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Current Oncology Reports Oct 2022This article reviews the risk factors, clinical presentations, differential diagnosis, and the types of strokes frequently seen in patients with primary brain neoplasms.... (Review)
Review
PURPOSE OF REVIEW
This article reviews the risk factors, clinical presentations, differential diagnosis, and the types of strokes frequently seen in patients with primary brain neoplasms. This includes a discussion of approaches with a review of the available literature and provides recommendations for primary and secondary prevention specific to this patient population.
RECENT FINDINGS
Strokes in patients with brain tumors are often multifactorial. However, tailored approaches to stroke care are necessary to achieve optimal patient outcomes, AHA/ASA stroke guidelines provide little information on the management of stroke in cancer patients. A comprehensive algorithm for diagnosis for stroke in primary CNS tumor patients is proposed. Understanding the potential complex etiology of stroke in patients with brain tumors is essential to provide appropriate treatment and initiate optimal prevention measures early in the cancer treatment program. Optimal care therefore requires a comprehensive approach including a variety of specialists and healthcare providers.
Topics: Adult; Brain Neoplasms; Humans; Risk Factors; Stroke
PubMed: 35543860
DOI: 10.1007/s11912-022-01280-6 -
Cancer Apr 2020Brain metastasis (BM), the most common adult brain tumor, develops in 20% to 40% of patients with late-stage cancer and traditionally are associated with a poor... (Review)
Review
Brain metastasis (BM), the most common adult brain tumor, develops in 20% to 40% of patients with late-stage cancer and traditionally are associated with a poor prognosis. The management of patients with BM has become increasingly complex because of new and emerging systemic therapies and advancements in radiation oncology and neurosurgery. Current therapies include stereotactic radiosurgery, whole-brain radiation therapy, surgical resection, laser-interstitial thermal therapy, systemic cytotoxic chemotherapy, targeted agents, and immune-checkpoint inhibitors. Determining the optimal treatment for a specific patient has become increasingly individualized, emphasizing the need for multidisciplinary discussions of patients with BM. Recognizing and addressing the sequelae of BMs and their treatment while maintaining quality of life and neurocognition is especially important because survival for patients with BMs has improved. The authors present current and emerging treatment options for patients with BM and suggest approaches for managing sequelae and disease recurrence.
Topics: Brain Neoplasms; Combined Modality Therapy; Humans; Neoplasm Metastasis
PubMed: 31971613
DOI: 10.1002/cncr.32714 -
Neuro-oncology Nov 2022The mainstays of radiation therapy include external beam radiation therapy (EBRT) and internally implanted radiation, or brachytherapy (BT), all with distinct benefits... (Review)
Review
The mainstays of radiation therapy include external beam radiation therapy (EBRT) and internally implanted radiation, or brachytherapy (BT), all with distinct benefits and risks in terms of local or distant tumor control and normal brain toxicities, respectively. GammaTile® Surgically Targeted Radiation Therapy (STaRT) attempts to limit the drawbacks of other BT paradigms via a permanently implanted, bioresorbable, conformable, collagen tile containing four uniform intensity radiation sources, thus preventing deleterious direct contact with the brain and optimizing interseed spacing to homogenous radiation exposure. The safety and feasibility of GammaTile® STaRT therapy was established by multiple clinical trials encompassing the spectrum of primary and secondary brain neoplasms, both recurrent and newly-diagnosed. Implantable GT tiles were FDA approved in 2018 for use in recurrent intracranial neoplasms, expanded to newly-diagnosed malignant intracranial neoplasms by 2020. The current spectrum of trials focuses on better defining the relative efficacy and safety of non-GT standard-of-care radiation strategies for intracranial brain neoplasm. We summarize the key design and eligibility criteria for open and future trials of GT therapy, including registries and randomized trials for newly-diagnosed and recurrent brain metastases as well as recurrent and newly-diagnosed glioblastoma in combination with approved therapies.
Topics: Humans; Radiosurgery; Brain Neoplasms; Brachytherapy
PubMed: 36322100
DOI: 10.1093/neuonc/noac130 -
Cells Aug 2023Glioblastoma is the most aggressive intracranial tumor [...].
