Brain Cancer

Antibody-mediated, immunotherapeutic strategies targeting survivin, a key cancer-related protein, may offer benefit in a variety of cancers.

A USCF team has uncovered molecular insights into meningioma biology that could lead to new, less toxic treatment approaches.

In Part 2 of this two-part series, we review the clinical evidence in support of combining immunotherapy with stereotactic radiosurgery for the treatment of brain metastases; examine controversies regarding radiation dose and fractionation, as well as temporal sequencing of multimodality treatment; and discuss future directions in combined therapy.

In this review, we highlight preclinical and clinical data to support the rationale for combination of stereotactic radiosurgery with immunotherapy for the treatment of brain metastases; describe some areas of controversy, especially with regard to radiation fractionation and the timing of combination therapy; and discuss ongoing research into multimodality treatment of CNS tumors.

In Part 2 of this review article, we discuss the management of primary CNS lymphoma, focusing in particular on systemic therapies and radiation, as well as provide clinicians with a comprehensive overview by covering the key investigations that have brought us to our current state of knowledge, and studies that may guide future interventions.

Here, in Part 1, we will provide an overview of the epidemiology of primary CNS lymphoma, followed by a discussion of the diagnostic and staging evaluation. We will also review the current prognostication systems for primary CNS lymphoma.

The addition of tumor-treating fields to maintenance temozolomide chemotherapy significantly delayed progression and improved overall survival in patients with glioblastoma who had received standard radiochemotherapy compared with maintenance temozolomide alone.

The addition of bevacizumab to lomustine for patients with progressive glioblastoma did not result in a significant improvement in overall survival.

More than 25% of patients with recurrent, high-grade glioma treated with a gene therapy combination were alive more than 3 years after treatment, according to data from a subset of patients in a phase I clinical trial.

Given the longer course and natural history of low-grade gliomas, the goals of treatment should be to prolong overall survival and minimize neurocognitive decline.

Patients with resected brain metastases who underwent stereotactic radiosurgery had lower rates of local recurrence compared with observation alone, according to the results of a phase III trial.

A personalized peptide vaccination shows clinical benefit for human leukocyte antigen-A24-positive glioblastoma multiforme patients refractory to temozolomide-based therapy.

The US Food and Drug Administration has approved the optical imaging agent aminolevulinic acid hydrochloride to enhance visualization of malignant tissue during surgery for gliomas.

An intraoperative, multimodal optical cancer detection system can detect brain cancer with high degrees of accuracy, sensitivity, and specificity in real time during surgery, according to a new study.

This review discusses best practices for the treatment of glioblastoma in patients older than 65 years, and highlights management concerns in caring for this particular patient population.

Administration of autologous HER2-specific CAR-modified virus specific T Cells was safe and had clinical benefit for some patients with progressive glioblastoma, a disease with limited effective therapeutic options.

This video examines current research on the use of vaccines in low-grade glioma for the prevention of high-grade disease.

Cytomegalovirus targeted vaccination plus high-dose chemotherapy with temozolomide can lead to long-term progression-free and overall survival in patients with newly diagnosed glioblastoma.

This video examines how a specific combination of KIR/KIR-ligand genotypes in high-risk neuroblastoma patients may be predictive of outcomes when adding dinutuximab to isotretinoin.

Elderly patients with glioblastoma had longer survival when temozolomide was added to short-course radiotherapy compared with undergoing short-course radiotherapy alone.

Minimizing late treatment toxicities in these patients remains an important priority due to both the young age of the patients and the high cure rate that can be achieved.

In this article we discuss the specifics of refining current strategies for radiation delivery, as well as new and up-and-coming heavy particle techniques and radiotherapeutics.

The addition of an autologous tumor derived–heat shock protein vaccination to standard therapy may improve outcomes for patients with glioblastoma.

A study showed that testing pediatric brain tumors for genetic abnormalities is feasible and could play a role in guiding patients’ treatment.

Many childhood brain tumors harbor potentially targetable gene mutations, according to a prospective single-institution study of more than 200 tumor samples, researchers reported in the journal Neuro-Oncology.

Brain metastases from primary breast cancer tumors often acquire clinically actionable genetic alterations, according to a small study. About one fifth of ERBB2/HER2-negative cases switched to HER2-positivity in the brain metastases.

Researchers are reporting in the journal Cancer Research that they have identified a biomarker enzyme associated with aggressive glioma brain tumors. In addition, they have demonstrated potent efficacy in a mouse model of glioma for a small molecule inhibitor they recently developed.

A 22-year-old college student with primary amenorrhea due to Müllerian agenesis presented with a headache, dysarthria, nausea, vomiting, and left upper extremity weakness. MRI of the brain showed numerous intracranial lesions.

Epigenetic lesions, and not just genetic mutations, can cause brain cancer, and one important implication of that observation is that precision-medicine genetic and genomic tools will miss epigenetic lesions that may drive tumor growth or drug resistance.

An updated prognostic tool incorporating gene alteration data could help guide clinical management of patients with non–small-cell lung cancer.