Article
Oncology
Valentina Borzillo, Rossella Di Franco, Diana Giannarelli, Fabrizio Cammarota, Esmeralda Scipilliti, Emma D'Ippolito, Angela Petito, Marcello Serra, Sara Falivene, Antonio M. Grimaldi, Ester Simeone, Lucia Festino, Vito Vanella, Claudia Trojaniello, Maria Grazia Vitale, Gabriele Madonna, Paolo A. Ascierto, Paolo Muto
Summary: Combining ipilimumab with stereotactic radiotherapy/radiosurgery could improve local control in patients with melanoma brain metastases. However, the impact and timing of these two methods on patients' outcomes are still unclear.
Review
Oncology
Raees Tonse, Martin C. Tom, Minesh P. Mehta, Manmeet S. Ahluwalia, Rupesh Kotecha
Summary: In modern times, brain metastasis requires multi-modal management and interdisciplinary care. Traditionally, treatment strategies have focused on local treatments alone due to limited efficacy of cytotoxic chemotherapy. However, with the availability of molecular-based therapies with central nervous system penetration, individualized selection of tailored systemic therapies can now be used alongside local treatments. Moreover, the introduction of immune checkpoint inhibitors has further revolutionized the management of brain metastasis patients.
Review
Oncology
Kelly H. Yoo, David J. Park, John H. Choi, Neelan J. Marianayagam, Michael Lim, Antonio Meola, Steven D. Chang
Summary: Solid tumors metastasizing to the brain are a common occurrence, and conventional treatments like surgical resection and whole-brain radiotherapy have limitations in long-term survival and local control outcomes. Stereotactic radiosurgery (SRS) has emerged as an alternative approach to improve control rates, and the use of high-dose radiation has sparked interest in eliciting antitumor immunity. The blood-brain barrier has traditionally posed a challenge to systemic therapy, but recent developments in immunotherapy show promise in managing intracranial metastasis.
FRONTIERS IN ONCOLOGY
(2023)
Review
Oncology
Eric J. Lehrer, Heather M. McGee, Jason P. Sheehan, Daniel M. Trifiletti
Summary: Traditional treatments for brain metastases such as surgery, whole-brain radiation therapy, and glucocorticoids have significant morbidity. However, stereotactic radiosurgery (SRS) has shown to be an effective alternative with improved quality of life when combined with immune checkpoint inhibitors (ICI). Further prospective studies are needed to validate the survival benefits of this combination therapy.
JOURNAL OF NEURO-ONCOLOGY
(2021)
Article
Oncology
Rodney E. Wegner, Stephen Abel, Randy S. D'Amico, Gautam U. Mehta, Jason Sheehan
Summary: Evidence suggests that receiving immunotherapy within 7 days of SRS treatment may be associated with improved survival rates in melanoma patients with brain metastases.
JOURNAL OF NEURO-ONCOLOGY
(2021)
Article
Oncology
Mehran Yusuf, Abbas Rattani, Jeremy Gaskins, Alexandria L. Oliver, Steven F. Mandish, Eric Burton, Michael E. May, Brian Williams, Dale Ding, Mayur Sharma, Donald Miller, Shiao Woo
Summary: The study aimed to investigate the impact of single-fraction stereotactic radiosurgery (SRS) on lesion control (LC) in small melanoma brain metastases (MBM) patients, and found that planning parameter peripheral dose per lesion diameter (PDLDm) predicted LC. Additionally, there was a differential effect of dose per lesion size and LC by immunotherapy receipt. Future studies are needed to explore the efficacy of lower doses of single-fraction SRS in small MBM patients receiving immunotherapy.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Review
Oncology
Alex W. Brenner, Akash J. Patel
Summary: Brain metastases, the most common intracranial tumors, can be diagnosed through clinical examination and magnetic resonance imaging. Treatment options include surgery, radiotherapy, and systemic medical therapy, and recent advancements have led to improved performance and survival rates. Whole brain radiotherapy and stereotactic radiosurgery are supported by extensive evidence, while modern immunotherapeutic agents show promise.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
J. A. Crouzen, A. L. Petoukhova, M. L. D. Broekman, M. Fiocco, U. J. Fisscher, J. H. Franssen, C. G. M. Gadellaa-van Hooijdonk, M. Kerkhof, M. Kiderlen, M. E. Mast, C. M. van Rij, R. Nandoe Tewarie, M. A. E. van de Sande, P. P. G. van der Toorn, R. Vlasman, M. J. Vos, N. C. M. G. van der Voort van Zyp, R. G. J. Wiggenraad, L. M. Wiltink, J. D. Zindler
Summary: A multicenter prospective randomized study aims to compare the incidence of adverse local events in patients with brain metastases using fractionated stereotactic radiosurgery (fSRS) versus stereotactic radiosurgery (SRS) in one or three fractions. The study aims to reduce the risk of radionecrosis and improve the effectiveness of brain metastases treatment.