Glioblastoma is the most aggressive intracranial tumor [...].
Topics: Glioblastoma; Humans; Brain Neoplasms; Drug Resistance, Neoplasm
PubMed: 37626873
DOI: 10.3390/cells12162063 -
Neuro-oncology Oct 2018The development of brain metastasis (BM) of breast cancer is usually a late event with deleterious effect on the prognosis. Treatment options for intracerebral seeding... (Review)
Review
The development of brain metastasis (BM) of breast cancer is usually a late event with deleterious effect on the prognosis. Treatment options for intracerebral seeding of breast cancer are limited and, so far, nonspecific. Molecular detailing of subsequent events of penetration, seeding, and outgrowth in brain is highly relevant for developing therapeutic strategies to treat, or prevent, BM.We scrutinize recent literature for molecules and pathways that are operative in the formation of breast cancer BM. We also summarize current data on therapeutic efforts to specifically address BM of breast cancer. Data on molecular pathways underlying the formation of BM of breast cancer are sketchy and to some extent inconsistent. The molecular makeup of BM differs from that of the primary tumors, as well as from metastases at other sites. Current efforts to treat breast cancer BM are limited, and drugs used have proven effects on the primary tumors but lack specificity for the intracerebral tumors.More basic research is necessary to better characterize BM of breast cancer. Apart from the identification of drug targets defined by the intracerebral tumors, also targets in the molecular pathways involved in passing the blood-brain barrier and intracerebral tumor cell growth should be revealed.
Topics: Antineoplastic Agents; Brain Neoplasms; Breast Neoplasms; Female; Humans; Molecular Targeted Therapy; Neoplasm Proteins; Prognosis
PubMed: 29566179
DOI: 10.1093/neuonc/noy044 -
Advances in Cancer Research 2015Alterations in glycosylation are common in cancer and are thought to contribute to disease. Lung cancer and primary malignant brain cancer, most commonly glioblastoma,... (Review)
Review
Alterations in glycosylation are common in cancer and are thought to contribute to disease. Lung cancer and primary malignant brain cancer, most commonly glioblastoma, are genetically heterogeneous diseases with extremely poor prognoses. In this review, we summarize the data demonstrating that glycosylation is altered in lung and brain cancer. We then use specific examples to highlight the diverse roles of glycosylation in these two deadly diseases and illustrate shared mechanisms of oncogenesis. In addition to alterations in glycoconjugate biosynthesis, we also discuss mechanisms of postsynthetic glycan modification in cancer. We suggest that alterations in glycosylation in lung and brain cancer provide novel tumor biomarkers and therapeutic targets.
Topics: Animals; Brain Neoplasms; Glycoproteins; Glycosylation; Humans; Lung Neoplasms; Neoplasm Proteins
PubMed: 25727152
DOI: 10.1016/bs.acr.2014.11.007 -
Journal of Clinical Pathology Mar 2005Brain metastasis is a major cause of systemic cancer morbidity and mortality. Many factors participate in the development and maintenance of brain metastases. The... (Review)
Review
Brain metastasis is a major cause of systemic cancer morbidity and mortality. Many factors participate in the development and maintenance of brain metastases. The survival of the metastasis depends upon crucial interactions between tumour cells and the brain microenvironment during its development at the new site. This review focuses on the pathobiological mechanisms involved in the establishment and regulation of brain metastases. Developments in molecular biology have vastly expanded our knowledge about the mechanisms of invasion, proliferation, metastatic cell signalling, and angiogenesis in brain metastases. Advances in this understanding of the pathobiology of brain metastasis may lead to novel targeted treatment paradigms and a better prognosis for patients with brain metastatic disease.
