Stereotactic Radiosurgery for Brainstem Metastases

alexandrossfakianakis shared this article with you from Inoreader Stereotactic Radiosurgery for Brainstem Metastases via # Neuro-Oncology Current Issue Abstract AIMS Limited data exists on outcomes following SRS for brainstem metastases (BSM). The purpose of this audit was to explore the use of SRS using Cyberknife for BSM at a single centre; reporting rates of toxicity and survival outcomes. METHOD Patients undergoing SRS for BSM from 2013 to 2021 were identified from a prospective database. Clinical characteristics were collected including; gender, age, histology and KPS. The use of previous WBRT, the volume and the dose delivered to the BSM were also recorded. All target volumes were peer reviewed by a neuro-radiologist. RESULTS 41 patients with a BSM were identified. The median age was 62 years (range 35-78). Histology was lung 15 (36.6%), breast 13 (31.7%) and other 13(31.7%). The median brainstem target volume was 0.36cc (range 0.01 – 5.63cc). 32 patients had single fraction (dose range 14.5 to 18Gy) and 9 patients had 3 fractions (dose range 17-24Gy). 7 patients had p revious WBRT. Median overall survival was 242 days (range 19-1213). A radiological response or stable disease was seen in 26 out of 30 patients with post SRS imaging available for review. 2 patients developed a 6th nerve palsy. 12 patients required a prolonged course of dexamethasone. No statistically significant relationship was observed between patient age, brainstem lesion size or fractionation and the need for prolonged use of dexamethasone but there was a trend with lung cancer patients requiring prolonged dexamethasone (p=0.06). CONCLUSION Brainstem SRS is viable option with an acceptable late toxicity profile. Updated information on survival and local control will be presented. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Exploring a Link Between Alzheimer’s and Glioma by Investigating SORL1 Network

alexandrossfakianakis shared this article with you from Inoreader Exploring a Link Between Alzheimer's and Glioma by Investigating SORL1 Network via # Neuro-Oncology Current Issue Abstract AIMS Use bioinformatics methods to identify and validate associated proteins and genes in the SORL1 network. Generate a bank of patient derived cells in association with the Royal Preston Hospital BTNW tissue bank. Explore identified targets from the bioinformatics in patient derived cells. METHOD Proteins and genes associated with SORL1 and SORLA were identified on GeneCards. Connectivity mapping of known and predicted interactions linked to SORL1 was explored in STRING. For clinical validation differential expression was investigated by comparing genomic data from GTEX and TCGA, available at Xenabrowser. For survival analysis Kaplan-Meier curves were generated on cBioPortal. The five most differently expressed novel targets are taken forward for laboratory experiments using western blots for protein quantification and immunocytochemistry to identify and visualise target proteins. RESULTS A total of 73 genes (30 from GeneCards and 43 from STRING) were obtained. 63 genes from the generated SORL1-related network were shown to be differentially expressed whilst 40 were significantly different between low-surviving patients and high-surviving patients. The top five associated proteins are CKAP4, CTNND1, FN1, HSPA12A and SORCS3. CKAP4, CTNND1 and FN1 are highly expressed in both glioma and glioblastoma, but low expressed in healthy tissue. HSPA12A is low expressed in cancerous brain tissue and highly expressed in healthy samples. SORCS3 is differentially expressed in healthy samples and glioma, but significantly low expressed glioblastoma. CONCLUSION This project provides insight into SORL1 molecular relationships and function in tissue, cultured cells and serum from a patient cohort including demographics, disease progression and site. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tecovirimat therapy for severe monkeypox infection: Longitudinal assessment of viral titers and clinical response pattern – A first case‐series experience

alexandrossfakianakis shared this article with you from Inoreader Tecovirimat therapy for severe monkeypox infection: Longitudinal assessment of viral titers and clinical response pattern – A first case‐series experience via Journal of Medical Virology Abstract Tecovirimat is the only antiviral with conditional and emergency approval for treatment of monkeypox by the European Medicines Agency. We present longitudinal virologic data of three patients with severe monkeypox treated with Tecovirimat. These patients presented with underlying comorbidities (ulcerative colitis; acute syphilis; HIV infection) and higher baseline monkeypox viremia compared to patients with less severe disease courses. Tecovirimat was well-tolerated, and clinical improvement was observed. In median viremia decreased by more than 2 logs within one week of therapy. This article is protected by copyright. All rights reserved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Development of chemiluminescent lab‐on‐fiber immunosensor for rapid point‐of‐care testing of anti‐SARS‐CoV‐2 antibodies and evaluation of longitudinal immune response kinetics following three‐dose inactivation virus vaccination

alexandrossfakianakis shared this article with you from Inoreader Development of chemiluminescent lab‐on‐fiber immunosensor for rapid point‐of‐care testing of anti‐SARS‐CoV‐2 antibodies and evaluation of longitudinal immune response kinetics following three‐dose inactivation virus vaccination via Journal of Medical Virology Abstract Developing reliable, rapid, and quantitative point-of-care testing (POCT) technology of SARS-CoV-2 specific antibodies and understanding longitudinal vaccination response kinetics are highly required to restrain the ongoing Coronavirus Disease 2019 (COVID-19) pandemic. We demonstrate a novel portable, sensitive, and rapid chemiluminescent lab-on-fiber detection platform for detection of anti-SARS-CoV-2 antibodies: the c-LOFI. Using SARS-CoV-2 Spike S1 RBD protein functionalized fiber bio-probe, the c-LOFI can detect anti-SARS-CoV-2 IgG and IgM antibodies with high sensitivity based on their respective HRP labeled secondary antibodies. The limits of detection of anti-SARS-CoV-2 IgG and IgM antibodies were 0.6 ng/mL and 0.3 ng/mL, respectively. The c-LOFI was successfully applied for direct detection of anti-SARS-CoV-2 antibodies in whole blood samples with simple dilution, which can serve as a finger prick test to rapidly detect antibodies. Furthermore, the l ongitudinal immune response (>12 months) kinetics following three-dose inactivated virus vaccines was evaluated based on anti-SARS-CoV-2 IgG detection results, which can provide importance significance for understanding the immune mechanism against COVID-19 and identify individuals who may benefit from the vaccination and booster vaccination. The c-LOFI has great potential to become a sensitive, low-cost, rapid, high-frequency POCT tool for the detection of both SARS-CoV-2 specific antibodies and other biomarkers. This article is protected by copyright. All rights reserved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Partial laryngectomy for naïve pT3N0 laryngeal cancer: Systematic review on oncological outcomes

