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Showing 201 - 250Neurologic and Survival Outcomes After Awake Craniotomy for Glioblastoma
In an analysis from the GLIOMAP study reported in The Lancet Oncology, Gerritsen et al found that awake craniotomy for glioblastoma in eloquent brain areas (essential areas for carrying out basic neurological functions) was associated with reduced risk of neurologic deficits and improved survival...
ASTRO Issues Clinical Guideline on Radiation Therapy for Brain Metastases
A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance on the use of radiation therapy to treat patients with brain metastases. Evidence-based recommendations guide the multidisciplinary planning and delivery of advanced radiation therapy techniques to...
DESTINY-Lung01: Is Trastuzumab Deruxtecan the Answer for HER2-Mutant Lung Cancer?
The human epidermal growth factor (HER) family of receptors are a well-established therapeutic target. Indeed, seminal studies conducted nearly 2 decades ago identified a key association between activating mutations in the kinase domain of the epidermal growth factor receptor (EGFR, also known as...
Priscilla K. Brastianos, MD, on CNS Metastases: Understanding Their Evolution and the Clinical Implications
Priscilla K. Brastianos, MD, of Harvard Medical School and Massachusetts General Hospital, talks about her efforts to better understand how brain metastases evolve genomically and to test such agents as abemaciclib, paxalisib, and entrectinib, which may stop their growth. Palbociclib, a CDK...
Phase III Trials and Tribulations
Imagine this. You are a large pharmaceutical company that launches an international randomized phase III trial to assess whether one of your drugs improves the outcome of patients with a common type of cancer. The trial was solidly backed by preclinical evidence that the drug target was essential ...
Mihir Gupta, MD, and Ganesh M. Shankar, MD, PhD, Offer Commentary on the Use of ctDNA to Detect CNS Lymphoma
Mihir Gupta, MD, a neurosurgery resident at the University of California San Diego and postdoctoral fellow at Massachusetts General Hospital Department of Neurosurgery, and Ganesh M. Shankar, MD, PhD, Assistant Professor of Neurosurgery, Massachusetts General Hospital and Harvard Medical School,...
Noninvasive Diagnosis of CNS Lymphoma Possible Through ctDNA
Circulating tumor DNA (ctDNA) is readily detectable in the plasma and cerebrospinal fluid of patients with central nervous system (CNS) lymphoma and is a strong prognostic biomarker for outcomes, a team of researchers from Germany and Stanford University reported at the 2021 American Society of...
CAR T-Cell Therapy as Second-Line Treatment in Large B-Cell Lymphomas
“The mind is not a vessel to be filled but a fire to be kindled.” —Plutarch About 30% to 40% of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) experience relapse, and 10% are refractory to the...
New Guideline Offers Most Comprehensive Summary to Date of Therapies for Brain Metastases
In an effort to synthesize findings from multiple guidelines on various management approaches for brain metastases, ASCO, the Society for Neuro-Oncology (SNO), and the American Society for Radiation Oncology (ASTRO) spearheaded the development of a novel publication to inform and update physician...
T-DXd for Previously Treated Patients With Metastatic HER2-Mutant NSCLC
In the phase II DESTINY-Lung01 trial reported in The New England Journal of Medicine, Bob T. Li, MD, PhD, MPH, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) showed durable activity in patients with metastatic HER2-mutant non–small cell lung cancer (NSCLC) refractory to standard...
Is There an Association Between Maternal Hormonal Contraception Use and Risk of CNS Tumors in Children?
In a Danish nationwide cohort study reported in JAMA, Hargreave et al found no association between maternal hormonal contraception use and risk of central nervous system (CNS) tumors in children. As stated by the investigators, “The incidence of CNS tumors in children appears to be increasing, yet...
Does Armodafinil Improve Cancer-Related Fatigue in Patients With High-Grade Glioma?
In a phase III trial reported in JAMA Oncology, Porter et al found that armodafinil, a psychostimulant, did not improve cancer-related fatigue vs placebo in adult patients with high-grade glioma. As stated by the investigators, “Nearly 96% of patients with high-grade glioma report...
