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cns cancers

Phase III Trial of Combination Therapy for Progressive Glioblastoma

In a phase III trial reported in The New England Journal of Medicine, Wick et al found that adding bevacizumab (Avastin) to lomustine at first disease progression did not improve overall survival in patients with progressive glioblastoma. Study Details In the trial, 437 patients with disease...

cns cancers
survivorship

Predicting Risk of Subsequent CNS Tumors in Survivors of Childhood Cancer

As reported in the Journal of Clinical Oncology, Wang et al have developed a model for predicting risk of subsequent central nervous system (CNS) tumors in survivors of childhood cancer. Study Details In the study, matched childhood cancer survivors with (n = 82) and without (n = 228) subsequent...

cns cancers

Addition of EGFR-Targeting Vaccine to Temozolomide in EGFRvIII-Expressing Glioblastoma

The phase III ACT IV study has shown no survival benefit of adding rindopepimut, a vaccine targeting the epidermal growth factor receptor (EGFR) deletion mutation EGFRvIII, to temozolomide in patients with newly diagnosed EGFRvIII-positive glioblastoma. These findings were reported by Weller et al...

cns cancers

Adjuvant Temozolomide in 1p/19q Non-Codeleted Anaplastic Glioma

Interim results of the phase III CATNON trial (EORTC study 26053-22054) indicate a survival benefit of adjuvant temozolomide in 1p/19q non-codeleted anaplastic glioma. These findings were reported in The Lancet by van den Bent et al. Study Details In the open-label 2 x 2 factorial trial, 745...

cns cancers

Effect of BRAF V600E Mutation on Outcome in Pediatric Low-Grade Gliomas

An analysis reported by Lassaletta et al in the Journal of Clinical Oncology showed that BRAF V600E mutation is associated with a poor outcome in pediatric low-grade gliomas treated with standard adjuvant therapy. Study Details The study involved patients with low-grade gliomas with long-term...

cns cancers

Single-Center Trial of Stereotactic Radiosurgery for Completely Resected Brain Metastases

In a U.S. single-institution study reported in The Lancet Oncology, Mahajan et al found that stereotactic radiosurgery to the surgical cavity reduced local recurrence vs observation in patients with completely resected brain metastases. Study Details In the trial, 128 evaluable patients at MD...

cns cancers

Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Resected Metastatic Brain Disease

In the phase III NCCTG N107C/CEC.3 trial, stereotactic radiosurgery to the surgical cavity reduced cognitive deterioration and was associated with similar overall survival vs whole-brain radiotherapy in patients with resected brain metastasis. These results were reported by Brown et al in The...

cns cancers

Dinutuximab vs Temsirolimus in Combination Therapy for Children With Refractory or Relapsed Neuroblastoma

A randomized phase II trial (Children’s Oncology Group [COG] ANBL1221) has resulted in the selection of dinutuximab (Unituxin) plus irinotecan/temozolomide as a regimen to be further evaluated in the treatment of pediatric patients with refractory or relapsed neuroblastoma. Study results were ...

cns cancers

Revisions to the International Neuroblastoma Response Criteria

A consensus statement from a National Cancer Institute–sponsored clinical trials planning meeting, reported in the Journal of Clinical Oncology by Park et al, presents revisions to the International Neuroblastoma Response Criteria (INRC) for assessing treatment response in patients with...

cns cancers

Adding Temozolomide to Short-Course Radiotherapy in Older Patients With Glioblastoma

In a phase III trial reported in The New England Journal of Medicine, Perry et al found that adding temozolomide to short-course radiotherapy improved overall survival in patients aged ≥ 65 years with newly diagnosed glioblastoma. The survival advantage was largest among patients with methylated ...

cns cancers

Busulfan and Melphalan vs Carboplatin, Etoposide, and Melphalan in High-Risk Neuroblastoma

In a phase III trial reported in The Lancet Oncology, Ladenstein et al found that high-dose chemotherapy with busulfan and melphalan vs carboplatin, etoposide, and melphalan was associated with an improved event-free survival in patients with high-risk neuroblastoma and adequate disease response to ...

cns cancers

New Molecular-Based Prognostic Model for Glioblastoma in Temozolomide Era

In a study reported in JAMA Oncology, Bell et al derived a molecular-based recursive partitioning analysis model for overall survival in glioblastoma multiforme in the temozolomide era with the aim of refining existing clinically based models. Study Details The study involved analysis of 452...

cns cancers

Case Report of Regression of Glioblastoma After Chimeric Antigen Receptor T-Cell Therapy

In a brief report in The New England Journal of Medicine, Brown et al described regression of glioblastoma after chimeric antigen receptor (CAR) T-cell therapy. A 50-year-old patient with recurrent multifocal glioblastoma after tumor resection, radiation therapy, and temozolomide was treated with...

