Radiology in Modern Neuro-Oncology Practice

Epilepsy is a common clinical manifestation and a source of significant morbidity in patients with brain tumors. Neuroimaging has a pivotal role in neuro-oncology practice, including tumor detection, differentiation, grading, treatment guidance, and posttreatment monitoring. In this review, we highlight studies demonstrating that imaging can also provide information about brain tumor-associated epileptogenicity and assist delineation of the peritumoral epileptic cortex to optimize postsurgical seizure outcome. Most studies focused on gliomas and glioneuronal tumors where positron emission tomography (PET) and advanced magnetic resonance imaging (MRI) techniques can detect metabolic and biochemical changes associated with altered amino acid transport and metabolism, neuroinflammation, and neurotransmitter abnormalities in and around epileptogenic tumors. PET imaging of amino acid uptake and metabolism as well as activated microglia can detect interictal or peri-ictal cortical increased uptake (as compared to non-epileptic cortex) associated with tumor-associated epilepsy. Metabolic tumor volumes may predict seizure outcome based on objective treatment response during glioma chemotherapy. Advanced MRI, especially glutamate imaging, can detect neurotransmitter changes around epileptogenic brain tumors. Recently, developed PET radiotracers targeting specific glutamate receptor types may also identify therapeutic targets for pharmacologic seizure control. Further studies with advanced multimodal imaging approaches may facilitate development of precision treatment strategies to control brain tumor-associated epilepsy.

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Assessing the utility and attitudes toward molecular testing in neuro-oncology: a survey of the Society for Neuro-Oncology members

Neuro-Oncology Practice ◽

10.1093/nop/npab003 ◽

2021 ◽

Author(s):

Shannon Fortin Ensign ◽

Maya Hrachova ◽

Susan Chang ◽

Maciej M Mrugala

Keyword(s):

Online Survey ◽

Clinical Decision Making ◽

Unmet Needs ◽

Practice Patterns ◽

Response Rate ◽

Clinical Decision ◽

Molecular Testing ◽

Newly Diagnosed ◽

Tumor Boards ◽

Oncology Practice

Abstract Background Molecular testing (MT) is utilized in neuro-oncology with increasing frequency. The aim of this study was to determine clinical practice patterns to acquire this information, interpret and utilize MT for patient care, and identify unmet needs in the practical clinical application of MT. Methods We conducted a voluntary online survey of providers within the Society for Neuro-Oncology (SNO) membership database between March and April 2019. Results We received 152 responses out of 2022 SNO members (7.5% of membership). 88.8% of respondents routinely order MT for newly diagnosed gliomas. Of those who do not, testing is preferentially performed in younger patients or those with midline tumors. 82.8% use MT in recurrent gliomas. Other common indications included: metastatic tumors, meningioma, and medulloblastoma. Many providers utilize more than one resource (36.0%), most frequently using in-house (41.8%) over commercially available panels. 78.1% used the results for clinical decision-making, with BRAF, EGFR, ALK, and H3K27 mutations most commonly directing treatment decisions. Approximately, half (48.5%) of respondents have molecular tumor boards at their institutions. Respondents would like to see SNO-endorsed guidelines on MT, organized lists of targeted agents available for specific mutations, a database of targetable mutations and clinical trials, and more educational programs on MT. Conclusion This survey was marked by several limitations including response rate and interpretation of MT. Among respondents, there is routine use of MT in Neuro-Oncology, however, there remains a need for increased guidance for providers to effectively incorporate the expanding genomic data resulting from MT into daily Neuro-Oncology practice.

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Assessing the immediate impact of COVID‐19 on surgical oncology practice: Experience from an NCI‐designated Comprehensive Cancer Center in the Northeastern United States

Journal of Surgical Oncology ◽

10.1002/jso.26475 ◽

2021 ◽

Author(s):

Victor Gazivoda ◽

Alissa Greenbaum ◽

Joshua Roshal ◽

Jenna Lee ◽

Lekha Reddy ◽

...

Keyword(s):

United States ◽

Surgical Oncology ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Northeastern United States ◽

Practice Experience ◽

Oncology Practice

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Liquid Biopsy Analysis in Clinical Practice: Focus on Lung Cancer

Journal of Molecular Pathology ◽

10.3390/jmp2030021 ◽

2021 ◽

Vol 2 (3) ◽

pp. 241-254

Author(s):

Pasquale Pisapia ◽

Francesco Pepe ◽

Antonino Iaccarino ◽

Roberta Sgariglia ◽

Mariantonia Nacchio ◽

...

Keyword(s):

Lung Cancer ◽

Liquid Biopsy ◽

Treatment Options ◽

Molecular Testing ◽

Specific Information ◽

Sample Collection ◽

Timely Manner ◽

Oncology Practice ◽

Nsclc Patients ◽

To Receive

Lung cancer is the leading cause of cancer death worldwide. Despite the emergence of highly effective targeted therapies, up to 30% of advanced stage non-small cell lung cancer (NSCLC) patients do not undergo tissue molecular testing because of scarce tissue availability. Liquid biopsy, on the other hand, offers these patients a valuable opportunity to receive the best treatment options in a timely manner. Indeed, besides being much faster and less invasive than conventional tissue-based analysis, it can also yield specific information about the genetic make-up and evolution of patients’ tumors. However, several issues, including lack of standardized protocols for sample collection, processing, and interpretation, still need to be addressed before liquid biopsy can be fully incorporated into routine oncology practice. Here, we reviewed the most important challenges hindering the implementation of liquid biopsy in oncology practice, as well as the great advantages of this approach for the treatment of NSCLC patients.

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