2024
Patterns of brain metastases response to immunotherapy with pembrolizumab
Mahajan A, Goldberg S, Weiss S, Tran T, Singh K, Joshi K, Aboian M, Kluger H, Chiang V. Patterns of brain metastases response to immunotherapy with pembrolizumab. Journal Of Neuro-Oncology 2024, 169: 555-561. PMID: 38963658, DOI: 10.1007/s11060-024-04754-8.Peer-Reviewed Original ResearchNon-small cell lung cancerBrain metastasesComplete resolutionLung cancerMedian time to CNS progressionLesion progressionNon-small cell lung cancer patientsModified RECIST criteriaPD-1 inhibitorsTrial of pembrolizumabEffective systemic treatmentResponse to immunotherapyPhase II trialCell lung cancerMethodsThis retrospective studyLocal treatment decisionsPurposeCentral nervous systemCNS progressionRECIST criteriaPD-1Local therapySystemic treatmentMRI evaluationResponse assessmentRetrospective study154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery
Robert S, Kiziltug E, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery. Neurosurgery 2024, 70: 35-36. DOI: 10.1227/neu.0000000000002809_154.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingInterferon-stimulated genesStereotactic radiosurgeryNatural killerMyeloid cellsImmune cellsRadiosurgical treatment of brain metastasesTreatment of brain metastasesCD4+ T cellsExpression of immune cellsMorbid side effectsTreatment of RNSubpopulations of myeloid cellsStereotactic radio surgeryMetastatic brain tumorsInvasive brain biopsyCellular immune profilesInflammatory immune responseCSF of patientsRN patientsBrain metastasesCD8+Immunotherapy optionsMetastatic tumorsExecutive summary of the American Radium Society appropriate use criteria for brain metastases in epidermal growth factor receptor mutated-mutated and ALK-fusion non-small cell lung cancer
Nagpal S, Milano M, Chiang V, Soltys S, Brackett A, Halasz L, Garg A, Sahgal A, Ahluwalia M, Tom M, Palmer J, Knisely J, Chao S, Gephart M, Wang T, Lo S, Chang E. Executive summary of the American Radium Society appropriate use criteria for brain metastases in epidermal growth factor receptor mutated-mutated and ALK-fusion non-small cell lung cancer. Neuro-Oncology 2024, 26: 1195-1212. PMID: 38459978, PMCID: PMC11226873, DOI: 10.1093/neuonc/noae041.Peer-Reviewed Original ResearchNon-small cell lung cancerTyrosine kinase inhibitorsCell lung cancerCentral nervous systemAmerican Radium SocietyALK-fusionBrain metastasesAmerican Radium Society Appropriate Use CriteriaLung cancerSequence of tyrosine kinase inhibitorsALK tyrosine kinase inhibitorsTreatment of brain metastasesEGFR tyrosine kinase inhibitorsWhole-brain RTEpidermal growth factor receptorGrowth factor receptorAppropriate Use CriteriaBrain RTEGFR-mutantRadiotherapyTreatment optionsFactor receptorKinase inhibitorsNervous systemLiterature search
2023
SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES
Strowd R, Chan M, Tatter S, Chiang V, Fecci P, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES. Neuro-Oncology 2023, 25: v269-v269. PMCID: PMC10640195, DOI: 10.1093/neuonc/noad179.1031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesRadiographic progressionKaplan-MeierStereotactic radiosurgeryLocal controlMedian Karnofsky performance statusFuture radiographic progressionRadiotherapeutic treatment optionsResults Ninety patientsBrain metastasis patientsMulti-center registryRecurrent brain metastasesMedian hospitalization timeLesional progressionMultivariable FineNinety patientsSymptom controlCumulative incidenceMetastasis patientsPerformance statusSystemic therapySelected-Lesion Stereotactic Radiosurgery in Treatment of Patients with Multiple Brain Metastases: A Single Institution Retrospective Study
