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cns cancers

Ten Best-Practice Measures Improve Quality of Care During Perioperative Period for Patients With Glioma

Ten best-practice measures identified by a multidisciplinary team at the Norris Cotton Cancer Center (NCCC) at the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, were used to improve the care provided to patients with glioma during the perioperative period. “Using a plan-do-study-act ...

cns cancers

Clinical Trials Actively Recruiting Patients With Glioblastoma

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with newly diagnosed or recurrent glioblastoma multiforme. The studies include pilot, phase I, I/II, III, and observational trials investigating chemoradiation therapy;...

leukemia

Inotuzumab Ozogamicin Plus Low-Intensity Chemotherapy: A Winner in Older Patients With Leukemia

Inotuzumab ozogamicin combined with a low-intensity chemotherapy called mini-hyper-CVD achieved highly encouraging results in older patients with acute lymphoblastic leukemia (ALL) in a phase II study reported at the 56th Annual Meeting of the American Society of Hematology.1 After the...

cns cancers

Dr. Howard Fine Named Founding Director of the Brain Tumor Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center

Howard A. Fine, MD, has been appointed to lead the newly established neuro-oncology program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, effective February 2. He will serve as Director of the Brain Tumor Center and Associate Director for Translational Research in the Sandra and...

cns cancers

Glioblastoma Clinical Trials

I am writing in regard to the recent installment to “Clinical Trials” on Glioblastoma published in The ASCO Post (February 10, 2015, pages 69-71). As a principal investigator, I’d also like to call attention to the following glioblastoma trial, which remains open.   PHASE II Study Type: Phase...

cns cancers

Having Cancer So Early in Life Gave Me Purpose

I had every classic brain tumor symptom in the book—severe headaches, dizziness, morning nausea—which plagued me for 16 years, starting when I was 8. In college, if I allowed myself to sleep more than 4 hours a night, the morning headaches, which were centered on the top of my head, were so severe, ...

cns cancers

Dinutuximab Combination Approved for Pediatric High-Risk Neuroblastoma

The U.S. Food and Drug Administration (FDA) has approved dinutuximab (Unituxin), a monoclonal antibody targeting glycolipid GD2,  as part of first-line therapy for pediatric patients with high-risk neuroblastoma. A chimeric monoclonal antibody that binds to the surface of neuroblastoma cells,...

cns cancers

Dinutuximab in Pediatric High-Risk Neuroblastoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On March 10, 2015, the chimeric monoclonal antibody dinutuximab...

cns cancers

Clinical Trials Actively Recruiting Patients With Neuroblastoma

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with newly diagnosed or relapsed or refractory neuroblastoma. The studies include pilot, observational, phase I, phase II, and phase III trials investigating single-agent and...

cns cancers

EGFR Amplification/Overexpression Associated With Improved Response of Glioblastoma to Metronomic Temozolomide

In a study reported in Journal of the National Cancer Institute, Cominelli and colleagues found that EGFR amplification/overexpression was associated with improved response of glioblastoma to adjuvant metronomic (every day of a 28 day cycle at a dosing of 50-75 mg/m2) but not standard (5...

issues in oncology

The Paradox of Positive Thinking

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

cns cancers

Will the PVS-RIPO Poliovirus Be a Game Changer in the Treatment of Recurrent Glioblastoma?

Although the idea of using viruses to target cancer cells dates back more than 100 years, technologic advances in the genetic engineering of viruses are now making it possible to safely test oncolytic virotherapy as a valid strategy against cancer cells. One type of genetically engineered virus...

cns cancers

Whole-Brain Radiation: Risks Outweigh Benefits for Limited Brain Metastases

New data from a phase III ­Alliance trial weighs in on a longstanding debate in the treatment of brain metastases: Should whole-brain radiation therapy be added to stereotactic radiosurgery? The study found that although whole-brain radiation therapy improved local tumor control in patients with...

