scholarly journals Combined Awake Craniotomy with Endoscopic Port Surgery for Resection of a Deep-Seated Temporal Lobe Glioma: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Lance Bodily ◽  
Arlan H. Mintz ◽  
Johnathan Engh
Keyword(s):  
Minimally Invasive ◽  
Temporal Lobe ◽  
Tumor Resection ◽  
High Grade Glioma ◽  
Awake Craniotomy ◽  
High Grade ◽  
Technical Aspects ◽  
Case Outcome ◽  
Invasive Techniques ◽  
The Brain

The authors describe the combination of awake craniotomy and minimally invasive endoscopic port surgery to resect a high-grade glioma located near eloquent structures of the temporal lobe. Combined minimally invasive techniques such as these may facilitate deep tumor resection within eloquent regions of the brain, allowing minimum white matter dissection. Technical aspects of this procedure, a case outcome involving this technique, and the direction of further investigations for the utility of these techniques are discussed.

A first-in-human study of neural stem cells (NSCs) expressing cytosine deaminase (CD) in combination with 5-fluorocytosine (5-FC) in patients with recurrent high-grade glioma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2018-2018 ◽  
Author(s):  
Jana Portnow ◽  
Behnam Badie ◽  
Timothy W. Synold ◽  
Alexander Annala ◽  
Bihong Chen ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Human Study ◽  
Tumor Resection ◽  
Cytosine Deaminase ◽  
High Grade Glioma ◽  
Intracerebral Microdialysis ◽  
High Grade ◽  
Drug Concentrations ◽  
Average Maximum ◽  
The Brain

2018 Background: Human NSCs are inherently tumor-tropic, making them attractive drug delivery vehicles. This pilot-feasibility study assessed the safety of using genetically-modified NSCs for tumor selective enzyme/prodrug therapy. An immortalized, clonal NSC line was retrovirally-transduced to stably express CD, which converts the prodrug 5-FC to 5-fluorouracil (5-FU), producing chemotherapy locally at sites of tumor in the brain. Methods: Patients 18 years or older with recurrent high-grade glioma underwent intracranial administration of NSCs during tumor resection or biopsy. Four days later, 5-FC was administered orally every 6 hours for 7 days. Study treatment was given only once. A standard 3+3 dose escalation schema was used to increase doses of NSCs from 1 x 107 to 5 x 107 and 5-FC from 75 to 150 mg/kg/day. Intracerebral microdialysis was performed to measure brain levels of 5-FC and 5-FU; serial blood samples were obtained to assess systemic drug concentrations. Three patients received iron-labeled NSCs for MRI tracking. Brain autopsies were done on 2 patients. Results: Fifteen patients received study treatment. Three were inevaluable for toxicity and replaced. All patients tolerated the NSCs well. There was 1 dose-limiting toxicity (grade 3 transaminitis) possibly related to 5-FC. At the highest dose level of NSCs, the average steady-state concentration of 5-FU in the brain was 63.9±7.9 nM. The average maximum 5-FU level in brain was 104±88 nM compared to 24±36 nM in plasma, indicating local production of 5-FU in the brain by the NSCs. MR imaging of iron-labeled NSCs showed preliminary evidence of NSC migration. Autopsy data documented (by IHC, FISH, and PCR) NSCs at distant sites of tumor in the brain and no development of secondary tumors. Conclusions: This first-in-human study has demonstrated safety and proof-of-concept regarding NSC-mediated conversion of 5-FC to 5-FU and NSC tumor-tropism. NSCs have the potential to overcome obstacles of drug delivery that limit current gene therapy strategies. Results of this pilot study will serve as the foundation for future NSC studies. (Supported by NCI 1R21 CA137639-01A1, CIRM DR-01421). Clinical trial information: NCT01172964.

Refractory photophobia elicited during awake craniotomy for the resection of a temporal high-grade glioma

2022 ◽  
Vol 78 ◽  
pp. 110650
Author(s):  
Alexandra Stauffer ◽  
Angelo Tortora ◽  
Serge Marbacher ◽  
Julia Frey ◽  
Markus Gschwind ◽  
...  
Keyword(s):  
High Grade Glioma ◽  
Awake Craniotomy ◽  
High Grade

CTNI-41. INITIAL RESULTS OF A PHASE I WINDOW OF OPPORTUNITY TRIAL EVALUATING A FIRST-IN-CLASS CD29 INHIBITOR, OS2966, IN RECURRENT HIGH-GRADE GLIOMA