Mange A, Singh C, Theriault B, Hansen J, An Y, Aneja S, Chiang V. Selected-Lesion Stereotactic Radiosurgery in Treatment of Patients with Multiple Brain Metastases: A Single Institution Retrospective Study. International Journal Of Radiation Oncology • Biology • Physics 2023, 117: e135. DOI: 10.1016/j.ijrobp.2023.06.939.Peer-Reviewed Original ResearchMultiple brain metastasesBrain metastasesStereotactic radiosurgeryMedian KPSCommon indicationTumor characteristicsClinical trialsSRS treatmentSingle-institution retrospective studySubsequent-line treatmentMethods Clinical dataPatient selection criteriaTreatment of patientsSubset of lesionsNumber of lesionsDiagnosis of melanomaCNS progressionCNS radiationPrior WBRTOverall survivalPalliative treatmentPatient characteristicsProgressive diseaseImmunotherapy trialsSurvival groupSelected-Lesion SRS as a Novel Strategy in Treatment of Patients with Multiple Brain Metastases
Singh C, Theriault B, An Y, Yu J, Knisely J, Shepard M, Wegner R, Warnick R, Peker S, Samanci Y, Trifiletti D, Lee C, Yang H, Bernstein K, Kondziolka D, Tripathi M, Mathieu D, Mantziaris G, Pikis S, Sheehan J, Chiang V. Selected-Lesion SRS as a Novel Strategy in Treatment of Patients with Multiple Brain Metastases. International Journal Of Radiation Oncology • Biology • Physics 2023, 117: e150-e151. DOI: 10.1016/j.ijrobp.2023.06.971.Peer-Reviewed Original ResearchWhole-brain radiation therapyTreatment of patientsSystemic diseaseBrain metastasesLesion locationIntracranial lesionsPrior whole-brain radiation therapyMultiple brain metastasesBrain radiation therapyUntreated brain metastasesBrain metastasis treatmentCurrent practice patternsSigns/symptomsPresence of symptomsMATERIAL/METHODSImmunotherapy optionsSystemic therapyUntreated lesionsMedical oncologyPerilesional edemaDrug optionsClinical trialsPractice patternsClinical indicationsMetastasis treatmentPACS-Integrated Tools for Peritumoral Edema Volumetrics Provide Additional Information to RANO-BM-Based Assessment of Lung Cancer Brain Metastases after Stereotactic Radiotherapy: A Pilot Study
Kaur M, Petersen G, Jekel L, von Reppert M, Varghese S, de Oliveira Santo I, Avesta A, Aneja S, Omuro A, Chiang V, Aboian M. PACS-Integrated Tools for Peritumoral Edema Volumetrics Provide Additional Information to RANO-BM-Based Assessment of Lung Cancer Brain Metastases after Stereotactic Radiotherapy: A Pilot Study. Cancers 2023, 15: 4822. PMID: 37835516, PMCID: PMC10571649, DOI: 10.3390/cancers15194822.Peer-Reviewed Original ResearchPost-SRTStereotactic radiotherapyLung cancer brain metastasesCancer brain metastasesPost-contrast T1-weighted imagesSignificant clinical symptomsContrast-enhancing tumorT1-weighted imagesCritical additional informationEdema changesBrain metastasesClinical symptomsCare treatmentHyperintense volumeEdema assessmentLesion changesLesion sizeEdemaDifferent timepointsPilot studyRadiotherapyLesionsVolumetric changesAdditional informationMETSSelected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases
Theriault B, Singh C, Yu J, Knisely J, Shepard M, Wegner R, Warnick R, Peker S, Samanci Y, Trifiletti D, Lee C, Yang H, Bernstein K, Kondziolka D, Tripathi M, Mathieu D, Mantziaris G, Pikis S, Sheehan J, Chiang V. Selected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases. Cureus 2023, 15: e45457. PMID: 37859877, PMCID: PMC10583225, DOI: 10.7759/cureus.45457.Peer-Reviewed Original ResearchWhole brain radiotherapyInternational Radiosurgery Research FoundationPrior whole brain radiotherapyBrain metastasesStereotactic radiosurgeryCommon reasonAsymptomatic brain metastasesNon-eloquent locationsSystemic treatment optionsMultiple brain metastasesPoor functional statusTreatment of patientsCentral nervous systemAttributable symptomsExtracranial diseaseSystemic therapyUntreated lesionsMedical oncologySystemic diseaseFunctional statusTreatment optionsClinical trialsSingle lesionLesion locationIntracranial lesionsJS09.5.A18F-FLUCICLOVINE PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY: IMAGE INTERPRETATION CRITERIA RESULTS FROM PURSUE, A PROSPECTIVE PHASE 2 TRIAL
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. JS09.5.A18F-FLUCICLOVINE PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY: IMAGE INTERPRETATION CRITERIA RESULTS FROM PURSUE, A PROSPECTIVE PHASE 2 TRIAL. Neuro-Oncology 2023, 25: ii12-ii13. PMCID: PMC10489492, DOI: 10.1093/neuonc/noad137.034.Peer-Reviewed Original ResearchRecurrent brain metastasesImage interpretation criteriaBrain metastasesRadiation therapyLesion uptakeDiagnostic performancePredictive valueProspective phase 2 trialSolid tumor brain metastasesTumor brain metastasesPhase 2 trialInterpretation criteriaNegative predictive valueLow background uptakePositive predictive valueExcellent diagnostic performanceBM recurrencePost-MRIPrimary endpointSecondary endpointsRadiation necrosisReference lesionsUnnecessary surgeryHistopathological analysisInitial cohortNEIM-05 PURSUE: RESULTS FROM A PROSPECTIVE, PHASE 2B TRIAL TO DEFINE IMAGE INTERPRETATION CRITERIA FOR18F-FLUCICLOVINE-PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. NEIM-05 PURSUE: RESULTS FROM A PROSPECTIVE, PHASE 2B TRIAL TO DEFINE IMAGE INTERPRETATION CRITERIA FOR18F-FLUCICLOVINE-PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY. Neuro-Oncology Advances 2023, 5: iii15-iii15. PMCID: PMC10402431, DOI: 10.1093/noajnl/vdad070.057.Peer-Reviewed Original ResearchBSBM-18 SINGLE-CELL PROFILING TUMOR-INFILTRATING IMMUNE CELLS REVEALS CXCL13+ FOLLICULAR HELPER-LIKE CD4+ T CELLS IN HUMAN BRAIN TUMORS
Lu B, Lucca L, DiStasio M, Liu Y, Pham G, Buitrago-Pocasangre N, Arnal-Estape A, Moliterno J, Chiang V, Omuro A, Hafler D. BSBM-18 SINGLE-CELL PROFILING TUMOR-INFILTRATING IMMUNE CELLS REVEALS CXCL13+ FOLLICULAR HELPER-LIKE CD4+ T CELLS IN HUMAN BRAIN TUMORS. Neuro-Oncology Advances 2023, 5: iii4-iii4. PMCID: PMC10402449, DOI: 10.1093/noajnl/vdad070.014.Peer-Reviewed Original ResearchT cell populationsT cell functionT cellsHigh-grade gliomasBrain metastasesHuman brain tumorsImmune cellsBrain tumorsNon-small cell lung cancer brain metastasesB cellsAnti-PD-1 therapy responseCell lung cancer brain metastasesLung cancer brain metastasesProductive antitumor immune responsesFollicular helper T cellsT-cell receptor sequencingTumor-infiltrating T cellsAntitumor T-cell functionCancer brain metastasesCo-inhibitory receptorsAntitumor immune responseCell receptor sequencingLonger overall survivalCell functionTertiary lymphoid structuresEvaluating the diagnostic performance of 18F-fluciclovine for detection of recurrent brain metastases after radiation therapy: Results from a prospective phase 2 trial.