Dabrafenib Plus Trametinib in BRAF V600E–Mutant High- and Low-Grade Glioma
In an interim analysis of a phase II basket trial (ROAR) reported in The Lancet Oncology, Patrick Y. Wen, MD, and colleagues found that the combination of dabrafenib and trametinib produced responses in adult patients with recurrent or progressive BRAF V600E–mutant high-grade and low-grade glioma. ...
T-DXd Makes Inroads in the Treatment of HER2-Mutant NSCLC
Previously treated patients with HER2-positive non–small cell lung cancer (NSCLC) achieved encouraging response rates and duration of response to the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) in the phase II DESTINY-Lung01 trial. These results were reported at the European...
Brain Substructure–Informed Radiotherapy Planning May Improve Neurocognitive Outcomes in Pediatric Patients With Medulloblastoma
In an analysis from the single-institution phase III SJMB03 trial reported in the Journal of Clinical Oncology, Acharya et al found that increasing radiation doses to the corpus callosum, frontal white matter, and hippocampus were associated with neurocognitive impairment in pediatric patients...
Erin Murphy, MD, on Low-Grade Glioma: Neurocognitive Function Following Treatment
Erin Murphy, MD, of Cleveland Clinic, discusses new data that show no apparent difference in cognitive performance up to 2 years post-treatment among adults with low-grade glioma who were treated with concurrent radiotherapy and temozolomide (Abstract 3258).
Integrated Molecular-Morphologic Risk Predictor for Recurrence of Meningioma
In a study reported in the Journal of Clinical Oncology, Maas et al developed a novel integrated molecular-morphologic risk classification score that improved prediction of disease recurrence in patients with meningioma. Study Details The study involved DNA methylation, copy-number, and mutation...
Diana D. Shi, MD, on IDH-Mutant Gliomas: De Novo Pyrmidine Synthesis Inhibitor Under Study
Diana D. Shi, MD, of Dana-Farber Cancer Institute and Brigham and Women’s Cancer Center, discusses studies being planned and already underway to test BAY 2402234, a de novo pyrimidine synthesis inhibitor that possibly could be used clinically to target IDH-mutant gliomas and may act as a...
Two Studies Examine the Efficacy of Immunotherapy for Leptomeningeal Carcinomatosis
Two new studies published in Nature Communications indicate that immunotherapy may benefit people with leptomeningeal carcinomatosis, a rare but serious complication of cancer that has spread to the brain and/or spinal cord. Approximately 5% to 8% of all patients with cancer develop leptomeningeal ...
DM-CHOC-PEN May Improve Outcomes for Adolescents and Young Adults With Central Nervous System Tumors
In a phase II clinical trial, the drug 4-demethyl-4-cholesteryloxycarbonylpenclomedine (DM-CHOC-PEN) improved survival for some adolescent and young adult patients with cancers involving the central nervous system, according to results presented by Morgan et al at the AACR-NCI-EORTC Virtual...
Novel HER2-Targeted Therapies Pose Sequencing Challenges
With three new HER2-targeted therapies approved over the past year or two alone, the treatment landscape for patients with metastatic breast cancer has become increasingly crowded. In the third-line setting and beyond, there are now at least eight HER2-targeted agents approved by the U.S. Food and...
Factors Associated With Risk of Hearing Loss in Pediatric Patients Receiving Radiation and Chemotherapy
In a single-institution cohort study reported in the Journal of Clinical Oncology, Keilty et al identified factors associated with an increased risk of hearing loss in pediatric patients receiving radiation therapy and chemotherapy for central nervous system and head and neck tumors. The study...
DA-EPOCH-R for Children and Adolescents With Newly Diagnosed Primary Mediastinal B-Cell Lymphoma
In a phase II trial reported in the Journal of Clinical Oncology, Burke et al found that dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) did not improve event-free survival vs historical controls in children and adolescents with ...
Older Adults With Primary CNS Lymphoma: Treatment Opportunities and Challenges
The ASCO Post is pleased to present the Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Desai, and DeAngelis explore the treatment of older patients with primary central nervous system lymphoma (PCNSL), which pose...
Belzutifan for Cancers Associated With von Hippel-Lindau Disease
On August 13, 2021, belzutifan, a hypoxia-inducible factor inhibitor, was approved for treatment of adults with von Hippel-Lindau (VHL) disease who require therapy for associated renal cell carcinoma, central nervous system (CNS) hemangioblastomas, or pancreatic neuroendocrine tumors but do not...