alexandrossfakianakis shared this article with you from Inoreader Partial laryngectomy for naïve pT3N0 laryngeal cancer: Systematic review on oncological outcomes via Head & Neck Abstract The first aim was to define the oncologic outcomes of open partial laryngectomy (OPL) in naïve pT3 laryngeal cancer. The second aim was to analyze the outcomes after OPL versus total laryngectomy (TL). A literature search was conducted in three databases (MEDLINE, EMBASE, and Cochrane Library) until January 2022. In 805 patients treated with OPL, 5-year OS, DSS, DFS and LFS were 80.5% (95% CI 70.6–87.6), 83.4% (95% CI 75.7–89), 77.4% (95% CI 66.3–85.7) and 77.9% (95% CI 68.7–85), respectively. Three articles compared TL versus OLP: 5-year OS, DSS and DFS risk difference were 0.100 (95% CI −0.092 to 0.291), 0.067 (95% CI −0.085 to 0.220) and 0.018 (95% CI −0.164 to 0.201) respectively. OPL for selected pT3 laryngeal cancer is able to guarantee a high percentage of oncological success. Accurate patient selection is of utmost importance to differentiate advanced disease amenable to conservative surgery. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

American Head and Neck Society position statement on the use of PD‐1 inhibitors for treatment of advanced cutaneous squamous cell carcinoma

alexandrossfakianakis shared this article with you from Inoreader American Head and Neck Society position statement on the use of PD‐1 inhibitors for treatment of advanced cutaneous squamous cell carcinoma via Head & Neck Abstract Background A position statement put forth by the American Head and Neck Society (AHNS) was constructed to provide evidence-based treatment recommendations for PD-1 inhibitor use in advanced cutaneous squamous cell carcinoma (cSCC). Secondarily, we sought to identify knowledge gaps warranting further investigation. Methods A literature search utilizing key terms: cutaneous squamous cell carcinoma, cutaneous cancer, checkpoint inhibitors, systemic therapy, Program Cell Death, PD-1 (PubMed, Cochrane, and Google Scholar) was carried out to generate evidence-based statements. The statements were distributed among the AHNS membership. Delphi methodology was applied to identify statements achieving 70% or greater consensus among the leadership team. Results Twenty-six position statements achieved consensus. Knowledge gaps for future research included: impact of immunosuppression on cSCC staging and associated treatment; role of PD-1 inhibitors in immunosuppressed patients. Conclusion This comprehensive position statement put forth by the AHNS represents majority consensus by practicing head and neck surgeons throughout the country. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular landscapes of longitudinal NF2/22q and non‐NF2/22q meningiomas show different life histories

alexandrossfakianakis shared this article with you from Inoreader Molecular landscapes of longitudinal NF2/22q and non‐NF2/22q meningiomas show different life histories via Brain Pathology Abstract Recurrence is a major complication of some meningiomas. Although there were many studies on biomarkers associated with higher grades or increased aggressiveness, few studies specifically examined longitudinal samples of primary meningiomas and recurrences from the same patients for molecular life history. We studied 99 primary and recurrent meningiomas from 42 patients by FISH for 22q, 1q, 1p, 3p, 5q, 6q, 10p, 10q, 14q, 18q, CDKN2A/B homozygous deletion, ALT (Alternative Lengthening of Telomere), TERT re-arrangement, targeted sequencing and TERTp sequencing. Although NF2 mutation and 22q were well known to be aetiological events in meningiomas, we found that in these paired meningiomas, combining the two events resulted in an NF2/22q group (57 tumors from 25 patients) which were almost mutually exclusive with those cases without these two changes (42 tumors from 17 patients) for NF2/22q. No other molecular changes were totally unique to NF2/22q or non-NF2/22q tumors. For molecular evolution, NF2/22q meningiomas had higher cytogenetic abnormalities than non-NF2/22q meningiomas (p = 0.003). Most of the cytogenetic changes in NF2/22q meningiomas were present from the outset whereas for non-NF2/22q meningiomas, cytogenetic events were uncommon in the primary tumors and most were acquired in recurrences. For non-NF2/22q tumors, CDKN2A/B homozygous deletion, 1q gain, 18p loss, 3p loss, and ALT were preferentially found in recurrences. Mutations were largely conserved between primary and recurrent tumors. Phylogenetic trees showed 11/11 patients with multiple recurrent tumors had a conserved evolutionary pattern. We conclude that for molecular life history, NF2 and 22q should be regarded as a group. NF2/22q recurring meningiomas showed more cytogenetic abnormalities in the primary tumors, whereas non-NF2/22q meningiomas showed C DKN2A/B deletion and other cytogenetic abnormalities and ALT at recurrences. Although chromosome 1p loss is a known poor prognostic marker in meningiomas, it was also associated with a shorter TBR (time between resection) in this cohort (p = 0.002). View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.