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Article ; Online: Moving the Pendulum for Glioblastoma Treatment: One Injection at a Time.

Wu, Xizi / Alvarez-Breckenridge, Christopher

2023 Volume 28, Issue 8, Page(s) 651–653

MeSH term(s)	Humans ; Glioblastoma/drug therapy
Language	English
Publishing date	2023-05-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1409038-7
ISSN	1549-490X ; 1083-7159
ISSN (online)	1549-490X
ISSN	1083-7159
DOI	10.1093/oncolo/oyad104
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Zs.A 4845: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Trabectedin for recurrent WHO grade 2 or 3 meningiomas-Paving the road for new opportunities.

Alvarez-Breckenridge, Christopher A / Cahill, Daniel P / Brastianos, Priscilla K

Neuro-oncology

2022 Volume 24, Issue 5, Page(s) 768–769

MeSH term(s)	Brain Neoplasms ; Humans ; Meningeal Neoplasms/drug therapy ; Meningioma/drug therapy ; Meningioma/pathology ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Trabectedin/therapeutic use ; World Health Organization
Chemical Substances	Trabectedin (ID0YZQ2TCP)
Language	English
Publishing date	2022-02-02
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2028601-6
ISSN	1523-5866 ; 1522-8517
ISSN (online)	1523-5866
ISSN	1522-8517
DOI	10.1093/neuonc/noac017
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Zs.A 5307: Show issues

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Article ; Online: The Use of Skin Staples as Fiducial Markers to Confirm Intraoperative Spinal Navigation Registration and Accuracy.

Alvarez-Breckenridge, Christopher / Muir, Matthew / Rhines, Laurence D / Tatsui, Claudio E

Operative neurosurgery (Hagerstown, Md.)

2021 Volume 21, Issue 3, Page(s) E193–E198

Abstract: Background: With the advent of intraoperative computed tomography (CT) for image guidance, numerous examples of accurate navigation being applied to cranial and spinal pathology have come to light. For spinal disorders, the utilization of image guidance ...

Abstract	Background: With the advent of intraoperative computed tomography (CT) for image guidance, numerous examples of accurate navigation being applied to cranial and spinal pathology have come to light. For spinal disorders, the utilization of image guidance for the placement of percutaneous spinal instrumentation, complex osteotomies, and minimally invasive approaches are frequently utilized in trauma, degenerative, and oncological pathologies. The use of intraoperative CT for navigation, however, requires a low target registration error that must be verified throughout the procedure to confirm the accuracy of image guidance. Objective: To present the use of skin staples as a sterile, economical fiducial marker for minimally invasive spinal procedures requiring intraoperative CT navigation. Methods: Staples are applied to the skin prior to obtaining the registration CT scan and maintained throughout the remainder of the surgery to facilitate confirmation of image guidance accuracy. Results: This low-cost, simple, sterile approach provides surface landmarks that allow reliable verification of navigation accuracy during percutaneous spinal procedures using intraoperative CT scan image guidance. Conclusion: The utilization of staples as a fiducial marker represents an economical and easily adaptable technique for ensuring accuracy of image guidance with intraoperative CT navigation.
MeSH term(s)	Fiducial Markers ; Humans ; Neurosurgical Procedures ; Spinal Diseases/surgery ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-06-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2767575-0
ISSN	2332-4260 ; 2332-4252
ISSN (online)	2332-4260
ISSN	2332-4252
DOI	10.1093/ons/opab132
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Article ; Online: Tumor Immune Microenvironment of Brain Metastases: Toward Unlocking Antitumor Immunity.

Strickland, Matthew R / Alvarez-Breckenridge, Christopher / Gainor, Justin F / Brastianos, Priscilla K

Cancer discovery

2022 Volume 12, Issue 5, Page(s) 1199–1216

Abstract: Brain metastasis (BrM) is a devastating complication of solid tumors associated with poor outcomes. Immune-checkpoint inhibitors (ICI) have revolutionized the treatment of cancer, but determinants of response are incompletely understood. Given the rising ...

