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Book ; Online ; E-Book: Central nervous system metastases

Ramakrishna, Rohan / Magge, Rajiv S. / Baaj, Ali A. / Knisely, Jonathan P. S.

diagnosis and treatment

2020

Author's details	Rohan Ramakrishna, Rajiv S. Magge, Ali A. Baaj, Jonathan P. S. Knisely editors
Keywords	Electronic books
Language	English
Size	1 Online-Ressource (xxv, 734 Seiten), Illustrationen, Diagramme
Publisher	Springer
Publishing place	Cham
Publishing country	Switzerland
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT020519948
ISBN	978-3-030-42958-4 ; 9783030429577 ; 3-030-42958-X ; 3030429571
DOI	10.1007/978-3-030-42958-4
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Mechanisms of EGFR Resistance in Glioblastoma.

Pan, Peter C / Magge, Rajiv S

International journal of molecular sciences

2020 Volume 21, Issue 22

Abstract: Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Despite numerous efforts to target epidermal growth factor receptor (EGFR), commonly dysregulated in GBM, approaches directed against EGFR have not achieved the same degree of ...

Abstract	Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Despite numerous efforts to target epidermal growth factor receptor (EGFR), commonly dysregulated in GBM, approaches directed against EGFR have not achieved the same degree of success as seen in other tumor types, particularly as compared to non-small cell lung cancer (NSCLC). EGFR alterations in glioblastoma lie primarily in the extracellular domain, unlike the kinase domain alterations seen in NSCLC. Small molecule inhibitors are difficult to develop for the extracellular domain. Monoclonal antibodies can be developed to target the extracellular domain but must contend with the blood brain barrier (BBB). We review the role of EGFR in GBM, the history of trialed treatments, and the potential paths forward to target the pathway that may have greater success.
MeSH term(s)	Animals ; Antibodies, Monoclonal/metabolism ; Blood-Brain Barrier/metabolism ; Brain Neoplasms/metabolism ; Carcinoma, Non-Small-Cell Lung/metabolism ; ErbB Receptors/metabolism ; Glioblastoma/metabolism ; Humans ; Lung Neoplasms/metabolism ; Signal Transduction/physiology
Chemical Substances	Antibodies, Monoclonal ; ErbB Receptors (EC 2.7.10.1)
Language	English
Publishing date	2020-11-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms21228471
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Article ; Online: Scientific and Clinical Challenges within Neuro-Oncology.

Barbaro, Marissa / Fine, Howard A / Magge, Rajiv S

World neurosurgery

2021 Volume 151, Page(s) 402–410

Abstract: Both primary and metastatic brain tumors carry poor prognoses despite modern advances in medical therapy, radiation therapy, and surgical techniques. Gliomas, including glioblastoma (GBM), are particularly difficult to treat, and high-grade gliomas have ... ...

Abstract	Both primary and metastatic brain tumors carry poor prognoses despite modern advances in medical therapy, radiation therapy, and surgical techniques. Gliomas, including glioblastoma (GBM), are particularly difficult to treat, and high-grade gliomas have poor outcomes. Treatment of brain tumors involves a unique set of scientific and clinical challenges, which are often not present in the treatment of systemic malignancies. With respect to scientific challenges, the anatomy and physiology of brain tumors (including the blood-brain barrier, blood-tumor barrier, and blood-cerebrospinal fluid barrier) prevent adequate drug delivery into the central nervous system. The unique nature of the immune system in the central nervous system as well as the immunosuppressive microenvironment of tumors such as GBM also create therapeutic roadblocks in the treatment of brain tumors. Tumor heterogeneity, particularly in GBM, has classically been believed to contribute to multitherapy resistance; however, recent data suggest that this may not be the case. Clinical challenges include neurologic and medical comorbidities of patients with brain tumor, as well as potential toxicity of tumor-directed treatment. Clinical trials investigating new treatment paradigms are needed, but several roadblocks exist to good and promising clinical trial availability.
MeSH term(s)	Brain Neoplasms/therapy ; Humans ; Medical Oncology/methods ; Neurology/methods
Language	English
Publishing date	2021-02-18
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2021.01.151
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Article ; Online: Innovations in Neuro-Oncology.

Magge, Rajiv S / Barbaro, Marissa / Fine, Howard A

World neurosurgery

2021 Volume 151, Page(s) 386–391

Abstract: Although outcomes for many brain tumors, especially glioblastomas, remain poor, there have been significant advances in clinical and scientific understanding of neuro-oncologic disease. Tumor molecular profiling has become a critical component of ... ...