Highlights From the 2021 ASCO Annual Meeting
Despite the ongoing challenges of the COVID-19 pandemic, the practice-changing studies presented at the 2021 ASCO Annual Meeting clarified the continuing momentum in the oncology community to improve the lives of our patients. Immunotherapy demonstrated efficacy in cancers where it had not been...
Assumptions, Data … and More Questions!
I read with great interest the results from the phase II ZUMA-12 study of axicabtagene ciloleucel, presented during the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 But the results raised several questions for me. Axicabtagene ciloleucel, an autologous anti-CD19...
Cross-Sectional Survey Reveals Disparities in Care of Patients With Brain Metastases
A cross-sectional survey of patients, caregivers, and physicians on the diagnosis and treatment of brain metastases, conducted by the American Brain Tumor Association (ABTA) as part of its Metastatic Brain Tumor Initiative, revealed disparities in practice patterns and communication around...
ALK Fusion–Positive High-Grade Glioma: Response to Lorlatinib in a Single Pediatric Case
In a letter to the editor published in The New England Journal of Medicine, Bagchi et al describe the course of treatment in a 3-year-old child with an intracranial tumor and his response to therapy with the kinase inhibitor lorlatinib. Key Points Magnetic resonance imaging (MRI) of the head in a...
Report Aims to Assess Contemporary Burden of Brain Tumors in the United States
A new study found that incidence rates for malignant brain and other central nervous system (CNS) tumors declined by 0.8% annually during 2008 through 2017 in the United States for all ages combined. The decline was driven by trends in adults, whereas rates have slightly increased by 0.5% to 0.7%...
Sonali M. Smith, MD: Can CNS Prophylaxis Prevent Secondary High-Grade B-Cell Lymphomas?
Sonali M. Smith, MD, of the University of Chicago, discusses the many uncertainties in preventing secondary high-grade B-cell lymphomas, which have a poor prognosis; how to discern the patients at highest risk; and whether prophylaxis with monoclonal antibodies such as rituximab can mitigate the...
FDA Approves Belzutifan for Cancers Associated With von Hippel-Lindau Disease
On August 13, the U.S. Food and Drug Administration (FDA) approved belzutifan (Welireg), a hypoxia-inducible factor inhibitor, for adult patients with von Hippel-Lindau (VHL) disease who require therapy for associated renal cell carcinoma (RCC), central nervous system (CNS) hemangioblastomas, or...
Comparison of I-131 Metaiodobenzylguanidine–Containing Regimens in Relapsed or Refractory Neuroblastoma
In a phase II New Approaches to Neuroblastoma Therapy (NANT) consortium study reported in the Journal of Clinical Oncology, DuBois et al found that combining the radiotherapeutic I-131 metaiodobenzylguanidine (MIBG) with vorinostat produced a higher response rate in relapsed or refractory...
CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas
To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel gene therapies for resistant non-Hodgkin lymphomas (NHL), including...
Carboplatin Intensification for the Treatment of Pediatric High-Risk Medulloblastoma
In a Children’s Oncology Group (COG) phase III trial reported in JAMA Oncology, Leary et al found that the addition of carboplatin to radiotherapy in pediatric patients with newly diagnosed high-risk medulloblastoma improved event-free survival in the group 3 molecular subgroup but not in others....
Lorlatinib for Metastatic ALK-Positive NSCLC
On March 3, 2021, lorlatinib was granted regular approval for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ALK-positive tumors as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA simultaneously approved the Ventana ALK (D5F3) CDx Assay ...
Expert Point of View: Jaishri O. Blakeley, MD
Invited study discussant Jaishri O. Blakeley, MD, Director of the Johns Hopkins Comprehensive Neurofibromatosis Center, Baltimore, changed the title of her talk to “Finding Needles in Haystacks,” “because this is what we do with CNS [central nervous system] tumors,” she told listeners. “ALK...
HER2-Specific CAR T-Cell Trial Addresses Pediatric Brain and Spinal Cord Tumors
Locoregional delivery of chimeric antigen receptor (CAR) T cells has resulted in objective responses in adults with glioblastoma, but the approach has not been evaluated in pediatric patients with brain and central nervous system tumors. The innovative, ongoing phase I BrainChild-01 trial is...