Abstract	Brain metastasis (BrM) is a devastating complication of solid tumors associated with poor outcomes. Immune-checkpoint inhibitors (ICI) have revolutionized the treatment of cancer, but determinants of response are incompletely understood. Given the rising incidence of BrM, improved understanding of immunobiologic principles unique to the central nervous system (CNS) and dissection of those that govern the activity of ICIs are paramount toward unlocking BrM-specific antitumor immunity. In this review, we seek to discuss the current clinical landscape of ICI activity in the CNS and CNS immunobiology, and we focus, in particular, on the role of glial cells in the CNS immune response to BrM. Significance: There is an urgent need to improve patient selection for and clinical activity of ICIs in patients with cancer with concomitant BrM. Increased understanding of the unique immunobiologic principles that govern response to ICIs in the CNS is critical toward identifying targets in the tumor microenvironment that may potentiate antitumor immunity.
MeSH term(s)	Brain Neoplasms ; Humans ; Immune Checkpoint Inhibitors ; Tumor Microenvironment
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2022-04-08
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2625242-9
ISSN	2159-8290 ; 2159-8274
ISSN (online)	2159-8290
ISSN	2159-8274
DOI	10.1158/2159-8290.CD-21-0976
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Article: Spinal Metastases and the Evolving Role of Molecular Targeted Therapy, Chemotherapy, and Immunotherapy.

Fomchenko, Elena I / Bayley, James C / Alvarez-Breckenridge, Christopher / Rhines, Laurence D / Tatsui, Claudio E

Neurospine

2022 Volume 19, Issue 4, Page(s) 978–993

Abstract: Metastatic involvement of the spine is a common complication of systemic cancer progression. Surgery and external beam radiotherapy are palliative treatment modalities aiming to preserve neurological function, control pain and maintain functional status. ...

Abstract	Metastatic involvement of the spine is a common complication of systemic cancer progression. Surgery and external beam radiotherapy are palliative treatment modalities aiming to preserve neurological function, control pain and maintain functional status. More recently, with development of image guidance and stereotactic delivery of high doses of conformal radiation, local tumor control has improved; however recurrent or radiation refractory disease remains a significant clinical problem with limited treatment options. This manuscript represents a narrative overview of novel targeted molecular therapies, chemotherapies, and immunotherapy treatments for patients with breast, lung, melanoma, renal cell, prostate, and thyroid cancers, which resulted in improved responses compared to standard chemotherapy. We present clinical examples of excellent responses in spinal metastatic disease which have not been specifically documented in the literature, as most clinical trials evaluate treatment response based on visceral disease. This review is useful for the spine surgeons treating patients with metastatic disease as knowledge of these responses could help with timing and planning of surgical interventions, as well as promote multidisciplinary discussions, allowing development of an individualized treatment strategy to patients presenting with widespread multifocal progressive disease, where surgery could lead to suboptimal results.
Language	English
Publishing date	2022-12-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3031654-6
ISSN	2586-6591 ; 2586-6583
ISSN (online)	2586-6591
ISSN	2586-6583
DOI	10.14245/ns.2244290.145
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Article: Carbon Fiber-Reinforced Polyetheretherketone Spinal Implants for Treatment of Spinal Tumors: Perceived Advantages and Limitations.

Alvarez-Breckenridge, Christopher / de Almeida, Romulo / Haider, Ali / Muir, Matthew / Bird, Justin / North, Robert / Rhines, Laurence / Tatsui, Claudio

Neurospine

2023 Volume 20, Issue 1, Page(s) 317–326

Abstract: Purpose: Carbon-fiber reinforced polyetheretherketone (CFRP)-based spinal implants are an alternative to titanium, offering less image artifact as their metallic counterparts while maintaining similar biomechanical and biocompatibility properties. Its ... ...

Abstract	Purpose: Carbon-fiber reinforced polyetheretherketone (CFRP)-based spinal implants are an alternative to titanium, offering less image artifact as their metallic counterparts while maintaining similar biomechanical and biocompatibility properties. Its use in the management of spinal tumors has been reported, however the perceived advantages related to improved imaging quality, radiation treatment planning, and detection of tumor recurrence have not been fully assessed. Methods: We performed a retrospective review of medical records amongst oncologic patients treated at MD Anderson Cancer Center with CFRP implants. Histology, tumor location, construct features, time of follow-up, adjuvant radiation, recurrences, overall survival, and hardware-related complications were recorded. Results: Sixty-nine consecutive patients were assessed (22 primary tumors, 47 metastases) and the median time for follow-up was 5.4 months. Amongst the cohort, a total of 491 CFRP pedicle screws were implanted. Hardware complications were observed in 5 cases (7.04%). Adjuvant radiation was completed in 8 patients with primary tumors and 29 patients with spinal metastases. A total of 28 patients (40.5%) from the combined primary and metastatic cohorts experienced systemic disease progression, with 12 patients (17.3%) demonstrating local recurrences. Amongst primary and metastatic tumors, overall survival (p = 0.363) and rate of local recurrence (p = 0.112) were similar. Conclusion: This largest series of CFRP implants demonstrates safe and effective spinal stabilization for patients with both primary and metastatic tumors. Enhanced postoperative imaging led to minimal imaging artifacts which facilitated postoperative radiation planning and the ability to detect local recurrence.
Language	English
Publishing date	2023-03-31
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	3031654-6
ISSN	2586-6591 ; 2586-6583
ISSN (online)	2586-6591
ISSN	2586-6583
DOI	10.14245/ns.2244920.460
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Article ; Online: In Reply: Congress of Neurological Surgeons Systematic Review and Evidence-Based Practice Guidelines on the Role of Surgery in the Management of Adults With Metastatic Brain Tumors.