Abstract	Although outcomes for many brain tumors, especially glioblastomas, remain poor, there have been significant advances in clinical and scientific understanding of neuro-oncologic disease. Tumor molecular profiling has become a critical component of clinical practice, allowing more accurate pathologic diagnosis and enhanced clarity of the pathogenesis of both primary and metastatic brain tumors. The development of cerebral organoids carries exciting potential to provide representative models of tumor growth and potential drug efficacy, while new radiology techniques continue to improve clinical decision making. New adaptive trial platforms have been developed to rapidly test therapies and biomarkers with good scientific rationale. Lastly, growth and development of neuro-oncology clinical care teams aim to further improve patients' outcomes and symptoms, especially at the end of life.
MeSH term(s)	Animals ; Brain Neoplasms ; Humans ; Medical Oncology/methods ; Medical Oncology/trends ; Molecular Biology/methods ; Molecular Biology/trends ; Neurology/methods ; Neurology/trends
Language	English
Publishing date	2021-07-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2021.02.093
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Article ; Online: Foundations of Neuro-Oncology: A Multidisciplinary Approach.

Barbaro, Marissa / Fine, Howard A / Magge, Rajiv S

World neurosurgery

2021 Volume 151, Page(s) 392–401

Abstract: Neuro-oncology is a branch of medicine focused on the diagnosis and treatment of primary and secondary tumors of the nervous system as well as the neurologic complications of cancer and cancer treatments. In practice, neuro-oncologists require an ... ...

Abstract	Neuro-oncology is a branch of medicine focused on the diagnosis and treatment of primary and secondary tumors of the nervous system as well as the neurologic complications of cancer and cancer treatments. In practice, neuro-oncologists require an intimate knowledge of the neurologic presentation and management of central nervous system tumors, including gliomas, meningiomas, primary central nervous system lymphoma, metastases to the nervous system, and others. The mainstays of treatment for most nervous system tumors include surgical intervention, radiation therapy, and medical treatment with chemotherapy, immunotherapy, and/or targeted therapy. Interdisciplinary collaboration is thus critical to neuro-oncology. The prognosis for many central nervous system tumors, including gliomas and brain metastases, is often poor despite the advent of novel medical therapies. Efforts to develop more effective therapies are ongoing, and patient enrollment in clinical trials assessing the efficacy of new treatments is crucial to improve outcomes.
MeSH term(s)	Central Nervous System Neoplasms ; Humans ; Medical Oncology ; Neurology
Language	English
Publishing date	2021-02-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2021.02.059
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Article ; Online: Molecular Pathogenesis and Emerging Treatment for Glioblastoma.

Ramos, Alexander D / Magge, Rajiv S / Ramakrishna, Rohan

World neurosurgery

2018 Volume 116, Page(s) 495–504

Abstract: Glioblastoma is the most common primary malignant brain tumor, with more than10,000 new cases each year in the United States. Significant basic science and clinical research has been devoted to understanding this disease, yet median survival with ... ...

Abstract	Glioblastoma is the most common primary malignant brain tumor, with more than10,000 new cases each year in the United States. Significant basic science and clinical research has been devoted to understanding this disease, yet median survival with standard of care treatment remains approximately 15 months. Over the past decade, advances in genomic sequencing technology, biostatistics, and computing have allowed for an unprecedented ability to profile the gene expression patterns and mutations driving the formation of tumors. These advances have generated both prognostic information as well as a multitude of treatment targets that are just now coming into clinical practice. This article aims to provide a comprehensive update on the recent use of genetic profiling to identify the molecular pathways altered in glioblastoma and to describe ongoing clinical trials to exploit these pathways for treatment.
MeSH term(s)	Brain Neoplasms/diagnosis ; Brain Neoplasms/genetics ; Brain Neoplasms/pathology ; Epigenomics ; Glioblastoma/diagnosis ; Glioblastoma/genetics ; Glioblastoma/pathology ; Humans ; Mutation/genetics ; Pathology, Molecular/methods ; Signal Transduction/genetics ; Signal Transduction/physiology
Language	English
Publishing date	2018-07-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2018.04.021
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Article ; Online: Concurrent immunotherapy and re-irradiation utilizing stereotactic body radiotherapy for recurrent high-grade gliomas.

