Podcasts about leptomeningeal

 Dr. John Fortunato interviews Dr. Adrienne Boirre about her and her team's recent manuscript entitled "Leptomeningeal metastases from solid tumors: A SNO and ASCO consensus review on clinical management and future directions", published online in Neuro-Oncology on 

BUFFALO, NY- January 24, 2024 – A new #case report was #published in Oncotarget's Volume 15 on January 16, 2024, entitled, “Lazarus effect in a patient initially empirically treated with osimertinib for EGFR L858R mutant non-small cell lung cancer with leptomeningeal disease: a case report.” Osimertinib has been shown to be effective for patients with non-small cell lung cancer (NSCLC) with activating EGFR mutations. These patients are also at risk for leptomeningeal disease (LMD). LMD is characterized by central nervous system metastases with spread to the cerebrospinal fluid or leptomeninges. In patients with NSCLC with EGFR activating mutations, there is an increased occurrence of LMD, which occurs in 9% of patients. In this new report, researchers Shreya Bhatia, Manuel G. Cortez, Spencer Lessans, and Wade T. Iams from Vanderbilt-Ingram Cancer Center present a patient of East Asian descent whose initial presentation included severe, progressive leptomeningeal carcinomatosis and a small lung mass, with limited tissue available for molecular testing. She responded to empiric, urgent initiation of osimertinib, repeat tissue sampling revealed an EGFR L858R mutation, and she has experienced durable disease improvement for 18 months on osimertinib monotherapy. “Our case demonstrates the nuances of decision-making in starting osimertinib in urgent clinical settings. Given our patient's progressively worsening functional status and spread of disease to her CNS upon presentation, there was a need to begin treatment imminently. Time constraints, financial constraints, and lack of sufficient tissue for analysis ultimately led to the empiric use of osimertinib. Through the urgent initiation of appropriate anti-cancer therapy, she experienced both a life saving improvement in functional status and improvement in her LUL primary tumor one month into treatment.” DOI - https://doi.org/10.18632/oncotarget.28550 Correspondence to - Wade T. Iams - wade.t.iams@vumc.org Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28550 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, EGFR mutation, leptomeningeal disease, non-small cell lung cancer, osimertinib About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh?si=&nd=1&dlsi=c12c9dbac1be421d Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

Dr. Iyad Alnahhas interviews Drs. Priya Kumthekar and Jeffrey Raizer about their recent manuscript entitled: A phase I/II study of intrathecal trastuzumab in human epidermal growth factor receptor 2-positive (HER2- positive) cancer with leptomeningeal metastases: Safety, efficacy, and cerebrospinal fluid pharmacokinetics", published online in Neuro-Oncology in March 2023.

Leptomeningeal disease is a type of metastatic cancer. The leptomeninges are two layers of tissue covering the brain and spinal cord. They are the innermost layers covering the brain's surface, blood vessels, and cerebrospinal fluid. Five to eight percent of people with cancer will develop leptomeningeal disease. It is estimated that of the ~54,000 Georgians diagnosed each year with invasive cancer, as many as 4,000 are at risk of developing leptomeningeal disease. Chris Curry sits down with Dr. Wallace, an assistant professor in the Department of Hematology/Oncology at the Medical College of Georgia to discuss Leptomeningeal disease and the newest clinic to aid in patient care and treatment of the disease.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.25.529915v1?rss=1 Authors: Binder, N., El Amki, M., Glueck, C., Middleham, W., Reuss, A. M., Bertolo, A., Thurner, P., Deffieux, T., Handelsmann, H.-L., Baumgartner, P., Orset, C., Bethge, P., Kulcsar, Z., Aguzzi, A., Tanter, M., Vivien, D., Wyss, M. T., Luft, A., Weller, M., Weber, B., Wegener, S. Abstract: Recanalization is the mainstay of ischemic stroke treatment. However, even with timely clot removal, many stroke patients recover poorly. Leptomeningeal collaterals (LMCs) are pial anastomotic vessels with yet unknown functions. Utilizing a thrombin-based mouse model of stroke and the gold standard fibrinolytic treatment rt-PA, we here show that LMCs play a critical role in preserving vascular function in ischemic territories. We applied laser speckle contrast imaging, ultrafast ultrasound, and two-photon microscopy, to show that after thrombolysis, LMCs allow for gradual reperfusion resulting in small infarcts. On the contrary, in mice with poor LMCs, distal segments of recanalized arteries collapse and deleterious hyperemia causes hemorrhage and mortality. Accordingly, in stroke patients with poor collaterals undergoing thrombectomy, rapid reperfusion resulted in hemorrhagic transformation and unfavorable recovery. Thus, we identify LMCs as key components regulating reperfusion after stroke. Future therapeutic interventions should aim to enhance collateral function, allowing for gradual reperfusion of ischemic tissues after stroke. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Dr Tripathy explains the rationale for the TBCRC049 trial, the challenges of investigating a disease that appears in less than 5% of patients with breast cancer, and potential avenues for future investigations.