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. Evaluating the diagnostic performance of 18F-fluciclovine for detection of recurrent brain metastases after radiation therapy: Results from a prospective phase 2 trial. Journal Of Clinical Oncology 2023, 41: 2001-2001. DOI: 10.1200/jco.2023.41.16_suppl.2001.Peer-Reviewed Original ResearchRecurrent brain metastasesImage interpretation criteriaF-fluciclovine PETF-fluciclovine uptakeBrain metastasesF-fluciclovineRadiation therapyDiagnostic performanceHistopathological analysisSUV maxFirst prospective multicenter trialProspective phase 2 trialSolid tumor brain metastasesTumor brain metastasesPhase 2 trialProspective multicenter trialIndependent blinded readersFluciclovine uptakePost-MRIPrimary endpointSecondary endpointsMulticenter trialRadiation necrosisRecurrent tumorsFuture trialsPeritumoral edema measurements provide additional information to RANO-BM based assessment of lung cancer brain metastases after Gamma Knife therapy (P10-13.002)
Kaur M, Cassinelli G, von Reppert M, Jekel L, Varghese S, Dixe I, Omuro A, Chiang V, Aboian M. Peritumoral edema measurements provide additional information to RANO-BM based assessment of lung cancer brain metastases after Gamma Knife therapy (P10-13.002). Neurology 2023, 100 DOI: 10.1212/wnl.0000000000203091.Peer-Reviewed Original Research465 Defining the Immune Profile of Radiation Necrosis Through Single-cell Analysis of Intracranial Lesions
Robert S, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 465 Defining the Immune Profile of Radiation Necrosis Through Single-cell Analysis of Intracranial Lesions. Neurosurgery 2023, 69: 97-98. DOI: 10.1227/neu.0000000000002375_465.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingImmune profileNatural killer (NK) cellsIncidence of radiation necrosisManagement of brain metastasesMetastatic brain tumor patientsMorbid side effectsTreatment of RNRecurrent metastatic diseaseExpression of Foxp3Cytotoxic T cellsInvasive brain biopsyCellular immune profilesInterleukin-7 receptorBrain tumor patientsBrain metastasesMetastatic diseaseMetastatic tumorsImmune landscapeIntraoperative samplesPatient survivalT cellsBrain biopsyIntracranial lesionsUse of stereotactic radiosurgery in treatment of brain metastases from pediatric extracranial solid tumors
Xu S, Campbell A, Chiang V, Bindra R, Vasquez J, Pashankar F. Use of stereotactic radiosurgery in treatment of brain metastases from pediatric extracranial solid tumors. Pediatric Blood & Cancer 2023, 70: e30303. PMID: 36975152, DOI: 10.1002/pbc.30303.Peer-Reviewed Original ResearchLocal Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis
Singh R, Bowden G, Mathieu D, Perlow H, Palmer J, Elhamdani S, Shepard M, Liang Y, Nabeel A, Reda W, Tawadros S, Abdelkarim K, El-Shehaby A, Emad R, Elazzazi A, Warnick R, Gozal Y, Daly M, McShane B, Addis-Jackson M, Karthikeyan G, Smith S, Picozzi P, Franzini A, Kaisman-Elbaz T, Yang H, Wei Z, Legarreta A, Hess J, Templeton K, Pikis S, Mantziaris G, Simonova G, Liscak R, Peker S, Samanci Y, Chiang V, Niranjan A, Kersh C, Lee C, Trifiletti D, Lunsford L, Sheehan J. Local Control and Survival Outcomes After Stereotactic Radiosurgery for Brain Metastases From Gastrointestinal Primaries: An International Multicenter Analysis. Neurosurgery 2023, 93: 592-598. PMID: 36942965, DOI: 10.1227/neu.0000000000002456.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusStereotactic radiosurgeryOverall survivalBrain metastasesUnivariate analysisLocal controlGI primaryExtracranial metastasesPrognostic factorsBrain metastases treated with stereotactic radiosurgeryAssociated with inferior LCAssociated with inferior OSMedian Karnofsky performance statusEvaluate potential prognostic factorsInternational multicenter analysisPlanning target volumePotential prognostic factorsKaplan-Meier analysisOne-yearProportional hazards modelInferior LCInferior OSOS ratesLC ratesGastrointestinal primaryPreliminary dosimetric comparison between fixed and rotating source stereotactic radiosurgery systems