cns cancers

ASCO Endorses ASTRO Guideline on Radiation Therapy for Glioblastoma

As reported by Erik P. Sulman, MD, PhD, of MD Anderson Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has endorsed the 2016 American Society for Radiation Oncology (ASTRO) evidence-based guideline on radiation therapy for glioblastoma. The endorsement was based on review of ...

cns cancers

Association of Extent of Surgeon-Assessed Resection on Outcome in High-Risk Neuroblastoma

In an analysis of patients with high-risk neuroblastoma from the Children’s Oncology Group A3973 study reported in the Journal of Clinical Oncology, von Allmen et al found that surgeon-assessed resection of at least 90% was associated with improved event-free survival and a reduced cumulative ...

cns cancers

‘Exceptional Response’ to First-Line Vismodegib Reported in Patient With Unresectable/Multifocal Adult Medulloblastoma

In a case report in Cancer Biology & Therapy, Lou et al described an exceptional response to first-line treatment with the hedgehog inhibitor vismodegib (Erivedge) in a 51-year-old patient with a history of basal cell carcinoma who was diagnosed with an unresectable/multifocal form of adult...

cns cancers

Dutch Study Shows High Prevalence of Early Endocrine Disorders in Survivors of Childhood Brain Tumors

Clement et al found that 25% of survivors of childhood brain tumors were diagnosed with endocrine disorders over 6.6 years of follow-up, based on a Dutch nationwide study reported in the Journal of Clinical Oncology. The study involved data from 718 survivors diagnosed at age ≤ 18 years with a...

cns cancers

Temozolomide vs Radiotherapy in High-Risk Low-Grade Glioma

In the phase III EORTC (European Organisation for Research and Treatment) 22033-26033 intergroup trial reported in The Lancet Oncology, Baumert et al found no progression-free survival difference between temozolomide chemotherapy and radiotherapy alone in patients with high-risk low-grade glioma....

cns cancers
lung cancer

Little Benefit Reported With WBRT in NSCLC Patients With Brain Metastases Unsuitable for Resection or Stereotactic Radiotherapy

In a UK-based phase III noninferiority trial (QUARTZ) reported in The Lancet, Mulvenna et al found that use of whole-brain radiotherapy in addition to optimal supportive care including dexamethasone was associated with little additional benefit in non–small cell lung cancer (NSCLC) patients...

cns cancers

Is Weekly Vinblastine Active in Chemotherapy-Naive Children With Progressive Low-Grade Glioma?

In a phase II Canadian Pediatric Brain Tumor Consortium Study reported in the Journal of Clinical Oncology, Lassaletta et al found that vinblastine monotherapy was associated with response or stable disease in most children with chemotherapy-naive low-grade glioma. Vinblastine monotherapy has shown ...

cns cancers

Clinically Relevant Mutations Identified Through Sequencing of Cerebrospinal Fluid of Patients With CNS Cancers

Next-generation sequencing identified clinically relevant somatic alterations in cancer-associated genes in the cerebrospinal fluid of patients with central nervous system (CNS) cancers, according to a report by Pentsova et al in the Journal of Clinical Oncology. Somatic Alterations The study...

cns cancers

KIR3DL1 and HLA-B Allele Combinations May Impact Response to Treatment in Neuroblastoma

In a study reported in the Journal of Clinical Oncology, Forlenza et al found that noninteracting KIR3DL1 and HLA-B subtypes were associated with better response to anti-GD2 antibody treatment in neuroblastoma. Study Details Treatment of neuroblastoma with anti-GD2 monoclonal antibody (eg, the...

cns cancers

Improved Overall Survival With Addition of Chemotherapy to Radiation in Low-Grade Glioma

The addition of chemotherapy with procarbazine, lomustine, and vincristine to radiotherapy significantly prolonged overall survival in patients with low-grade glioma, according to the final results of the phase III RTOG 9802 trial reported in The New England Journal of Medicine by Buckner et al. A...

cns cancers

Glioblastoma Multiforme With Mismatch Repair Deficiency May Be Target for Immune Checkpoint Inhibition

Glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency was characterized by hypermutation and elevated neoantigen load—characteristics associated with response to immune checkpoint inhibitors in other settings—according to a study reported in the Journal of ...

cns cancers

Finnish Study Identifies Increased Cancer Risks in Patients With Neurofibromatosis Type 1

In a Finnish study reported in the Journal of Clinical Oncology, Uusitalo et al found that patients with neurofibromatosis type 1 (NF1) were at increased risk of other cancers in addition to nervous system disease. The study included data from a population-based series of patients with...