This is a new stop in our ongoing series Road to a Cure. From the start, our goal for this series was not only to educate and give hope to every listener  but also to ensure that  each of these special interviews feels like an intimate conversation with our smartest friend who also happens to be an oncologist researcher. Co-hosts Victoria Goldberg and Dr. Paula Jayne sit down with neuro-oncologist Dr. Priya Kumthekar to talk about leptomeningeal metastases: what they are, how are they treated, and what research is upcoming, including a discussion on ANGled, the new Phase 3 trial for MBC patients newly diagnosed with leptomeningeal metastases.  We end this episode on a hopeful note with  a little Dash of Joy  from our Creator and Senior Producer Lisa Laudico.More info is available on our website:   www.ourmbclife.orgGot something to share?  Feedback? Email:   ourmbclife@sharecancersupport.orgSend us a voice recording via email or through speakpipe on our website.  Follow us on Facebook, Instagram, and Twitter @ourmbclife

Meredith McKean MD, MPH with Sarah Cannon Research Institute, Douglas Johnson, MD, Assistant Professor of Medicine at Vanderbilt, and Roman Groisberg, MD Medical Oncologist at Rutgers Health joined GRACE to discuss current updates in treatment for Melanoma. Dr. Roman Groisberg discusses Leptomeningeal disease and brain metastases in melanoma patients.A huge thank you to our sponsors #Merck and #Exelixis!For more, please visit http://cancerGRACE.org/. To join the conversation, visit https://cancergrace.org/forum.

Dr. Rae Bacharach discusses Jamie Talan's article in Neurology Today entitled, "New Assay Helps Diagnose Leptomeningeal Metastases"