cns cancers

Poliovirus for Glioblastoma Grabs National Attention

Researchers at The Preston Robert Tisch Brain Tumor Center at Duke University are being barraged by patients wishing to enroll in their clinical trial of an engineered poliovirus for recurrent glioblastoma. This comes as a result of a CBS 60 Minutes interview with lead researcher Matthias...

cns cancers

Investigators Update PVS-RIPO Data in Glioblastoma

At the 2015 ASCO Annual Meeting, Annick Desjardins, MD, Associate Professor of Neurology at Duke University Medical Center, presented a brief update on the ongoing study of oncolytic PVS-RIPO in glioblastoma, which now includes 24 patients.1 The median age of enrolled patients is 57, most have a...

cns cancers

New Concept for Brain Tumors: Tumor Treating Fields

A novel treatment modality that applies electric forces to brain tumors via scalp electrodes improved outcomes in a study reported at the 2015 ASCO Annual Meeting.1 In the first report of the full dataset, tumor treating fields significantly and consistently prolonged both progression-free...

cns cancers

FDA Grants Orphan Drug Designation to Antitropomyosin Drug for Neuroblastoma

The U.S. Food and Drug Administration (FDA) has granted Orphan Drug designation to Novogen Limited’s chemotherapy candidate drug Anisina for neuroblastoma. Anisina is a small molecule belonging to a family of compounds called antitropomyosins. It has been designed to inhibit Tpm3.1, a structural...

cns cancers

Glioblastoma: Novel Immunotherapy Approaches Generate Responses and Excitement

Checkpoint inhibitors were major attention grabbers at the 2015 ASCO Annual Meeting, but studies suggested there are other encouraging means of harnessing the immune system in the treatment of glioblastoma. EGFRvIII-Targeted Vaccine David A. Reardon, MD, Clinical Director of the Center for...

cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

cns cancers

New Molecular Classifications of Gliomas Established

Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...

cns cancers

Short Course of Radiotherapy May Be Adequate for Elderly and Frail Patients With Glioblastoma Multiforme

No difference in overall survival or progression-free survival was observed between elderly and/or frail patients undergoing short and standard courses of radiotherapy for glioblastoma multiforme, according to data presented by Elena Fidarova, MD, at the 2015 Multinational Association of Supportive ...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is the most likely diagnosis for this patient? Correct Answer: B. Primary central nervous system lymphoma. Expert Perspective In an immunocompetent host, the differential diagnosis of isolated or multiple brain lesion(s) includes autoimmune etiologies such as neurosarcoidosis,...

cns cancers

California Agency Invests $20 Million in Clinical Trial for Glioblastoma Vaccine

California’s Stem Cell Agency (CIRM) has awarded $19.9 million to ImmunoCellular Therapeutics to carry out a phase III clinical trial in patients with newly diagnosed glioblastoma using an immunotherapeutic ­vaccine. “This kind of deadly disease is precisely why we created CIRM 2.0, our new...

cns cancers

FDA Approves Expanded Indication for Medical Device to Treat Newly Diagnosed Glioblastoma Multiforme

The U.S. Food and Drug Administration (FDA) has approved an expanded indication for the Optune tumor-treating fields device to treat patients with newly diagnosed glioblastoma multiforme. It is given along with the chemotherapy drug temozolomide following standard treatments that include surgery,...

cns cancers

FDA Grants Orphan Drug Designation to Bivalent Vaccine for Neuroblastoma

The U.S. Food and Drug Administration (FDA) has granted orphan drug designation to MabVax Therapeutics’ vaccine for the treatment of relapsed or recurrent high-risk neuroblastoma in remission or with limited residual disease after best available treatment. The bivalent vaccine is intended to elicit ...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...

lymphoma

Questions: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear here with expert ­commentary. In the October 25 issue of The ASCO Post, part 1 of a...

cns cancers

Cooperative Group Study Finds Radiation May Benefit Patients With Atypical Meningiomas