Study Explores Ketogenic Diet and Intermittent Fasting in Patients With Brain Cancer
More research into the efficacy of a modified ketogenic diet may be beneficial for people with brain tumors, according to a new study published by Schreck et al in the journal Neurology. The diet, which is high in fat and low in carbohydrates, led to changes in the metabolism in the body and the...
Oncolytic Adenovirus for Malignant Glioma: Feasibility and Safety
In a first-in-human phase I trial reported in The Lancet Oncology, Fares et al found that neural stem cell delivery of an oncolytic adenovirus (NSC-CRAd-S-pk7) was safe and feasible in patients with newly diagnosed malignant glioma, with immunologic and histopathologic findings supporting continued ...
Effect of ALK Amplification and Mutation on Outcomes in High-Risk Neuroblastoma
In an analysis from the European Neuroblastoma Study Group (SIOPEN) HR-NBL1 high-risk neuroblastoma trial reported in the Journal of Clinical Oncology, Bellini et al found that ALK amplification and clonal mutation were associated with poorer outcomes in pediatric patients with high-risk...
Reduced-Dose and Reduced-Volume Radiotherapy Plus Chemotherapy in Newly Diagnosed Patients With Average-Risk Medulloblastoma
As reported in the Journal of Clinical Oncology by Jeff M. Michalski, MBA, MD, and colleagues, the Children’s Oncology Group noninferiority phase III ACNS0331 trial has shown no decrease in event-free survival with reduced radiation boost volume in patients with newly diagnosed, average-risk...
Study Explores Incidence Rates for Various Pediatric Cancers Across Age and Racial Groups
New research has uncovered substantial differences in the rates of childhood cancers when considering a single year of age rather than grouping several years together. The study, published by Marcotte et al in the journal Cancer, also found that minority children seem to have different risks than...
Adjuvant and Concurrent Temozolomide in 1p/19q Non-Codeleted Anaplastic Glioma: Survival Benefit Analysis
In the second interim analysis of the phase III CATNON trial reported in The Lancet Oncology, Martin J. van den Bent, MD, PhD, and colleagues found that adjuvant temozolomide—but not temozolomide concurrent with radiotherapy—was associated with an overall survival benefit in patients with newly...
Cognitive Performance at Baseline and Over Time in Infants Treated for Brain Tumors
In a prospective longitudinal trial reported in the Journal of Clinical Oncology, Ali et al found that infants treated for central nervous system (CNS) malignancies had baseline intellectual quotient (IQ) and parent-reported working memory and adaptive functioning worse than normative expectations; ...
Expert Point of View: Patrick Y. Wen, MD
“This study is interesting, and the results were a little surprising,” said Patrick Y. Wen, MD, Professor of Neurology at Harvard Medical School and Director of the Center for Neuro-Oncology at Dana-Farber Cancer Institute. “The prognosis of these tumors in children and adolescents is so terrible...
Dual BRAF/MEK Inhibition Under Study in BRAF V600E–Mutant Gliomas
The combination of dabrafenib plus trametinib led to encouraging and durable responses in patients with low- and high-grade gliomas harboring BRAF V600E mutations, according to the results of the phase II basket study known as ROAR. Results were presented during the virtual edition of the American...
Pertuzumab/High-Dose Trastuzumab in Patients With HER2-Positive Metastatic Breast Cancer and Progressive Brain Metastases
In the phase II PATRICIA trial reported in the Journal of Clinical Oncology, Nancy U. Lin, MD, and colleagues found that pertuzumab plus high-dose trastuzumab produced central nervous system (CNS) objective responses and clinical benefit in 68% of patients with HER2-positive metastatic breast...
Surveillance Protocol and Early Cancer Detection in Patients With Constitutional Mismatch Repair Deficiency Syndrome
As reported in the Journal of Clinical Oncology by Durno et al in the International Replication Repair Deficiency Consortium (IRRDC), use of an IRRDC surveillance protocol was associated with improved overall survival among patients with constitutional mismatch repair deficiency syndrome (CMMRD)....
Cannabis
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this article, Nirupa Raghunathan, MD, and Jyothirmai Gubili, MS, focus on the increasing use...