Article
Oncology
Douglas Guedes de Castro, Carlos Henrique Andrade Teixeira, Guilherme Rocha Melo Gondim, Patricia Bailao Aguilar, Marcos Andre de Sa Barreto Costa, Thiago William Carnier Jorge, Rodrigo de Morais Hanriot
Summary: This real-world study evaluated the impact of cranial stereotactic radiotherapy (SRT) on the overall survival (OS) of melanoma brain metastases patients treated with combined nivolumab and ipilimumab (CNI). The results showed that CNI + SRT led to a significant improvement in OS compared to CNI.
CLINICAL & TRANSLATIONAL ONCOLOGY
(2022)
Article
Oncology
Amy Le, Homan Mohammadi, Toka Mohammed, Heather Burney, Yong Zang, Douglas Frye, Kevin Shiue, Tim Lautenschlaeger, James Miller
Summary: In patients with brain metastases, concurrent use of SRS and ICI can improve treatment efficacy and enhance distant brain control. However, prospective studies are needed to further confirm the impact of concurrent SRS and ICI on disease outcomes.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Article
Clinical Neurology
Georgios Mantziaris, Stylianos Pikis, Zhiyuan Xu, Reed Mullen, Juan Alzate, Kenneth Bernstein, Douglas Kondziolka, Zhishuo Wei, Ajay Niranjan, L. Dade Lunsford, Roman Liscak, Jaromir May, Cheng-chia Lee, Huai-che Yang, Francois-Louis Coupe, David Mathieu, Kimball Sheehan, Darrah Sheehan, Joshua D. Palmer, Haley K. Perlow, Selcuk Peker, Yavuz Samanci, Jennifer Peterson, Daniel M. Trifiletti, Matthew J. Shepard, Shahed Elhamdani, Rodney E. Wegner, Herwin Speckter, Wenceslao Hernandez, Ronald E. Warnick, Jason Sheehan
Summary: This retrospective study showed that stereotactic radiosurgery (SRS) is an effective treatment option for intraventricular metastases (IVMs), with a comparable local control rate to SRS for parenchymal brain metastases. However, careful follow-up is needed to detect leptomeningeal spread and hydrocephalus in patients with IVMs.
Article
Clinical Neurology
Adomas Bunevicius, Karen Lavezzo, Leah Shabo, Jesse McClure, Jason P. Sheehan
Summary: The study evaluated the quality of life in patients treated with stereotactic radiosurgery for brain metastases, finding that the quality of life remained largely stable post-treatment. Factors such as the patient's RPA class, upfront whole-brain radiation therapy, and the number of intracranial lesions were identified as independent predictors of post-treatment quality of life deterioration. Additionally, a lower pre-treatment quality of life was associated with shorter survival independently of other clinical and demographic variables.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Stylianos Pikis, Adomas Bunevicius, Cheng-Chia Lee, Huai-Che Yang, Brad E. Zacharia, Roman Liscak, Gabriela Simonova, Manjul Tripathi, Narendra Kumar, David Mathieu, Remi Perron, Selcuk Peker, Yavuz Samanci, Jason Gurewitz, Kenneth Bernstein, Douglas Kondziolka, Ajay Niranjan, L. Dade Lunsford, Nikolaos Mantziaris, Jason P. Sheehan
Summary: This multicenter study evaluated the safety and efficacy of stereotactic radiosurgery (SRS) in the management of intracranial prostate cancer metastases. The results showed that SRS was a safe, well-tolerated, and effective treatment option for these patients.
