المؤلفون: Justin Leu, Meredith Akerman, Christopher Mendez, Jonathan W. Lischalk, Todd Carpenter, David Ebling, Jonathan A. Haas, Matthew Witten, Marissa Barbaro, Paul Duic, Lee Tessler, Michael C. Repka

المصدر: Frontiers in Oncology, Vol 13 (2023)

مصطلحات موضوعية: stereotactic radiosurgery, brain metastases, immunotherapy, radionecrosis, treatment delays, cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fonc.2023.1192726/fullTest; https://doaj.org/toc/2234-943XTest

الوصول الحر: https://doaj.org/article/b6f8c241b60643f08e07c8c49fbc0fecTest

المؤلفون: Justin Leu, Meredith Akerman, Christopher Mendez, Jonathan W. Lischalk, Todd Carpenter, David Ebling, Jonathan A. Haas, Matthew Witten, Marissa Barbaro, Paul Duic, Lee Tessler, Michael C. Repka

المصدر: Frontiers in Oncology, Vol 13 (2023)

مصطلحات موضوعية: stereotactic radiosurgery, brain metastases, immunotherapy, radionecrosis, treatment delays, cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: IntroductionBrain metastases are the most common intracranial tumor diagnosed in adults. In patients treated with stereotactic radiosurgery, the incidence of post-treatment radionecrosis appears to be rising, which has been attributed to improved patient survival as well as novel systemic treatments. The impacts of concomitant immunotherapy and the interval between diagnosis and treatment on patient outcomes are unclear.MethodsThis single institution, retrospective study consisted of patients who received single or multi-fraction stereotactic radiosurgery for intact brain metastases. Exclusion criteria included neurosurgical resection prior to treatment and treatment of non-malignant histologies or primary central nervous system malignancies. A univariate screen was implemented to determine which factors were associated with radionecrosis. The chi-square test or Fisher’s exact test was used to compare the two groups for categorical variables, and the two-sample t-test or Mann-Whitney test was used for continuous data. Those factors that appeared to be associated with radionecrosis on univariate analyses were included in a multivariable model. Univariable and multivariable Cox proportional hazards models were used to assess potential predictors of time to local failure and time to regional failure.ResultsA total of 107 evaluable patients with a total of 256 individual brain metastases were identified. The majority of metastases were non-small cell lung cancer (58.98%), followed by breast cancer (16.02%). Multivariable analyses demonstrated increased risk of radionecrosis with increasing MRI maximum axial dimension (OR 1.10, p=0.0123) and a history of previous whole brain radiation therapy (OR 3.48, p=0.0243). Receipt of stereotactic radiosurgery with concurrent immunotherapy was associated with a decreased risk of local failure (HR 0.31, p=0.0159). Time interval between diagnostic MRI and first treatment, time interval between CT simulation and first treatment, and concurrent immunotherapy had no impact on incidence of radionecrosis or regional failure.DiscussionAn optimal time interval between diagnosis and treatment for intact brain metastases that minimizes radionecrosis and maximizes local and regional control could not be identified. Concurrent immunotherapy does not appear to increase the risk of radionecrosis and may improve local control. These data further support the safety and synergistic efficacy of stereotactic radiosurgery with concurrent immunotherapy.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fonc.2023.1132777/fullTest; https://doaj.org/toc/2234-943XTest

الوصول الحر: https://doaj.org/article/3320c9ff6e714a2ea7a7c7e5157bd4e3Test

المؤلفون: Garni Barkhoudarian, Michael Badruddoja, Nicholas Blondin, Sajeel Chowdhary, Charles Cobbs, Julius Paul Duic, John Paul Flores, Ekokobe Fonkem, Edward McClay, Louis Burt Nabors, Michael Salacz, Lynn Taylor, Brian Vaillant, Jaya Gill, Santosh Kesari

المصدر: CNS Oncology, Vol 12, Iss 3 (2023)

مصطلحات موضوعية: brain tumor, clinical trial, electromagnetic field, GBM, medical device, novel therapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Aim: The EMulate Therapeutics Voyager™ is a simple, wearable, home-use device that uses an alternating electromagnetic field to alter biologic signaling within cells. Objective: To assess the safety/feasibility of the Voyager in the treatment of recurrent glioblastoma (rGBM). Methods: In this study, patients with rGBM were treated with Voyager as monotherapy or in combination with standard chemotherapy at the Investigator's discretion. Safety was assessed by incidence of adverse events associated with the Voyager. Patients were followed until death. Results: A total of 75 patients were enrolled and treated for at least one day with the Voyager (safety population). Device-related adverse events were uncommon and generally did not result in interruption or withdrawal from treatment. There were no serious adverse events associated with Voyager. A total of 60 patients were treated for at least one month (clinical utility population). The median progression-free survival (PFS) was 17 weeks (4.3 months) in the Voyager only group (n = 24) and 21 weeks (5.3 months) in the Voyager + concurrent therapy group (n = 36). The median overall survival (OS) was 7 months in the Voyager only group and 9 months in the Voyager + concurrent therapy group. In patients treated with Voyager + concurrent therapy, the median OS for patients enrolled with their 1st or 2nd recurrence (n = 26) was 10 months, while in patients enrolled with their 3rd or 4th recurrence (n = 10) OS was 7 months. Conclusion: The data support the safety and feasibility of the Voyager for the treatment of rGBM. Further prospective study of the device is warranted. Trial Registration Number: NCT02296580 (ClinicalTrials.gov).

العلاقة: https://doaj.org/toc/2045-0907Test; https://doaj.org/toc/2045-0915Test; https://doaj.org/article/0926388dd46840d7b67cdd3a03d7b358Test

الإتاحة: https://doi.org/10.2217/cns-2022-0016Test
https://doaj.org/article/0926388dd46840d7b67cdd3a03d7b358Test

المؤلفون: Charles Cobbs, Edward McClay, J Paul Duic, L Burt Nabors, Donna Morgan Murray, Santosh Kesari

المصدر: CNS Oncology, Vol 8, Iss 1 (2019)

مصطلحات موضوعية: brain tumor, clinical trials, Glioblastoma multiforme, medical device, novel therapy, recurrent GBM, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

الوصف: Aim: Evaluation of the Nativis Voyager® device in patients with recurrent glioblastoma (rGBM). Materials & methods: Voyager is a noninvasive, nonthermal, nonionizing and portable investigational device which delivers ultra-low radio frequency energy (ulRFE®) that uses a magnetic field to penetrate tissues to alter specific biologic functions within cells. Patients with rGBM were treated with Voyager alone (V) or Voyager in combination with standard of care (V + SoC). Safety and clinical utility were assessed every 2–4 months. Results: Data from the first 11 patients treated are reported here. Median progression-free survival was 10 weeks in the V arm and 16 weeks in the V + SoC arm. Median overall survival was 16 months in V arm and 11 months in the V + SoC arm. No serious adverse events associated with the device were reported. Conclusion: These data suggest that the Voyager is safe and feasible for the treatment of rGBM

العلاقة: https://doaj.org/toc/2045-0907Test; https://doaj.org/toc/2045-0915Test; https://doaj.org/article/fa3e4c93c1534b618bb11c7cceb3aec3Test

الإتاحة: https://doi.org/10.2217/cns-2018-0013Test
https://doaj.org/article/fa3e4c93c1534b618bb11c7cceb3aec3Test