This podcast describes the results of the BLOOM study, evaluating the efficacy of osimertinib in EGFR-mutated lung cancer with leptomeningeal disease after failure of prior EGFR TKI therapy. TRANSCRIPT This JCO Podcast provides observations and commentary on the JCO article “Osimertinib In Patients With Epidermal Growth Factor Receptor Mutation-Positive Non-Small-Cell Lung Cancer and Leptomeningeal Metastases: The BLOOM Study” by Yang et al. My name is Jürgen Wolf and I am the medical director of the Center for Integrated Oncology at the University Hospital of Cologne in Germany. I am a medical oncologist with expertise in personalized lung cancer care.   About 10% of patients with advanced EGFR-mutated lung cancer suffer from leptomeningeal disease. While this disease manifestation in non-small-cell lung cancer is generally associated with a particularly poor prognosis, with survival times of only a few months, the question arises whether treatment with specific tyrosine kinase inhibitors might enable a better disease control. Most studies evaluating the efficacy of 1st and 2nd generation EGFR-TKIs in leptomeningeal disease were retrospective and difficult to interpret, given the heterogeneity of the disease as well as of the preceding treatment procedures. Small prospective studies with patient numbers below 20 tested standard dose erlotinib or afatinib as well as high-dose pulsatile EGFR TKI treatment and reported disappointing results with survival times of around 4 months only.   The 3rd generation EGFR TKI osimertinib initially was approved for T790M positive failure of 1st and 2nd generation EGFR TKIs and is now commonly regarded as 1st line standard treatment for EGFR-mutated lung cancer based on a superior progression-free survival, overall survival and toxicity profile. In studies with primates and healthy volunteers, osimertinib has been shown to exert a higher blood-brain barrier permeability and a higher brain exposure compared with other TKIs. In the AURA clinical development program for osimertinib, 22 patients with T790M-positive relapse after EGFR TKI treatment and leptomeningeal disease were retrospectively identified, and an impressive median overall survival of 18.8 months was reported. A small prospective Japanese trial evaluated osimertinib in 13 patients with T790M-positive leptomeningeal disease which, however, could be confirmed only in 5 patients. Responses were seen in some patients, and the median progression free survival for all patients was reported with 7.2 months.   The BLOOM study part B, which is discussed in this podcast, is a multicenter phase I study evaluating osimertinib in EGFR-mutated lung cancer patients with leptomeningeal metastases and failure of previous EGFR TKI treatment. Study objectives were the assessment of clinical parameters like response, overall survival neurological status, and safety but also pharmacokinetics in blood and cerebrospinal fluid. Main inclusion criteria included confirmed diagnosis of EGFR Exon 19 deletion or L858R mutation and confirmation of leptomeningeal disease by positive cytology of cerebrospinal fluid and at least one leptomeningeal site assessable by MRI. There were two sequential cohorts, one unselected for the T790M mutation and with stable non-CNS disease at enrollment, and one for T790M positive patients without the requirement for stable non-CNS disease. Osimertinib dose was 160 mg once daily, which is twice the approved dose. Besides investigator-based response assessment, according to RECIST, leptomeningeal disease was also assessed by a neuroradiological blinded central review according to the RANO-LM working group criteria, which integrates clinical examination, cerebrospinal fluid cytology and neuraxis MRI.   41 patients from South Korea and Taiwan were included, 20 in the unselected and 21 in the T790M-positive cohort. About 70% of the patients had co-existing brain mets and about 50% prior radiotherapy. For 4 patients, no response data from the independent review were available.   The confirmed overall response rate for leptomeningeal disease was impressive at 62% as assessed by blinded independent review and nearly identical between both cohorts.  By comparison, the overall response rate was only 27% by investigator assessment, which, in turn, revealed a higher stable disease rate. Prior brain radiotherapy had no influence on efficacy. Median duration of response was comparable between blinded independent review and investigator, with 15.2 and 18.9 months, respectively. In about one third of the evaluable patients confirmed CSF clearance could be observed. PK analysis indicated that plasma concentration of osimertinib and its active metabolites reached steady state by day 15; the ratio for osimertinib exposure in cerebrospinal fluid vs. plasma was around 16%.   Surprisingly, only half of the patients had an abnormal neurological baseline assessment, most of them with mild symptoms. Symptom stabilization occurred in 54% during treatment; only 5% showed regression of neurological functions.   Overall, median progression-free survival, as assessed by the investigators, was 8.6 months and median overall survival 11 months. Progression-free survival and overall survival differed markedly between both cohorts. For instance, overall survival was 16.6 months in the unselected and 8.1 months in the selected group. Possibly, the requirement for stable non-CNS disease in the unselected group was partly responsible for the better survival outcome in this subset . However, this has to be interpreted cautiously in view of small patient numbers and large confidence intervals.   Osimertinib 160mg was well tolerated in the majority of patients with the known osimertinib side-effect profile. However, 24% of the patients suffered from adverse events grade 3 or more—possibly related to osimertinib, according to the investigators’ assessment. Dose reduction had to be performed in 12% and discontinuation of treatment in 22% of the patients due to adverse events. 17% of the patients had fatal events that did not appear to be causally related to osimertinib.   What can we learn from this study? This is the largest prospective study so far in this setting and osimertinib clearly shows clinical efficacy. The study methodology was sound, with response assessment by blinded independent review and based on RECIST criteria as well as on the RANO criteria established in particular for leptomeningeal disease. The overall response rate of leptomeningeal disease of around 60% and the duration of response of around 15 months is clinically relevant in particular, as it is correlated with improvement or at least neurological stabilization in most patients. Although the toxicity of the treatment is substantially higher than reported in osimertinib trials so far, it is manageable, and the risk/benefit ratio appears to be favorable.   What are the limitations of the study? Patient numbers are small, and the patients are heterogeneous with respect to several important factors such as pretreatment whole-brain radiotherapy, occurrence of simultaneous CNS metastases and neurological symptoms. Thus, absolute values for efficacy have to be interpreted cautiously, and comparison with already published trials remains difficult. Also, unfortunately in view of the toxicity, the question remains open whether the 160mg dose, which is not approved, is actually necessary. Finally, since osimertinib increasingly becomes the first-line treatment standard in EGFR-mutated lung cancer, the number of patients with failure of 1st- or 2nd-generation EGFR TKI treatment will decrease.   Despite these limitations, the trial provides the most convincing data so far in this special patient population and, in my opinion, defines  an important new option to consider for patients with EGFR-mutated lung cancer and leptomeningeal disease after failure of previous EGFR TKI treatment.   This concludes this JCO Podcast. Thank you for listening.