JOURNAL OF NEUROSURGERY
(2022)
Article
Oncology
Mohammed Abdulhaleem, Hannah Johnston, Ralph D'Agostino, Claire Lanier, Michael LeCompte, Christina K. Cramer, Jimmy Ruiz, Thomas Lycan, Hui-Wen Lo, Kuonosuke Watabe, Stacey O'Neill, Christopher Whitlow, Jaclyn J. White, Stephen B. Tatter, Adrian W. Laxton, Jing Su, Michael D. Chan
Summary: This retrospective study compared the clinical outcomes of lung cancer patients receiving immune checkpoint inhibitors and stereotactic radiosurgery with a historical control group. The results showed that patients receiving immunotherapy had improved overall survival and local control compared to the control group.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Article
Oncology
Angela Barillaro, Mara Caroprese, Laura Cella, Anna Viggiano, Francesca Buccelli, Chiara Daponte, Chiara Feoli, Caterina Oliviero, Stefania Clemente, Antonio Farella, Manuel Conson, Roberto Pacelli
Summary: Brain metastases are severe events in patients with solid tumors. Stereotactic radiation therapy is an effective treatment for brain metastases, but it may lead to radiation necrosis, which can impact patient's quality of life. Prompt recognition and treatment are necessary for managing radiation necrosis.
Article
Biophysics
Shanshan Jiang, Pengfei Guo, Hye-Young Heo, Yi Zhang, Jingpu Wu, Yuecen Jin, John Laterra, Charles G. Eberhart, Michael Lim, Jaishri O. Blakeley
Summary: The value of amide proton transfer-weighted (APTw) MRI radiomic features for differentiating tumor recurrence from treatment effect in malignant gliomas was evaluated in this study. The APTw-based model showed the highest accuracy (86.0%) in distinguishing tumor recurrence from treatment effect, compared to other MR image features. Adding APTw-based radiomic features increased the accuracy of MRI in assessing treatment response in post-treatment malignant gliomas.
NMR IN BIOMEDICINE
(2023)
Review
Biochemistry & Molecular Biology
Anita L. Kalluri, Pavan P. Shah, Michael Lim
Summary: Primary CNS neoplasms have high mortality and morbidity rates, and current therapies have limited success. The tumor immune microenvironment has been recognized as a critical factor in primary CNS neoplasms, affecting malignancy, prognosis, and response to therapy. This review focuses on the tumor microenvironment of glioblastoma and meningioma, and discusses current therapeutic strategies such as checkpoint inhibitor therapy and immunotherapeutic vaccines.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Clinical Neurology
Raymond J. So, Anita L. Kalluri, Joshua Materi, Sumil K. Nair, Michael Lim, Judy Huang, Chetan Bettegowda, Risheng Xu
Summary: This study compared postoperative pain and numbness outcomes in trigeminal neuralgia patients undergoing microvascular decompression using either venous transposition or coagulation. The study found no significant difference in postoperative pain between the two techniques, but venous transposition was significantly associated with worse postoperative numbness. Therefore, the results of this study can help inform preoperative counseling and surgical management for trigeminal neuralgia cases involving pure venous compression.
