Jefferson Physicians

JHN Journal - Winter 2018

jhn-journal-winter-2018

The neuro-oncology special issue of JHN Journal reported the results of the following studies: 

  • Salvage Fractionated Stereotactic Re-irradiation (FSRT) for Patients with Recurrent High Grade Gliomas Progressed after Bevacizumab Treatment- Favorable outcomes were observed using FSRT to treat patients with recurrent HGG and the treatment was well tolerated. Prospective study is warranted to further evaluate the efficacy of salvage FSRT for patients with recurrent HGG after bevacizumab failure.
  • Phase 1 Trial of Vaccination with Autologous Tumor Cells and Antisense Directed Against the Insulin Growth Factor Type 1 Receptor (IGF-1R AS ODN) in Patients with Recurrent Glioblastoma- The vaccine paradigm was well-tolerated with a favorable median survival. Data supports this as a novel treatment paradigm that promotes anti-tumor immunity.
  • Phase I Study of Ipilimumab Combined with Whole Brain Radiation Therapy or Radiosurgery for Melanoma Patients with Brain Metastases- Concurrent ipilimumab 10 mg/kg with SRS is safe. The WBRT arm was closed early due to slow accrual, but demonstrated safety with ipilimumab 3 mg/kg. No patient experienced DLT. Larger studies with ipilimumab 10 mg/kg and SRS are warranted.
  • Principles of Pituitary Surgery-  As neurosurgeons continue to take on the challenge of endoscopy and surmount their learning curve, endoscopic transsphenoidal surgery for pituitary adenomas will certainly become the standard. 
  • Advanced Magnetic Resonance Imaging in Glioblastoma: A Review-  As MR imaging becomes more cost-effective and the adoption of advanced MR modalities becomes more widespread, it will become more critical than ever to incorporate advanced imaging and the power of large datasets into the management of glioblastoma. 
  • Stereotactic Radiosurgery Practice Patterns for Brain Metastases in the United States: A National Survey- This is among the first national assessments of the use of SRS for brain metastases in clinical practice in the U.S. The data indicates that radiation oncologists are increasingly using SRS for the treatment of intracranial lesions, even in situations which were historically treated with WBRT.