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi69-vi69
Author(s):  
James Liu ◽  
Chibueze D Nwagwu ◽  
Amanda V Immidisetti ◽  
Gabriela Bukanowska ◽  
Anne-Marie Carbonell ◽  
...  
Keyword(s):  
Adverse Events ◽  
Phase I ◽  
Tumor Resection ◽  
High Grade Glioma ◽  
Underlying Disease ◽  
Tissue Level ◽  
High Grade ◽  
Convection Enhanced Delivery ◽  
Tumor Biopsy ◽  
Safety Issues

Abstract BACKGROUND OS2966 is a first-in-class, humanized and deimmunized monoclonal antibody which antagonizes CD29/β1integrin, a mechanosignaling receptor prominently upregulated in glioblastoma. Preclinical studies in mice and non-human primates have demonstrated safety and encouraging efficacy. A two-part, ascending concentration, phase I clinical trial was therefore initiated to evaluate the safety and feasibility of delivering OS2966 directly to the site of disease via convection-enhanced delivery (CED) in recurrent high-grade glioma patients. METHODS This study has a 2-part design: In part 1, patients undergo stereotactic tumor biopsy followed by placement of a multiport CED catheter for delivery of OS2966 to the bulk contrast enhancing tumor. Subsequently, patients undergo a clinically-indicated tumor resection followed by placement of two CED catheters and delivery of OS2966 to the surrounding tumor-infiltrated brain. A unique concentration-based accelerated titration design is utilized for dose escalation. Given availability of pre and post infusion samples, pharmacodynamic data will be analyzed to explore mechanism of action of OS2966. RESULTS Two subjects have been treated at two corresponding dose levels (0.2mg/mL and 0.4 mg/mL). No dose-limiting toxicity or unexpected safety issues have been identified. To date, reported adverse events were mild (i.e., grade 1) and consistent with underlying disease and surgical procedures. No adverse events were attributed to OS2966 or CED catheter placement. Further, no clinically significant changes from baseline neurological exam have been noted for either patient through initial follow-up. Maximal tumor coverage and concomitant gross total resection were achieved for both patients. Tumor volume measured 1.63 cm3 and 16 cm3 for Patient 1 and 2 respectively with an intratumoral Vd/Vi ratio of 1.3. and 0.94. Pharmacodynamic analysis via tissue-level biomarkers is ongoing and will be presented. CONCLUSION Initial data demonstrates the safety and feasibility of direct intracranial delivery of OS2966.

scholarly journals Effect of Anesthesia on The Outcome of High-Grade Glioma Patients Undergoing Supratentorial Resection: Study Protocol for A Randomized Controlled Trial 

2021 ◽  
Author(s):  
Dexiang Wang ◽  
Jia Dong ◽  
Min Zeng ◽  
Xiaoyuan Liu ◽  
Xiang Yan ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Tumor Resection ◽  
High Grade Glioma ◽  
High Grade ◽  
Intravenous Anesthesia ◽  
Inhalation Anesthesia ◽  
Randomized Controlled

Abstract Background High-grade glioma (HGG) is the most malignant brain tumor with poor outcome. Whether anesthetic methods have impact on the outcome of these patients is still unknown. Retrospective study has found that there is no difference between two anesthesia methods on the overall survival (OS), however, intravenous anesthesia with propofol might be beneficial in subgroup patients of KPS<80. Further prospective studies are needed to evaluate the results.Methods This is a single-centered, randomized controlled, parallel group trial. 196 patients with primary HGG for tumor resection will be randomly assigned to receive either the intravenous anesthesia with propofol or inhalation anesthesia with sevoflurane. The primary outcome is the OS within 18 months. Secondary outcomes include progression-free survival (PFS), the numerical rating scale (NRS) of pain intensity and sleep quality, the postoperative encephaloedema volume, complications, the length and cost effectiveness of hospital stay of the patients.Discussion This is a randomized controlled trial to compare the effect of intravenous or inhalation anesthesia maintenance on the outcome of supratentorial HGG patients.The results will help to optimizing the anesthesia methods in these patients.Trial registration: ClinicalTrials.gov (ID: NCT02756312). Registered on 27 April 2020 https://register.clinicaltrials.gov/

scholarly journals A review of the new minimally invasive brain stimulation techniques in psychiatry

2001 ◽  
Vol 23 (2) ◽  
pp. 100-109 ◽  
Author(s):  
Jeong-Ho Chae ◽  
Xingbao Li ◽  
Ziad Nahas ◽  
F. Andrew Kozel ◽  
Mark S. George
Keyword(s):  
Minimally Invasive ◽  
Brain Stimulation ◽  
Functional Neuroimaging ◽  
Neuropsychiatric Disorders ◽  
Brain Regions ◽  
Therapeutic Tools ◽  
Invasive Techniques ◽  
The Brain ◽  
Neuroimaging Techniques ◽  
Deep Brain