Norris Cotton Cancer Center Grand Rounds presented on June 12, 2018 Paula K. Rauschkolb, DO Assistant Professor of Medicine, Geisel School of Medicine, Dartmouth

GRACE is happy to present the 8th in our series ASCO 2016 Lung Cancer Roundtable, Highlights and New Approaches in Lung Cancer.  Featuring Jack West, MD, Janet Freeman-Daily, Everett Vokes, MD, and Suresh Ramalingam, MD, this roundtable discussion, moderated by Dr. West, highlights the newest and most intriguing discussions from ASCO 2016. Drs. West, Vokes and Ramalingam, along with patient advocate Janet Freeman-Daily, discuss new trials of targeting therapies used to treat leptomeningeal carcinomatosis.

GRACE is happy to present the 8th in our series ASCO 2016 Lung Cancer Roundtable, Highlights and New Approaches in Lung Cancer.  Featuring Jack West, MD, Janet Freeman-Daily, Everett Vokes, MD, and Suresh Ramalingam, MD, this roundtable discussion, moderated by Dr. West, highlights the newest and most intriguing discussions from ASCO 2016. Drs. West, Vokes and Ramalingam, along with patient advocate Janet Freeman-Daily, discuss new trials of targeting therapies used to treat leptomeningeal carcinomatosis.

GRACE is happy to present the 8th in our series ASCO 2016 Lung Cancer Roundtable, Highlights and New Approaches in Lung Cancer.  Featuring Jack West, MD, Janet Freeman-Daily, Everett Vokes, MD, and Suresh Ramalingam, MD, this roundtable discussion, moderated by Dr. West, highlights the newest and most intriguing discussions from ASCO 2016. Drs. West, Vokes and Ramalingam, along with patient advocate Janet Freeman-Daily, discuss new trials of targeting therapies used to treat leptomeningeal carcinomatosis.

Dr. Ross Camidge talks about a clinical trial that will test to see if the drug tesevatinib will work to kill cancer that has progressed in the brains of EGFR-mutant lung cancer patients. The trial is scheduled to begin in late 2015 or early 2016.

Dr. Ross Camidge talks about a clinical trial that will test to see if the drug tesevatinib will work to kill cancer that has progressed in the brains of EGFR-mutant lung cancer patients. The trial is scheduled to begin in late 2015 or early 2016.

Dr. Ross Camidge talks about a clinical trial that will test to see if the drug tesevatinib will work to kill cancer that has progressed in the brains of EGFR-mutant lung cancer patients. The trial is scheduled to begin in late 2015 or early 2016.

Leptomeningeal disease (LMD), which is also referred to as leptomeningeal carcinomatosis (LC), is a rare complication of cancer where the disease spreads to the membranes (meninges) surrounding the brain and spinal cord. Having a diagnosis of LMD may feel grim, but Cynthia Weisinger, a LMD and stage four breast cancer patient at MD Anderson Cancer Center, represents hope. Cynthia was diagnosed with LMD by Ivo Tremont, M.D., assistant professor of Neuro-Oncology, in October 2013 and is now receiving maintenance LMD treatment. Listen as they discuss this rare disease and how together they cope with LMD.

Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

Question and answer session with Dr. Minesh Mehta, Professor of Radiation Oncology at Northwestern University, on topics related to treatments for brain metastases and related complications, especially in the setting of lung cancer.

Question and answer session with Dr. Minesh Mehta, Professor of Radiation Oncology at Northwestern University, on topics related to treatments for brain metastases and related complications, especially in the setting of lung cancer.

Leptomeningeal metastases and acute dizziness. This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Michelle Mauermann interviews Dr. Lisa DeAngelis about her paper on leptomeningeal metastases. In the next segment, Dr. Ryan Overman is reading our e-Pearl of the week about hemiballism. In the next part of the podcast Dr. Beau Bruce interviews Dr. David Newman-Toker on acute dizziness for our Lesson of the Week. The participants had nothing to disclose except Dr. DeAngelis.Dr. DeAngelis has served on a scientific advisory board for Genentech, Inc.; serves on the editorial board of Neurology; receives royalties from the publication of The Neurologic Complications of Cancer (Oxford University Press, 2008); and has received research support from the NIH (UO1 CA-105663-01 [Participating Member in the NABTC]).