Mahase, Sean S / Roytman, Michelle / Roth O'Brien, Diana / Ivanidze, Jana / Schwartz, Theodore H / Pannullo, Susan C / Ramakrishna, Rohan / Magge, Rajiv S / Williams, Nicholas / Fine, Howard A / Chiang, Gloria Chia-Yi / Knisely, Jonathan P S

Cancer reports (Hoboken, N.J.)

2023 Volume 6, Issue 7, Page(s) e1788

Abstract: Background: Clinical trials evaluating immune checkpoint inhibition (ICI) in recurrent high-grade gliomas (rHGG) report 7%-20% 6-month progression-free survival (PFS), while re-irradiation demonstrates 28%-39% 6-month PFS.: Aims: We evaluate outcomes ...

Abstract	Background: Clinical trials evaluating immune checkpoint inhibition (ICI) in recurrent high-grade gliomas (rHGG) report 7%-20% 6-month progression-free survival (PFS), while re-irradiation demonstrates 28%-39% 6-month PFS. Aims: We evaluate outcomes of patients treated with ICI and concurrent re-irradiation utilizing stereotactic body radiotherapy/fractionated stereotactic radiosurgery (SBRT) compared to ICI monotherapy. Methods and results: Patients ≥18-years-old with rHGG (WHO grade III and IV) receiving ICI + SBRT or ICI monotherapy between January 1, 2016 and January 1, 2019 were included. Adverse events, 6-month PFS and overall survival (OS) were assessed. Log-rank tests were used to evaluate PFS and OS. Histogram analyses of apparent diffusion coefficient maps and dynamic contrast-enhanced magnetic resonance perfusion metrics were performed. Twenty-one patients with rHGG (ICI + SBRT: 16; ICI: 5) were included. The ICI + SBRT and ICI groups received a mean 7.25 and 6.2 ICI cycles, respectively. There were five grade 1, one grade 2 and no grade 3-5 AEs in the ICI + SBRT group, and four grade 1 and no grade 2-5 AEs in the ICI group. Median PFS was 2.85 and 1 month for the ICI + SBRT and ICI groups; median OS was 7 and 6 months among ICI + SBRT and ICI groups, respectively. There were significant differences in pre and posttreatment tumor volume in the cohort (12.35 vs. 20.51; p = .03), but not between treatment groups. Conclusions: In this heavily pretreated cohort, ICI with re-irradiation utilizing SBRT was well tolerated. Prospective studies are warranted to evaluate potential therapeutic benefits to re-irradiation with ICI + SBRT in rHGG.
MeSH term(s)	Humans ; Adolescent ; Radiosurgery/adverse effects ; Radiosurgery/methods ; Re-Irradiation/adverse effects ; Re-Irradiation/methods ; Glioma/pathology ; Progression-Free Survival ; Immunotherapy
Language	English
Publishing date	2023-02-07
Publishing country	United States
Document type	Journal Article
ISSN	2573-8348
ISSN (online)	2573-8348
DOI	10.1002/cnr2.1788
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Article ; Online: [Ga68] DOTATATE PET/MRI-Guided Radiosurgical Treatment Planning and Response Assessment in Meningiomas.

Ivanidze, Jana / Chang, Se Jung / Haghdel, Arsalan / Kim, Joon Tae / RoyChoudhury, Arindam / Wu, Alan / Ramakrishna, Rohan / Schwartz, Theodore H / Cisse, Babacar / Stieg, Philip / Muller, Leland / Osborne, Joseph R / Magge, Rajiv S / Karakatsanis, Nicolas A / Roytman, Michelle / Lin, Eaton / Pannullo, Susan C / Palmer, Joshua D / Knisely, Jonathan P S

Neuro-oncology

2024

Abstract: Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery.: Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and ...