Alvarez-Breckenridge, Christopher / Nahed, Brian V

Neurosurgery

2019 Volume 85, Issue 3, Page(s) E618

MeSH term(s)	Brain Neoplasms ; Evidence-Based Practice ; Humans ; Neurosurgeons
Language	English
Publishing date	2019-08-02
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyz235
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 539: Show issues

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Article ; Online: Tumor treating fields suppress tumor cell growth and neurologic decline in models of spinal metastases.

Ledbetter, Daniel / de Almeida, Romulo Augusto Andrade / Wu, Xizi / Naveh, Ariel / Patel, Chirag B / Gonzalez, Queena / Beckham, Thomas H / North, Robert / Rhines, Laurence / Li, Jing / Ghia, Amol / Aten, David / Tatsui, Claudio / Alvarez-Breckenridge, Christopher

JCI insight

2024 Volume 9, Issue 9

Abstract: Spinal metastases can result in severe neurologic compromise and decreased overall survival. Despite treatment advances, local disease progression is frequent, highlighting the need for novel therapies. Tumor treating fields (TTFields) impair tumor cell ... ...

Abstract	Spinal metastases can result in severe neurologic compromise and decreased overall survival. Despite treatment advances, local disease progression is frequent, highlighting the need for novel therapies. Tumor treating fields (TTFields) impair tumor cell replication and are influenced by properties of surrounding tissue. We hypothesized that bone's dielectric properties will enhance TTFields-mediated suppression of tumor growth in spinal metastasis models. Computational modeling of TTFields intensity was performed following surgical resection of a spinal metastasis and demonstrated enhanced TTFields intensity within the resected vertebral body. Additionally, luciferase-tagged human KRIB osteosarcoma and A549 lung adenocarcinoma cell lines were cultured in demineralized bone grafts and exposed to TTFields. Following TTFields exposure, the bioluminescence imaging (BLI) signal decreased to 10%-80% of baseline, while control cultures displayed a 4.48- to 9.36-fold increase in signal. Lastly, TTFields were applied in an orthotopic murine model of spinal metastasis. After 21 days of treatment, control mice demonstrated a 5-fold increase in BLI signal compared with TTFields-treated mice. TTFields similarly prevented tumor invasion into the spinal canal and development of neurologic symptoms. Our data suggest that TTFields can be leveraged as a local therapy within minimally conductive bone of spinal metastases. This provides the groundwork for future studies investigating TTFields for patients with treatment-refractory spinal metastases.
MeSH term(s)	Animals ; Humans ; Mice ; Spinal Neoplasms/secondary ; Spinal Neoplasms/therapy ; Cell Line, Tumor ; Lung Neoplasms/secondary ; Lung Neoplasms/pathology ; Lung Neoplasms/therapy ; Cell Proliferation ; Disease Models, Animal ; Osteosarcoma/pathology ; Osteosarcoma/therapy ; Female ; A549 Cells ; Xenograft Model Antitumor Assays
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ISSN	2379-3708
ISSN (online)	2379-3708
DOI	10.1172/jci.insight.176962
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Article ; Online: Emerging Systemic Treatment Perspectives on Brain Metastases: Moving Toward a Better Outlook for Patients.

Alvarez-Breckenridge, Christopher / Remon, Jordi / Piña, Yolanda / Nieblas-Bedolla, Edwin / Forsyth, Peter / Hendriks, Lizza / Brastianos, Priscilla K

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

2022 Volume 42, Page(s) 1–19

Abstract: The diagnosis of brain metastases has historically been a dreaded, end-stage complication of systemic disease. Additionally, with the increasing effectiveness of systemic therapies that prolong life expectancy and improved imaging tools, the incidence of ...