Topics: Brain Neoplasms; Humans; Neoplasm Invasiveness; Neoplasm Metastasis; Neovascularization, Pathologic; PTEN Phosphohydrolase; Phosphoric Monoester Hydrolases; Tumor Suppressor Proteins
PubMed: 15735152
DOI: 10.1136/jcp.2003.013623 -
The Primary Care Companion For CNS... Dec 2022Adolescents diagnosed with brain or central nervous system tumors face elevated levels of depression and anxiety compared to the general pediatric population. The... (Review)
Review
Adolescents diagnosed with brain or central nervous system tumors face elevated levels of depression and anxiety compared to the general pediatric population. The objective of this review was to explore factors associated with elevated depression and anxiety symptoms in these patients, as well as various currently recommended interventions. Articles were searched in PubMed and filtered to select for the following MeSH keywords: AND ( OR OR OR OR ). Articles were limited to those published in English between 2000 and 2020. A total of 1,537 articles were retrieved, and 36 studies were reviewed. Articles were selected if they pertained to human subjects, specifically adolescents aged ≤ 18 years. Additionally, only articles about depression and anxiety were included. Symptoms of depression and anxiety before a brain tumor diagnosis or as symptoms of a possible brain tumor were excluded. Articles were screened by title and abstract as they pertained to depression and anxiety in patients diagnosed with brain tumors in adolescence. Data extracted included information about risk factors associated with depression and anxiety, interventions, and pharmacologic considerations. Factors associated with increased depressive and anxiety symptoms include intensity of cancer treatment, female sex, and brain tumor diagnosis. Pediatric brain tumor patients also experience elevated antidepressant prescription rates. When treating depression and anxiety in these patients, it is also important to focus on multifaceted interventions like behavioral and communication therapies, as the nature of brain tumors can affect psychological, social, and cognitive abilities. Depression and anxiety can have long-lasting effects on pediatric brain tumor patients and put them at risk for developing other psychosocial problems. Therefore, it is important to recognize factors contributing to depression and anxiety as well as potential interventions.
Topics: Adolescent; Child; Humans; Female; Psychotherapy; Depression; Anxiety; Anxiety Disorders; Brain Neoplasms
PubMed: 36548176
DOI: 10.4088/PCC.21r03228 -
Journal of Nuclear Medicine : Official... May 2023For decades, several amino acid PET tracers have been used to optimize diagnostics in patients with brain tumors. In clinical routine, the most important clinical...
For decades, several amino acid PET tracers have been used to optimize diagnostics in patients with brain tumors. In clinical routine, the most important clinical indications for amino acid PET in brain tumor patients are differentiation of neoplasm from nonneoplastic etiologies, delineation of tumor extent for further diagnostic and treatment planning (i.e., diagnostic biopsy, resection, or radiotherapy), differentiation of treatment-related changes such as pseudoprogression or radiation necrosis after radiation or chemoradiation from tumor progression at follow-up, and assessment of response to anticancer therapy, including prediction of patient outcome. This continuing education article addresses the diagnostic value of amino acid PET for patients with either glioblastoma or metastatic brain cancer.
Topics: Humans; Amino Acids; Positron-Emission Tomography; Brain Neoplasms; Glioblastoma; Biopsy; Tyrosine
PubMed: 37055222
DOI: 10.2967/jnumed.122.264859 -
Journal of Child Neurology Nov 2009Pediatric low-grade gliomas encompass a heterogeneous set of tumors of different histologies. Cerebellar pilocytic astrocytomas occur most frequently followed by... (Review)
Review
Pediatric low-grade gliomas encompass a heterogeneous set of tumors of different histologies. Cerebellar pilocytic astrocytomas occur most frequently followed by supratentorial diffuse fibrillary astrocytomas. Recent research has implicated activation of the RAS/RAF/MEK pathway in tumorigenesis of these tumors. Surgery is the mainstay of therapy. Overall survival rates for patients whose tumors are completely resected are 90% or greater, 10 years from diagnosis. Conversely, most optic pathway/hypothalamic, deep midline, and brain stem gliomas have minimal potential for resection; these tumors can be difficult to treat and deserve special attention. Combination chemotherapy is currently recommended as front-line adjuvant treatment for progressive or recurrent tumors. Second-line radiotherapy can also improve overall survival but is associated with more frequent and significant neurocognitive, endocrine, and other long-term toxicities.
Topics: Brain Neoplasms; Child; Glioma; Humans; Models, Neurological; Neoplasm Staging
PubMed: 19841428
DOI: 10.1177/0883073809342005