OPERATIVE NEUROSURGERY
(2023)
Article
Oncology
Aleksandar Obradovic, Casey Ager, Mikko Turunen, Thomas Nirschl, Mohsen Khosravi-Maharlooei, Alina Iuga, Christopher M. Jackson, Srinivasan Yegnasubramanian, Lorenzo Tomassoni, Ester Calvo Fernandez, Patrick McCann, Meri Rogava, Angelo M. DeMarzo, Christina M. Kochel, Mohamad Allaf, Trinity Bivalacqua, Michael Lim, Ronald Realubit, Charles Karan, Charles G. Drake, Andrea Califano
Summary: By analyzing the transcriptional state of tumor-infiltrating regulatory T cells (TI-Tregs), 17 candidate master regulators (MRs) were identified as important determinants in TI-Treg recruitment and retention. CRISPR-Cas9 screening confirmed the essentiality of 8 MRs in TI-Treg function and targeting one of the most significant MRs (Trps1) successfully reduced tumor growth. Additionally, low-dose gemcitabine was found to reverse the activity of TI-Treg MRs, leading to tumor inhibition.
Article
Clinical Neurology
Risheng Xu, Raymond J. So, Kevin K. Lee, Anita L. Kalluri, Joshua Materi, Sumil K. Nair, Judy Huang, Michael Lim, Chetan Bettegowda
Summary: This retrospective study examined the demographic, clinical, and procedural characteristics of patients with sequential onset bilateral trigeminal neuralgia (TN). The findings revealed that the more surgical interventions were performed, the lower the likelihood of pain relief. At final follow-up, 82.4% of patients still relied on medication for pain management.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2023)
Editorial Material
Biochemistry & Molecular Biology
Adela Wu, Michael Lim
Summary: Combining oncolytic virus with immune checkpoint inhibition shows treatment responses and longer survival for immunologically 'cold' recurrent glioblastomas, but creative treatment strategies are still needed for highly anti-inflammatory tumors.
Article
Biochemistry & Molecular Biology
Jasia Mahdi, Jorg Dietrich, Karin Straathof, Claire Roddie, Brian J. Scott, Tom Belle Davidson, Laura M. Prolo, Tracy T. Batchelor, Cynthia J. Campen, Kara L. Davis, Juliane Gust, Michael Lim, Robbie G. Majzner, Julie R. Park, Sonia Partap, Sneha Ramakrishna, Rebecca Richards, Liora Schultz, Nicholas A. Vitanza, Leo D. Wang, Crystal L. Mackall, Michelle Monje
Summary: Cancer immunotherapies can cause unique toxicities and it is important to establish grading scales and standardized treatment algorithms to improve safety. The authors propose a new toxicity syndrome called tumor inflammation-associated neurotoxicity (TIAN) in patients treated with cell therapies for CNS tumors. They also suggest a grading scale and discuss management strategies to standardize reporting and treatment for this syndrome.
Meeting Abstract
Oncology
Jasia Mahdi, Jorg Dietrich, Karin Straathof, Claire Roddie, Brian Scott, Tom Belle Davidson, Laura Prolo, Tracy Batchelor, Cynthia Campen, Kara Davis, Juliane Gust, Michael Lim, Robbie Majzner, Julie Park, Sonia Partap, Sneha Ramakrishna, Rebecca Richards, Liora Schultz, Nicholas Vitanza, Leo Wang, Crystal Mackall, Michelle Monje
Article
Clinical Neurology
Sumil K. Nair, Michael E. Xie, Kathleen Ran, Anita Kalluri, Collin Kilgore, Judy Huang, Michael Lim, Chetan Bettegowda, Risheng Xu
Summary: In most cases of trigeminal neuralgia, the trigeminal nerve is compressed by arterial vasculature. This study aimed to compare pain outcomes in patients with sole arterial versus sole venous compression.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Collin B. Kilgore, Raymond J. So, Kaitlyn Storm, Sumil K. Nair, Kathleen R. Ran, Anita L. Kalluri, Michael Lim, Judy Huang, Chetan Bettegowda, Risheng Xu
Summary: Trigeminal neuralgia is more prevalent in women, and microvascular decompression is the most effective surgical treatment for it. This study aims to investigate the relationship between sex and pain outcomes following microvascular decompression for trigeminal neuralgia.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Maureen Rakovec, Samantha Camp, David Day, Sachiv Chakravarti, Megan Parker, Jose L. Porras, Christopher M. Jackson, Judy Huang, Chetan Bettegowda, Michael Lim, Debraj Mukherjee
Summary: This study examines the perioperative outcomes of using tubular retractors for biopsy or resection of deep-seated intracranial lesions. The results demonstrate that tubular retractors can minimize damage to white matter tracts and improve surgical success rates. However, there may be some post-operative complications.
