the most difficult to treat, and despite decades of research and the advent of new therapies, patients with glioblastoma continue to have a very poor prognosis. Leading brain tumor experts at the recent 25th Annual Cancer Progress Conference in ...

cns cancers

Considerable Extension of Survival Achieved With Conventional Treatment in Grade 2 Glioma

Long-term results from the Radiation Therapy Oncology Group (RTOG) 9802 study in high-risk grade 2 gliomas were presented at the 2014 ASCO Annual Meeting. The study’s mature analysis showed a 41% reduction in mortality at 5 years with combination radiation therapy followed by six cycles of PCV...

cns cancers

MSH6 Mutations May Influence Temozolomide Resistance in Treatment-Naive Gliomas Independent of MGMT Methylation

Resistance to temozolomide in glioblastoma has been thought to be largely mediated by expression of the DNA repair enzyme MGMT, although there are data suggesting a role for inactivation of MSH6 and other mismatch repair proteins. In a study reported in Clinical Cancer Research, Nguyen and...

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