Abstract	The diagnosis of brain metastases has historically been a dreaded, end-stage complication of systemic disease. Additionally, with the increasing effectiveness of systemic therapies that prolong life expectancy and improved imaging tools, the incidence of intracranial progression is becoming more common. Within this context, there has been increasing attention directed at understanding the molecular underpinnings of intracranial progression. Exploring the unique features of brain metastases compared with their extracranial counterparts to identify aberrant signaling pathways, which can be targeted pharmacologically, may help lead to new treatments for this patient population. Additionally, critical discoveries outside the sphere of the central nervous system are increasingly being applied to brain metastases with the emergence of immune checkpoint inhibition, becoming a prevalent treatment option for patients with brain metastases across multiple histologies. As novel treatment strategies are considered, they require thoughtful incorporation of agents that can cross the blood-brain barrier and can synergize with pre-existing agents through rational combinations. Lastly, as clinicians and scientists continue to understand key molecular features of these tumors, they will continue to influence the treatment algorithms that are developing for the management of these patients. Due to the complexity of treatment decisions for patients with brain metastases, an emerging tool is the utilization of multidisciplinary brain metastasis tumor boards to ensure optimal treatment decisions are made and that patients are provided access to applicable clinical trials. Looking to the future, the collective effort to understand the various tumor-intrinsic and tumor-extrinsic factors that promote central nervous system seeding and propagation will have the potential to change the clinical trajectory for these patients.
MeSH term(s)	Brain Neoplasms/drug therapy ; Brain Neoplasms/secondary ; Humans ; Immune Checkpoint Inhibitors
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2022-05-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2431126-1
ISSN	1548-8756 ; 1548-8748
ISSN (online)	1548-8756
ISSN	1548-8748
DOI	10.1200/EDBK_352320
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Article ; Online: Definitive single fraction spine stereotactic radiosurgery for metastatic sarcoma: Simultaneous integrated boost is associated with high tumor control and low vertebral fracture risk.

Shanker, Mihir D / Cavazos, Adriana P / Li, Jing / Beckham, Thomas H / Yeboa, Debra N / Wang, Chenyang / McAleer, Mary Frances / Briere, Tina Marie / Amini, Behrang / Tatsui, Claudio E / North, Robert Y / Alvarez-Breckenridge, Christopher A / Cezayirli, Phillip Cem / Rhines, Laurence D / Ghia, Amol J / Bishop, Andrew J

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

2024 Volume 193, Page(s) 110119

Abstract: Introduction: Sarcoma spinal metastases (SSM) are particularly difficult to manage given their poor response rates to chemotherapy and inherent radioresistance. We evaluated outcomes in a cohort of patients with SSM uniformly treated using single- ... ...

Abstract	Introduction: Sarcoma spinal metastases (SSM) are particularly difficult to manage given their poor response rates to chemotherapy and inherent radioresistance. We evaluated outcomes in a cohort of patients with SSM uniformly treated using single-fraction simultaneous-integrated-boost (SIB) spine stereotactic radiosurgery (SSRS). Materials and methods: A retrospective review was conducted at a single tertiary institution treated with SSRS for SSM between April 2007-April 2023. 16-24 Gy was delivered to the GTV and 16 Gy uniformly to the CTV. Kaplan-Meier analysis was conducted to assess time to progression of disease (PD) with proportionate hazards modelling used to determine hazard ratios (HR) and respective 95 % confidence intervals (CI). Results: 70 patients with 100 lesions underwent SSRS for SSM. Median follow-up was 19.3 months (IQR 7.7-27.8). Median age was 55 years (IQR42-63). Median GTV and CTVs were 14.5 cm Conclusion: This study represents one of the most homogenously treated and the largest cohorts of patients with SSM treated with single-fraction SSRS. Despite inherent radioresistance, SSRS confers durable and high rates of local control in SSM without unexpected long-term toxicity rates.
MeSH term(s)	Humans ; Middle Aged ; Radiosurgery/adverse effects ; Spinal Fractures/etiology ; Fractures, Compression/etiology ; Spinal Neoplasms/radiotherapy ; Spinal Neoplasms/secondary ; Neoplasm Recurrence, Local/surgery ; Sarcoma/radiotherapy ; Sarcoma/surgery ; Retrospective Studies ; Neoplasms, Second Primary/etiology
Language	English
Publishing date	2024-02-03
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	605646-5
ISSN	1879-0887 ; 0167-8140
ISSN (online)	1879-0887
ISSN	0167-8140
DOI	10.1016/j.radonc.2024.110119
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