Management of the vast majority of meningiomas is straightforward, but treatment of atypical meningiomas has been controversial. Should radiation be part of therapy or not has been the question. The first analysis of Radiation Therapy Oncology Group (RTOG) 0539 suggested that patients will have...

cns cancers

Pilot Study: Research Team Used Focused Ultrasound to Open Blood-Brain Barrier in Patient With Malignant Brain Tumor

A team at Sunnybrook Health Sciences Centre in Toronto has used focused ultrasound to enable temporary and targeted opening of the blood-brain barrier, allowing the more effective delivery of chemotherapy into a patient’s malignant brain tumor. This is the first known report of the noninvasive...

cns cancers

Actionable Targets Identified in Brain Metastases

New research shows that paired primary tumor and brain metastases share a common ancestor, but as the metastases develop in the brain, they exhibit novel genetic alterations that can activate a number of signaling pathways. More than half of the mutations represent potential therapeutic targets....

cns cancers

Study Lowers the Age Bar for Radiation in Children With Ependymoma

The good news is that children as young as 1 year old with the aggressive brain tumor ependymoma can be treated safely and effectively with immediate postoperative radiation therapy, according to the results of a trial presented at the 2015 ASTRO Annual Meeting.1 “Ependymoma is the third most...

Third Annual JADPRO Live at APSHO Conference Attracts Over 700 Advanced Practitioners in Hematology-Oncology

Over 700 nurse practitioners, physician assistants, pharmacists, clinical nurse specialists, and other oncology health-care professionals were convened in Phoenix, Arizona, earlier this month to participate in JADPRO Live at ­APSHO (Advanced Practitioner Society in Hematology and Oncology), the...

lymphoma

A: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...

lymphoma

Q: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear on page 84 with expert commentary. In the November 10 issue of The ASCO Post, part 2 of ...

lung cancer

ASCO Endorsement of ACCP Guideline on Treating SCLC: Moving Forward to Better Outcomes in Oncology

In the current climate of rising health-care costs, particularly in the field of oncology, clinical guidelines provide a crucial tool to guide practitioners in evidence-based care and to improve the quality and consistency of care.1 The ASCO review and endorsement of the American College of Chest...

issues in oncology
cns cancers

DNA Repair Enzyme Identified as a Potential Brain Cancer Drug Target

Rapidly dividing cells rely on an enzyme called Dicer to help them repair the DNA damage that occurs as they make mistakes in copying their genetic material over and over for new cells. Researchers have built on the discovery of Dicer’s role in fixing DNA damage to uncover a new potential...

lung cancer

Alectinib Highly Active in Crizotinib-Refractory ALK-Rearranged NSCLC

In a phase II trial reported in the Journal of Clinical Oncology, Ou et al found that the investigational ALK inhibitor alectinib, which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high CNS penetration, was associated with considerable activity in patients with ...

cns cancers

Prognostic Factors in Men With Brain Metastases From Germ Cell Tumors

As reported in the Journal of Clinical Oncology, Feldman et al, of the Global Germ Cell Cancer Group, identified prognostic factors in men with brain metastases from germ cell cancer at initial diagnosis or relapse. Overall survival was better in patients with metastases at diagnosis, a greater...

lung cancer
cns cancers

Prognostic Factors Identified in Patients With ALK‑Rearranged NSCLC and Brain Metastasis

In a study reported in the Journal of Clinical Oncology, Johung and colleagues identified factors that distinguished survival rates among patients with ALK-rearranged non–small cell lung cancer (NSCLC) and brain metastasis. The study included 90 patients from six institutions. Of them, 84...

cns cancers

Experimental Drug Shown to Prevent Neuroblastoma in Preclinical Study

Australian scientists have identified a critical molecular “feedback loop” that helps initiate and drive neuroblastoma, a cancer of the nervous system in children that is triggered in embryonal nerve cells. This feedback loop massively accelerates cancer development. The research team...

cns cancers

Preclinical Study Finds Pediatric Low-Grade Gliomas With CRAF Fusions May Require Differential and Combinatorial Targeted Therapies