Abstract	Background: Our purpose was to determine the utility of [68Ga]-DOTATATE PET/MRI in meningioma response assessment following radiosurgery. Methods: Patients with meningioma prospectively underwent postoperative DOTATATE PET/MRI. Co-registered PET and gadolinium-enhanced T1-weighted MRI were employed for radiosurgery planning. Follow-up DOTATATE PET/MRI was performed at 6-12 months post radiosurgery. Maximum absolute standardized uptake value (SUV) and SUV ratio (SUVRSSS) referencing superior sagittal sinus (SSS) blood pool were obtained. Size change was determined by Response Assessment in Neuro-Oncology (RANO) criteria. Association of SUVRSSS change magnitude and PFS was evaluated using Cox regression. Results: 27 patients with 64 tumors (26% WHO-1, 41% WHO-2, 26% WHO-3, 7% WHO-unknown) were prospectively followed post stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT) (mean dose: 30 Gy, modal dose 35 Gy, mean of 5 fractions). Post-irradiation SUV and SUVRSSS decreased by 37.4% and 44.4%, respectively (p < 0.0001). Size product decreased by 8.9%, thus failing to reach the 25% significance threshold as determined by RANO guidelines. Mean follow-up time was 26 months (range: 6-44). Overall mean PFS was 83% and 100%/100%/54% in WHO-1/-2/-3 subcohorts, respectively, at 34 months. At maximum follow-up (42-44 months), PFS was 100%/83%/54% in WHO-1/-2/-3 subcohorts, respectively. Cox regression analyses revealed a hazard ratio of 0.48 for 10-unit reduction in SUVRSSS in the SRS cohort. Conclusions: DOTATATE PET SUV and SUVRSSS demonstrated marked, significant decrease post radiosurgery. Lesion size decrease was statistically significant, however it was not clinically significant by RANO criteria. DOTATATE PET/MR thus represents a promising imaging biomarker for response assessment in meningiomas treated with radiosurgery.
Language	English
Publishing date	2024-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2028601-6
ISSN	1523-5866 ; 1522-8517
ISSN (online)	1523-5866
ISSN	1522-8517
DOI	10.1093/neuonc/noae067
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Article ; Online: DOTATATE PET/MR Imaging Differentiates Secondary-Progressive from de Novo World Health Organization Grade 3 Meningiomas.

Kim, Joon Tae / Chang, Se Jung Chris / Haghdel, Arsalan / Ramakrishna, Rohan R / Pannullo, Susan C / Schwartz, Theodore H / Osborne, Joseph R / Magge, Rajiv S / Fine, Howard A / Cisse, Babacar / Stieg, Philip / Lin, Eaton / Roytman, Michelle / Palmer, Joshua D / Karakatsanis, Nicolas A / Pisapia, David / Liechty, Benjamin / Knisely, Jonathan P S / Ivanidze, Jana

AJNR. American journal of neuroradiology

2024

Abstract: Background and purpose: WHO grade 3 meningiomas are rare and poorly understood and have a higher propensity for recurrence, metastasis, and worsened clinical outcomes compared with lower-grade meningiomas. The purpose of our study was to prospectively ... ...

Abstract	Background and purpose: WHO grade 3 meningiomas are rare and poorly understood and have a higher propensity for recurrence, metastasis, and worsened clinical outcomes compared with lower-grade meningiomas. The purpose of our study was to prospectively evaluate the molecular profile, PET characteristics, and outcomes of patients with World Health Organization grade 3 meningiomas who were imaged with gallium 68 ( Materials and methods: Patients with World Health Organization grade 3 meningiomas enrolled in our prospective observational cohort evaluating the utility of ( Results: Patients met the inclusion criteria (secondary-progressive: 7/14; de novo: 7/14). The secondary-progressive cohort had a significantly higher per-patient number of surgeries (4.1 versus 1.6; Conclusions: Our study confirms prior work illustrating distinct clinical outcomes in secondary-progressive and de novo World Health Organization grade 3 meningiomas. Furthermore, our findings support (
Language	English
Publishing date	2024-04-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	603808-6
ISSN	1936-959X ; 0195-6108
ISSN (online)	1936-959X
ISSN	0195-6108
DOI	10.3174/ajnr.A8219
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Article ; Online: Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [

Kim, Sean H / Roytman, Michelle / Madera, Gabriela / Magge, Rajiv S / Liechty, Benjamin / Ramakrishna, Rohan / Pannullo, Susan C / Schwartz, Theodore H / Karakatsanis, Nicolas A / Osborne, Joseph R / Lin, Eaton / Knisely, Jonathan P S / Ivanidze, Jana

Scientific reports

2022 Volume 12, Issue 1, Page(s) 9256

Abstract: Multiple approaches with [ ...

Abstract	Multiple approaches with [
MeSH term(s)	Gallium Radioisotopes ; Humans ; Magnetic Resonance Imaging/methods ; Meningeal Neoplasms/diagnostic imaging ; Meningeal Neoplasms/drug therapy ; Meningioma/diagnostic imaging ; Organometallic Compounds/therapeutic use ; Positron-Emission Tomography/methods ; Radionuclide Imaging ; Radiopharmaceuticals
Chemical Substances	Gallium Radioisotopes ; Organometallic Compounds ; Radiopharmaceuticals ; copper dotatate CU-64
Language	English
Publishing date	2022-06-03
Publishing country	England
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-13467-9
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