JOURNAL OF CLINICAL NEUROSCIENCE
(2023)
Editorial Material
Biochemistry & Molecular Biology
Kirit Singh, Kelly M. Hotchkiss, Ian F. Parney, John De Groot, Solmaz Sahebjam, Nader Sanai, Michael Platten, Evanthia Galanis, Michael Lim, Patrick Y. Wen, Giuseppe Minniti, Howard Colman, Timothy F. Cloughesy, Minesh P. Mehta, Marjolein Geurts, Isabel Arrillaga-Romany, Annick Desjardins, Kirk Tanner, Susan Short, David Arons, Elizabeth Duke, Wolfgang Wick, Stephen J. Bagley, David M. Ashley, Priya Kumthekar, Roel Verhaak, Anthony J. Chalmers, Anoop P. Patel, Colin Watts, Peter E. Fecci, Tracy T. Batchelor, Michael Weller, Michael A. Vogelbaum, Matthias Preusser, Mitchel S. Berger, Mustafa Khasraw
Summary: A breakthrough in drug discovery for glioblastoma necessitates the consecutive collection of central nervous system tissue through window of opportunity trials.
Article
Clinical Neurology
Sumil K. Nair, Michael E. Xie, Kathleen Ran, Anita Kalluri, Collin Kilgore, Kyra Halbert-Elliott, Judy Huang, Michael Lim, Chetan Bettegowda, Risheng Xu
Summary: This study retrospectively analyzed patients who underwent MVD surgery at a hospital and compared the pain outcomes between patients who underwent primary MVD surgery and those who had prior SRS surgery. The results suggest that prior SRS surgery does not seem to increase the risk of pain recurrence after MVD surgery.
OPERATIVE NEUROSURGERY
(2023)
Article
Cell Biology
Christopher Douville, Samuel Curtis, Mahmoud Summers, Tej D. Azad, Jordina Rincon-Torroella, Yuxuan Wang, Austin Mattox, Bracha Avigdor, Jonathan Dudley, Joshua Materi, Divyaansh Raj, Sumil Nair, Debarati Bhanja, Kyle Tuohy, Lisa Dobbyn, Maria Popoli, Janine Ptak, Nadine Nehme, Natalie Silliman, Cherie Blair, Kathy Judge, Gary L. Gallia, Mari Groves, Christopher M. Jackson, Eric M. Jackson, John Laterra, Michael Lim, Debraj Mukherjee, Jon Weingart, Jarushka Naidoo, Carl Koschmann, Natalya Smith, Karisa C. Schreck, Carlos A. Pardo, Michael Glantz, Matthias Holdhoff, Kenneth W. Kinzler, Nickolas Papadopoulos, Bert Vogelstein, Chetan Bettegowda
Summary: Introduced Real-CSF, an analytic technique that detects central nervous system cancers by evaluating DNA in cerebro-spinal fluid. Real-CSF accurately distinguishes between cancerous and non-cancerous brain lesions, identifying 67% of cancerous and 96% of non-cancerous lesions in 280 CSF samples.
CELL REPORTS MEDICINE
(2023)
Review
Oncology
Alexander L. Ren, Janet Y. Wu, Si Yeon Lee, Michael Lim
Summary: Immunotherapy has potential for glioma treatment, but clinical trials have not shown significant improvements in patient survival. It is important for preclinical models in glioma research to accurately represent clinical features and immune mechanisms. This review explores common preclinical models in glioma immunology, discussing their advantages, disadvantages, and translational research applications.