Pediatric low-grade gliomas are the most common type of brain tumor diagnosed in children, and represent a heterogeneous group of tumors, which are poorly classified based on histology and location, according to Payal Jain, a graduate student at the University of Pennsylvania, and lead author of a...

cns cancers
survivorship

Chemotherapy-Induced Hearing Loss Affects Cognition in Pediatric Brain Tumor Survivors

More children are surviving malignant brain tumors than in the past, thanks to the use of intense treatments using platinum-based chemotherapy (cisplatin and high-dose carboplatin). Unfortunately, the therapy has a known side effect of permanent hearing loss, resulting from damage to the inner ear. ...

leukemia
issues in oncology

Reduced Relapse but No Quality-of-Life Benefit With ATRA/Arsenic Trioxide vs ATRA/Idarubicin in Acute Promyelocytic Leukemia

In a UK-based phase III trial (AML17) reported in The Lancet Oncology, Burnett et al found that a chemotherapy-free regimen of arsenic trioxide plus all-trans retinoic acid (ATRA) did not improve quality of life, the primary endpoint, vs ATRA plus idarubicin in patients with acute promyelocytic...

cns cancers
supportive care

Telotristat Etiprate Shows Clinical Benefit in Treating Carcinoid Syndrome in Cancer Patients When Added to Standard of Care

Lexicon Pharmaceuticals, Inc's telotristat etiprate was shown to have clinical benefit in treating carcinoid syndrome in cancer patients not adequately controlled by long-acting somatostatin analog therapy, the current standard of care, according to data from the phase III TELESTAR study presented...

cns cancers
cns cancers

ASTRO 2015: Pediatric Patients With Ependymoma Have Favorable Outcomes With Immediate Postsurgical Radiation Therapy

Outcomes for pediatric patients as young as 12 months old with ependymoma who are treated with immediate postoperative radiation therapy are favorable and consistent, based upon tumor surgical resection and tumor grade, according to research presented by Merchant et al (Abstract 1) on October...

cns cancers

ASTRO 2015: Patients With Intermediate-Risk Meningiomas Who Receive Postoperative Radiotherapy Have a 96% 3-Year Progression-Free Survival

Patients with intermediate meningiomas treated with radiation therapy after surgery experienced a 96% 3-year progression-free survival rate and had minimal adverse events, according to research presented by Rogers et al October 21, 2015, at the American Society for Radiation Oncology’s...

cns cancers

Targeted Chemotherapy Shows Early Signs of Slowing Neuroblastoma Tumor Growth With Less Toxicity in Preclinical Models

Surviving neuroblastoma as a child can come with just as many challenges as the cancer itself, mainly because of the toxic effects of chemotherapy. But a team of surgeons is in the nascent stages of developing a more targeted, less toxic method of treating neuroblastoma patients with chemotherapy....

cns cancers

No Difference in Outcomes With Short-Course vs Longer-Course Radiotherapy in Elderly or Frail Patients With Newly Diagnosed Glioblastoma

In a noninferiority phase III trial reported in the Journal of Clinical Oncology, Roa et al found no difference in overall survival, progression-free survival, or quality of life between short-course and longer-course radiotherapy in elderly or frail patients with newly diagnosed glioblastoma...

cns cancers

FDA Approves Expanded Indication for Medical Device to Treat Newly Diagnosed Glioblastoma Multiforme

The U.S. Food and Drug Administration (FDA) today approved an expanded indication for the Optune tumor treating fields device to treat patients with newly diagnosed glioblastoma multiforme. It is given along with the chemotherapy drug temozolomide following standard treatments that include...

solid tumors
lung cancer
cns cancers

ECC 2015: Lung and Gastrointestinal Neuroendocrine Tumors and Results From the RADIANT-4 Trial

An international team of researchers has shown that the use of the mTOR inhibitor everolimus can delay tumor growth among both gastrointestinal and lung neuroendocrine tumors. This is particularly important for patients with lung tumors, the researchers say, because there is currently no approved...

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