cns cancers

Alisertib Shows Activity With Irinotecan/Temozolomide in Relapsed or Refractory Neuroblastoma

The oral Aurora A kinase inhibitor alisertib was active in combination with irinotecan/temozolomide in patients with relapsed or refractory neuroblastoma, in a phase I dose-escalation trial reported in the Journal of Clinical Oncology by DuBois et al. The maximum tolerated dose of alisertib was 60...

cns cancers

Single-Center Study Evaluates Proton Radiotherapy for Pediatric Medulloblastoma

In a phase II study reported in The Lancet Oncology by Yock et al, use of proton radiotherapy for pediatric medulloblastoma was associated with acceptable long-term toxic effects and good survival outcomes. Study Details In the study, 59 patients aged 3 to 21 years were treated at...

survivorship
cns cancers
issues in oncology

Increased Risk of Severe Neurocognitive Impairment in Adult Survivors of Pediatric CNS Tumors

As reported in the Journal of Clinical Oncology by Brinkman et al, a study in the St. Jude Lifetime Cohort showed that adult survivors of pediatric central nervous system (CNS) tumors are at increased risk of severe neurocognitive impairment. Study Details The study involved 224 survivors of CNS...

solid tumors
lung cancer
cns cancers

Everolimus Improves Progression-Free Survival in Advanced Neuroendocrine Tumors of the Lung or Gastrointestinal Tract

In a phase III RADIANT-4 trial reported in The Lancet, Yao et al found that everolimus (Afinitor) and supportive care significantly prolonged progression-free survival vs placebo and supportive care in patients with advanced nonfunctional neuroendocrine tumors of the lung or gastrointestinal tract. ...

cns cancers

Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma

On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...

cns cancers

No Event-Free Survival Difference With Chemotherapy Before vs After Radiotherapy in Children With High-Risk Medulloblastoma 

A number of different strategies for combining chemotherapy and radiation therapy have been evaluated in the effort to improve survival in patients with high-risk medulloblastoma. In a trial (POG 9031) reported in Journal of Clinical Oncology, Nancy J. Tarbell, MD, of Massachusetts General...

cns cancers

Postresection Adenovirus-Mediated Gene Therapy Improves Time to Death/Reintervention but Not Survival in Adult Glioblastoma 

In an open-label phase III trial (ASPECT) reported in Lancet Oncology, Manfred Westphal, MD, of University Hospital Eppendorf in Hamburg, and colleagues assessed the effects of locally applied adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir after surgical...

cns cancers

Resistance to Anti-VEGF Drugs in Glioblastoma Is Linked to Mesenchymal Transition 

Antiangiogenic therapy reduces tumor vascular permeability and delays tumor progression but may ultimately promote an aggressive treatment-resistant phenotype. In a study reported in Clinical Cancer Research, Piao and colleagues attempted to identify factors responsible for glioblastoma resistance...

cns cancers
head and neck cancer

Tumor-Infiltrating Lymphocytes in Glioblastoma Are Related to Specific Genomic Alterations

The role of tumor-infiltrating lymphocytes in glioblastoma has not been fully defined. In a study reported in Clinical Cancer Research, Rutledge and colleagues assessed the association between tumor-infiltrating lymphocytes and molecular alterations, histologies, and survival in glioblastoma. In...

cns cancers

Investigators Report Valganciclovir May Increase Survival in Glioblastoma

In a letter to The New England Journal of Medicine, Cecilia Söderberg-­Nauclér, MD, PhD, and colleagues from the Karolinska Institutet, Stockholm, described experience with the anti-cytomegalovirus (CMV) agent valganciclovir (Valcyte) in the treatment of glioblastoma, citing dramatically improved...

cns cancers

Mutation Predicts Benefit From Alkylating Chemotherapy in Oligodendroglial Tumors

Patients in the Radiation Therapy Oncology Group (RTOG) 9402 study with 1p/19q codeleted anaplastic oligodendroglial tumors had markedly prolonged overall survival after chemoradiotherapy (with procarbazine, lomustine, and vincristine) compared with radiation therapy alone. Some patients with...

cns cancers

MSH6 Mutations May Influence Temozolomide Resistance in Treatment-Naive Gliomas Independent of MGMT Methylation

Resistance to temozolomide in glioblastoma has been thought to be largely mediated by expression of the DNA repair enzyme MGMT, although there are data suggesting a role for inactivation of MSH6 and other mismatch repair proteins. In a study reported in Clinical Cancer Research, Nguyen and...

cns cancers

Dissemination of Glioblastoma Multiforme Outside Brain Is Common

The finding of extracranial metastases after organ transplantation from glioblastoma multiforme donors raised issues with the notion that disease spread is restricted to the brain. In a study reported in Science Translational Medicine, Müller and colleagues found that hematogenous spread of...

