In Part 2 of this review article, we discuss the management of primary CNS lymphoma, focusing in particular on systemic therapies and radiation, as well as provide clinicians with a comprehensive overview by covering the key investigations that have brought us to our current state of knowledge, and studies that may guide future interventions.
Immunotherapy Plus Stereotactic Radiosurgery: Building on the Promise of Precision Medicine for CNS Malignancies—PART 1: Principles of Combined Treatment
In this review, we highlight preclinical and clinical data to support the rationale for combination of stereotactic radiosurgery with immunotherapy for the treatment of brain metastases; describe some areas of controversy, especially with regard to radiation fractionation and the timing of combination therapy; and discuss ongoing research into multimodality treatment of CNS tumors.
Here, in Part 1, we will provide an overview of the epidemiology of primary CNS lymphoma, followed by a discussion of the diagnostic and staging evaluation. We will also review the current prognostication systems for primary CNS lymphoma.
The addition of tumor-treating fields to maintenance temozolomide chemotherapy significantly delayed progression and improved overall survival in patients with glioblastoma who had received standard radiochemotherapy compared with maintenance temozolomide alone.
The addition of bevacizumab to lomustine for patients with progressive glioblastoma did not result in a significant improvement in overall survival.
More than 25% of patients with recurrent, high-grade glioma treated with a gene therapy combination were alive more than 3 years after treatment, according to data from a subset of patients in a phase I clinical trial.
Given the longer course and natural history of low-grade gliomas, the goals of treatment should be to prolong overall survival and minimize neurocognitive decline.
Patients with resected brain metastases who underwent stereotactic radiosurgery had lower rates of local recurrence compared with observation alone, according to the results of a phase III trial.
An intraoperative, multimodal optical cancer detection system can detect brain cancer with high degrees of accuracy, sensitivity, and specificity in real time during surgery, according to a new study.
The US Food and Drug Administration has approved the optical imaging agent aminolevulinic acid hydrochloride to enhance visualization of malignant tissue during surgery for gliomas.