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Lisa M. DeAngelis, MD, and Ingo K. Mellinghoff, MD, both of Memorial Sloan Kettering Cancer Center, discuss findings from the INDIGO trial showing that the IDH1/2 inhibitor vorasidenib improves progression-free survival for patients with residual or recurrent grade 2 glioma with an IDH1/2 mutation. These data demonstrate the clinical benefit of vorasidenib in this patient population for whom chemotherapy and radiotherapy are being delayed.
Louis B. Nabors, MD, of the O’Neal Comprehensive Cancer Center at UAB, discusses the three subtypes of adult gliomas classified by the World Health Organization, treatments influenced by IDH mutation status, the roles of radiotherapy and chemotherapy, molecular testing, and pseudoprogression and RANO (response assessment in neuro-oncology) criteria.
David Reardon, MD, of Dana-Farber Cancer Institute, discusses phase I/II results from the EOGBM1-18/ROSALIE study, which showed the EO2401 vaccine plus nivolumab generated systemic immune responses correlating with efficacy in patients with recurrent glioblastoma. Adding bevacizumab to this combination appeared to improve efficacy. (Abstract 642).
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).
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 tumor-selective radiosensitizer (Abstract 167).
Jeff M. Michalski, MD, MBA, of the Washington University School of Medicine, discusses a Children’s Oncology Group study that confirmed data previously reported: Involved-field radiotherapy is noninferior to posterior fossa radiotherapy in patients with average risk-medulloblastoma. However, low-dose craniospinal irradiation is not as effective as standard-dose irradiation in younger children (Abstract 1).
Vinai Gondi, MD, of Northwestern Medicine Cancer Center and Northwestern Medicine Proton Center, discusses the preliminary results of an NRG Oncology study of radiotherapy dose intensification using intensity-modulated radiotherapy vs standard-dose radiotherapy with temozolomide in patients with newly diagnosed glioblastoma (Abstract 42).
Erica H. Bell, PhD, of The Ohio State University, discusses phase III findings from a prognostic and predictive molecular subgroup analysis of radiotherapy vs radiotherapy plus procarbazine/lomustine/vincristine in high-risk low-grade gliomas (Abstract 161).
As reported in the Journal of Clinical Oncology by Twist et al, use of reduced therapy for subsets of pediatric patients with intermediate-risk neuroblastoma in the Children’s Oncology Group (COG) study ANBL0531 did not affect the excellent overall survival rates observed in prior COG studies ...
On June 28, the U.S. Food and Drug Administration (FDA) approved bevacizumab-bvzr (Zirabev), a biosimilar to bevacizumab (Avastin), for the treatment of five types of cancer: metastatic colorectal cancer; unresectable, locally advanced, recurrent, or metastatic nonsquamous non–small cell ...
Through a systematic review of published studies, researchers report they have identified a distinct subtype of primary central nervous system (PCNS) lymphoma that should be considered for surgical removal, suggesting a major shift in how this type of tumor is evaluated and managed. These findings...
Ahluwalia et al shared research results on SurVaxM at the 2019 ASCO Annual Meeting, reporting that combination therapy with the immunotherapy vaccine was more effective than standard therapy for nearly all patients with newly diagnosed glioblastoma in a phase II trial (Abstract 2016). SurVaxM...
A recent, updated predictive analysis of the three World Health Organization (WHO)-defined molecular subgroups based on IDH mutation status and 1p/19q codeletion status represented in the high-risk treatment arms of a phase III trial found that both IDH-mutant subgroups may derive benefit ...
In a phase II trial reported in The Lancet Oncology, Fangusaro et al found that the MEK1/2 inhibitor selumetinib was active in pediatric patients with recurrent, refractory, or progressive pilocytic astrocytoma with common BRAF aberrations and neurofibromatosis type 1...
Manmeet S. Ahluwalia, MD, of the Taussig Center Institute, Cleveland Clinic, discusses phase II findings on the efficacy and immunogenicity of SurVaxM, a novel cancer vaccine targeting the tumor-specific antigen survivin in newly diagnosed glioblastoma (Abstract 2016).
In a study reported in the Journal of Clinical Oncology, Olivier et al found that pediatric patients with severe sensorineural hearing loss associated with the treatment of embryonal brain tumors experienced greater reading difficulties over time. The study involved data from 260 children and...
This week, the U.S. Food and Drug Administration granted designations in relapsed or refractory multiple myeloma, adenoid cystic carcinoma, and Kaposi sarcoma; and the FDA’s Oncologic Drugs Advisory Committee (ODAC) held votes on treatments for tenosynovial giant cell tumor and acute...
A phase I/IB study evaluating the activity of entrectinib in children and adolescents with recurrent or refractory solid tumors, including central nervous system (CNS) tumors, has found that the agent produced responses in children with tumors harboring target aberrations...
A comparison of three types of radiotherapy for pediatric brain tumors suggests that a type of proton therapy called pencil-beam scanning (PBS) offers the best hope of preserving cognitive functions. The study, presented by Toussaint et al at ESTRO 38, the annual congress of the European Society...
This week, the U.S. Food and Drug Administration (FDA) granted designations for treatments for recurrent glioblastoma, neurofibromatosis type 1 and plexiform neurofibromas, multiple myeloma, and relapsed or refractory FLT3-ITD acute myeloid leukemia (AML). Fast Track Designation for Ad-RTS-hIL-12...
In a retrospective cohort study reported in JAMA Oncology, Cagney et al found that pachymeningeal seeding was fairly common after neurosurgical resection in patients with brain metastases treated with adjuvant stereotactic radiation. Study Details The study involved 1,188 consecutive patients...
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...
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...
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...
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.
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 ...
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...
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 ...
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...
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...
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...
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 ...
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...
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...
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 ...
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...
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...
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...
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...
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 ...
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...
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.
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,...
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...
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...
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...
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 ...
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...
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...
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,...