cns cancers

CENTRIC Trial Shows No Benefit of Adding Cilengitide to Therapy in Glioblastoma With Methylated MGMT Promoter

In the phase III CENTRIC/European Organisation for Research and Treatment of Cancer (EORTC) 26071-22072 trial reported in The Lancet ­Oncology, Roger Stupp, MD, of University Hospital Zurich, and colleagues found that adding the selective αvβ3 and αvβ5 integrin inhibitor cilengitide to standard...

cns cancers

Effect of Micro-RNA on M2 Macrophages and Murine Glioblastoma

Monocyte-derived glioma-associated macrophages are the largest infiltrating immune cell population in glioblastomas and act to facilitate gliomagenesis. In a study reported in the Journal of the National Cancer Institute, Xu and colleagues assessed the effect of microRNA (miR)-142-3p on...

cns cancers

Dinutuximab in Pediatric High-Risk Neuroblastoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.   On March 10, 2015, the chimeric monoclonal antibody dinutuximab ...

cns cancers

Prognostic Factors in Men With Brain Metastases From Germ Cell Tumors

As reported in the Journal of Clinical Oncology, Feldman et al, of the Global Germ Cell Cancer Group, identified prognostic factors in men with brain metastases from germ cell cancer at initial diagnosis or relapse. Overall survival was better in patients with metastases at diagnosis, a greater...

lung cancer
cns cancers

Prognostic Factors Identified in Patients With ALK‑Rearranged NSCLC and Brain Metastasis

In a study reported in the Journal of Clinical Oncology, Johung and colleagues identified factors that distinguished survival rates among patients with ALK-rearranged non–small cell lung cancer (NSCLC) and brain metastasis. The study included 90 patients from six institutions. Of them, 84...

cns cancers

No Difference in Outcomes With Short-Course vs Longer-Course Radiotherapy in Elderly or Frail Patients With Newly Diagnosed Glioblastoma

In a noninferiority phase III trial reported in the Journal of Clinical Oncology, Roa et al found no difference in overall survival, progression-free survival, or quality of life between short-course and longer-course radiotherapy in elderly or frail patients with newly diagnosed glioblastoma...

cns cancers
issues in oncology

Molecular Classification of Glioma Based on IDH Mutation, 1p/19q Codeletion, and TERT Promoter Mutation Status

In a study reported in The New England Journal of Medicine, Eckel-Passow et al identified a molecular classification scheme for gliomas based on IDH mutation, codeletion of chromosome arms 1p and 19q (1p/19q codeletion), and TERT promoter mutation status. Molecular Classification The study...

cns cancers
issues in oncology

Assay Permits Rapid Molecular Characterization of Glioma

As reported in JAMA Oncology, Shankar et al developed a rapid genotyping assay to detect single nucleotide variants in telomerase reverse transcriptase (TERT) promoter and isocitrate dehydrogenase 1 (IDH1) genes that may assist in intraoperative decisions to perform definitive neurosurgical...

cns cancers
issues in oncology

Addition of Bevacizumab to Radiotherapy and Temozolomide Does Not Worsen Health-Related Quality of Life in Glioblastoma Patients

In the phase III AVAglio trial, the addition of bevacizumab (Avastin) to radiotherapy and temozolomide improved progression-free survival in patients with newly diagnosed glioblastoma. As reported by Taphoorn et al in the Journal of Clinical Oncology, bevacizumab treatment did not worsen...

cns cancers
supportive care

Donepezil Provides Modest Improvement in Cognitive Function Domains in Irradiated Brain Tumor Survivors

In a phase III trial reported in the Journal of Clinical Oncology, Rapp et al found that the neurotransmitter modulator donepezil may modestly improve some cognitive function domains in patients undergoing cranial irradiation for brain tumors. Improvements were greater in patients with greater...

cns cancers

Clinically Distinct Subgroup of Childhood Secondary High-Grade Glioma Defined by BRAF Mutation and CDKN2A Deletion

In a study reported in the Journal of Clinical Oncology, Mistry et al found that presence of BRAF V600E mutation and CDKN2A deletion defined a clinically distinct subtype of pediatric secondary high-grade glioma. BRAF V600E mutation was associated with a prolonged time to transformation. Study...

lung cancer
cns cancers

Crizotinib Produces Systemic and Intracranial Disease Control in Patients With Advanced ALK-Rearranged NSCLC and Brain Metastases

In a retrospective analysis reported in the Journal of Clinical Oncology, Costa et al found that crizotinib (Xalkori) treatment resulted in high systemic and intracranial disease control rates in patients with ALK-rearranged non–small cell lung cancer (NSCLC) who had asymptomatic brain...

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