New knowledge about the specific brain regions involved in neuropsychiatric disorders is rapidly evolving due to recent advances in functional neuroimaging techniques. The ability to stimulate the brain in awake alert adults without neurosurgery is a real advance that neuroscientists have long dreamed for. Several novel and minimally invasive techniques to stimulate the brain have recently developed. Among these newer somatic interventions, transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS) and deep brain stimulation (DBS) show promise as therapeutic tools in the treatment of neuropsychiatric disorders. This article reviews the history, methodology, and the future of these minimally invasive brain stimulation (MIBS) techniques and their emerging research and therapeutic applications in psychiatry

scholarly journals Single-Cell Transcriptome Analysis of Lineage Diversity and Microenvironment in High-Grade Glioma

2018 ◽  
Author(s):  
Jinzhou Yuan ◽  
Hanna Mendes Levitin ◽  
Veronique Frattini ◽  
Erin C. Bush ◽  
Deborah M. Boyett ◽  
...  
Keyword(s):  
Single Cell ◽  
Glioma Cells ◽  
High Grade Glioma ◽  
Transformed Cells ◽  
High Grade ◽  
Tight Coupling ◽  
Mesenchymal Tumors ◽  
Neural Lineage ◽  
Mesenchymal Transformation ◽  
The Brain

ABSTRACTBackgroundDespite extensive molecular characterization, we lack a comprehensive understanding of lineage identity, differentiation, and proliferation in high-grade gliomas (HGGs). We sampled the cellular milieu of HGGs with massively-parallel single-cell RNA-Seq.ResultsWhile HGG cells can resemble glia or even immature neurons and form branched lineage structures, mesenchymal transformation results in unstructured populations. Glioma cells in a subset of mesenchymal tumors lose their neural lineage identity, express inflammatory genes, and co-exist with marked myeloid infiltration, reminiscent of molecular interactions between glioma and immune cells established in animal models. Additionally, we discovered a tight coupling between lineage resemblance and proliferation among malignantly transformed cells. Glioma cells that resemble oligodendrocyte progenitors, which proliferate in the brain, are often found in the cell cycle. Conversely, glioma cells that resemble astrocytes, neuroblasts, and oligodendrocytes, which are non-proliferative in the brain, are generally non-cycling in tumors.ConclusionsThese studies reveal a relationship between cellular identity and proliferation in HGG and distinct population structures that reflects the extent of neural and non-neural lineage resemblance among malignantly transformed cells.

scholarly journals Fluorescence-Guided Surgery and Biopsy in Gliomas with an Exoscope System

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
José Piquer ◽  
Jose L. Llácer ◽  
Vicente Rovira ◽  
Pedro Riesgo ◽  
Ruben Rodriguez ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Brain Biopsy ◽  
High Grade Glioma ◽  
Radical Resection ◽  
Histopathological Diagnosis ◽  
High Grade ◽  
Tumor Surgery ◽  
High Definition ◽  
Stereotactic Brain Biopsy ◽  
High Grade Astrocytoma

Background. The introduction of fluorescence-guided resection allows a better identification of tumor tissue and its more radical resection. We describe our experience with a modified exoscope to detect 5 ALA-induced fluorescence in neuronavigation-guided brain surgery or biopsy of malignant brain tumors.Methods. Thirty-eight patients with a suspected preoperative diagnosis of high-grade astrocytoma were included. We used a neuronavigation device and a high-definition exoscope system with a built-in filter to detect 5-ALA fluorescence in all cases. Thirty patients underwent craniotomy with tumor resection and 8 underwent frameless stereotactic brain biopsy.Results. Histopathological diagnosis confirmed the presence of high-grade gliomas in 34 patients. Total resection was achieved in 23 cases and subtotal in 7. No relevant complications related to the administration of 5-ALA were detected.Conclusions. The use of the exoscope in 5-ALA fluorescence-guided tumor surgery has twofold implications: during brain tumor surgery it can be considered a valuable tool to achieve a more radical resection of the lesion, and when applied to a biopsy of a suspected brain high-grade glioma, it decreases the possibility of a negative biopsy.

scholarly journals Dose distribution of the brain tissue associated with cognitive functions in high-grade glioma patients

2020 ◽  
Vol 24 (1) ◽  
pp. 1-10
Author(s):  
J. Jacob ◽  
E. Clausse ◽  
M.A. Benadjaoud ◽  
C. Jenny ◽  
M. Ribeiro ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Cognitive Functions ◽  
Dose Distribution ◽  
High Grade Glioma ◽  
High Grade ◽  
The Brain
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