Draeger E, Chen Z, Hansen J, Chiang V, Tien C. Preliminary dosimetric comparison between fixed and rotating source stereotactic radiosurgery systems. Journal Of Applied Clinical Medical Physics 2023, 24: e13907. PMID: 36660774, PMCID: PMC10161057, DOI: 10.1002/acm2.13907.Peer-Reviewed Original ResearchConceptsConformity indexRadiation Therapy Oncology Group conformity indexGK plansSuperior conformity indexNon-metastatic casesPaddick conformity indexDosimetric plan qualityGK patientsBrain metastasesRadiosurgery systemTrigeminal neuralgiaPrescription dosesGamma Knife systemMetastatic casesArteriovenous malformationsPituitary adenomasConformality indexLarge cohortDosimetric comparisonStereotactic radiosurgery systemGK IconPatientsCohortTreatment timeDosimetric resultsManagement of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy?
Merkin R, Chiang V, Goldberg S. Management of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy? Therapeutic Advances In Medical Oncology 2023, 15: 17588359231175438. PMID: 37275964, PMCID: PMC10233588, DOI: 10.1177/17588359231175438.Peer-Reviewed Original ResearchImmune checkpoint inhibitorsBrain metastasesTargetable genetic alterationsLocal therapyLung cancerStereotactic radiosurgeryDeath 1 ligand 1 expressionManagement of BMSole metastatic siteStage IV diseaseWhole brain radiotherapyLigand 1 expressionPD-L1 expressionProspective clinical trialsTime of diagnosisManagement of patientsCell lung cancerCancer-related deathGenetic alterationsCentral nervous systemGenetic driver alterationsAnaplastic lymphoma kinaseEpidermal growth factor receptorGrowth factor receptorUpfront radiotherapyEfficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases
Chan M, Tatter S, Chiang V, Fecci P, Strowd R, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neuro-Oncology Advances 2023, 5: vdad031. PMID: 37114245, PMCID: PMC10129388, DOI: 10.1093/noajnl/vdad031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesLocal controlMedian Karnofsky performance statusRecurrent brain metastasesMedian hospitalization timeLow patient morbidityLesional progressionMultivariable FineCumulative incidenceOverall survivalPerformance statusSymptom controlHospitalization timeSystemic therapyMedian timeNeurological deathSymptom managementKaplan-MeierPatient morbiditySeizure prevalenceUS Centers
2022
Multicenter analysis of stereotactic radiosurgery for multiple brain metastases from EGFR and ALK driven non-small cell lung cancer
Wandrey N, Gao D, Robin T, Contessa J, Singh C, Chiang V, Li J, Chen A, Wang Y, Sheehan J, Dutta S, Weiss S, Paly J, Rusthoven C. Multicenter analysis of stereotactic radiosurgery for multiple brain metastases from EGFR and ALK driven non-small cell lung cancer. Lung Cancer 2022, 176: 144-148. PMID: 36641932, PMCID: PMC10552603, DOI: 10.1016/j.lungcan.2022.11.019.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerOverall survivalCell lung cancerStereotactic radiosurgeryBrain metastasesMultivariable adjustmentMulticenter analysisLung cancerNext-generation tyrosine kinase inhibitorsSRS treatmentOnly negative prognostic factorWhole brain radiotherapyMedian overall survivalMultiple brain metastasesNegative prognostic factorFavorable overall survivalTyrosine kinase inhibitorsTreatment 1CNS progressionMulticenter outcomesMedian followPrognostic factorsFavorable prognosisCNS diseaseTreatment options