bluuebunny/crossref_metadata_2025_split huggingface dataset:
QLTI-17. COMPARATIVE ANALYSIS OF LUMBAR PUNCTURE UTILITY IN DIAGNOSIS OF PRIMARY VERSUS SECONDARY CNS LYMPHOMA: A RETROSPECTIVE STUDY
Authors: Bardhan Mainak , Namrouti Amina , Sagheer Tiba Al , Linhares Yuliya , Rubens Muni , Odia Yazmin , Ahluwalia Manmeet S , Chen Zhijian 
Published: November 2024

Abstract

OBJECTIVES
Central nervous system lymphoma (CNSL) is a subtype of non-Hodgkin lymphoma, which affects the brain, spinal cord, leptomeninges, or eyes. It includes primary (PCNSL) and secondary CNSL (SCNSL). CNSL diagnosis relies on neuroimaging, cerebrospinal fluid (CSF) analysis (cytology, flow cytometry), and/or tissue biopsy. Lumbar punctures (LP) aid in investigating leptomeningeal involvement. Positive findings confirm CNS involvement and guide treatment decisions. This study seeks to determine the effectiveness of CSF analysis via LP in diagnosing SCNSL compared to PCNSL.

METHODS
This retrospective study comprised patients who received treatment with HD-MTX treated at our center from July 2020 to January 2024. Data was retrospectively collected from electronic medical records (EMR). Pathology reports from tissue biopsy and enhancement of CNS visualized on imaging were utilized to diagnose and differentiate PCNSL and SCNSL. CNS cytology and flow cytometry from LP were analyzed to determine the diagnostic accuracy of LP CSF cytology results in diagnosing CNSL. Descriptive statistical and comparative analysis was conducted to analyze the results.

RESULTS
The sample included 70 patients, 35 each diagnosed with PCNSL and SCNSL. Of these, only 49 patients underwent LP, with a significantly higher proportion of patients in the SCNSL group, 33 (67%), compared to the PCNSL group, 16 (33%) (P&lt;0.001). Among those who underwent LP, CSF cytology and/or flow cytometry were positive in 19 cases, with significantly higher detection rates among the SCNSL cases (16 of 33, 48.5%) compared to the PCNSL cases (3 of 16, 18.8%; p=0.045).

CONCLUSION
Our findings indicate that LPs play a crucial role in diagnosing SCNSL, with a significantly higher CSF detection rate than PCNSL. LP has a limited impact on diagnosing PCNSL, suggesting that tissue biopsy should be prioritized to avoid increased time for PCNSL diagnosis. This study underscores the importance of tailored diagnostic approaches for suspected PCNSL and SCNSL, emphasizing the utility of LP in diagnosing SCNSL and tissue biopsy for PCNSL.
QLTI-20. BRIDGING THE GAP: UNDERSTANDING THE CURRENT TREATMENT RESPONSES TO ENHANCE THE STANDARD OF CARE AND OUTCOMES FOR MALIGNANT PERIPHERAL NERVE SHEATH TUMORS
Authors: Sachdeva Ishita , Luo Chongliang , Yang Kuangying , Zhang Lindy , Makri Stavriani , Pratilas Christine A , Hirbe Angela C 
Published: November 2024

Abstract
Malignant peripheral nerve sheath tumor (MPNST) are a rare and aggressive cancer that make up 5-10% of all sarcomas. There is currently no effective targeted therapy to treat MPNST and surgical resection remains the mainstay of treatment, though often not feasible due to location, size of the tumor, or presence of metastases. Evaluation of MPNST treatment response to palliative chemotherapy regimens could serve as a reference point for target response rates in clinical trials going forward. We performed a retrospective electronic health record analysis of patients with biopsy-proven diagnoses of MPNST at Washington University and Johns Hopkins University. We evaluated tumor characteristics along with treatment response, overall survival (OS), and progression free survival (PFS) rates for different chemotherapeutic regimens. The cohort comprises 140 patients, with ages at diagnosis ranging from 21 to 40 years. Most patients had tumors located in the extremities, with sizes ranging from 5-10 cm at the time of diagnosis. We identified 66 patients who received adjuvant chemotherapy, 44 received neoadjuvant chemotherapy and 28 did not receive any chemotherapy. We will present objective response rate (ORR) and clinical benefit rate (CBR) for neoadjuvant chemotherapy. Among patients with metastatic disease (n=53), 12 chemotherapy regimens were assessed. All regimens other than gemcitabine-docetaxel chemotherapy regimen performed better than the median PFS of 1.77 months which has been observed in clinical trials of targeted agents to date with the most compelling response to vincristine-irinotecan-temozolomide regimen. Despite advancements in our understanding of MPNST pathogenesis, these tumors carry a poor prognosis. Our study has identified several systemic therapies which should be further evaluated prospectively to improve treatment options and outcomes for patients with this aggressive sarcoma. These results can serve as a benchmark for future clinical trials.
QOL-02. SOCIAL NETWORKS CAN BE QUANTITATIVELY MEASURED AND NETWORKS WITH GREATER STRUCTURAL DIVERSITY ARE ASSOCIATED WITH HIGHER HUMAN FLOURISHING
Authors: Rhee John , Mastrangelo Carissa , Youssef Gilbert , Rothfeld-Wehrwein Zachary , Dhongade Vrushali , Nakhate Vihang , Batchelor Tracy , Dhand Amar 
Published: November 2024

Abstract

BACKGROUND
In patients with glioblastoma, the predicted progressive deterioration in physical and cognitive abilities leads to decreased quality of life for patients and their caregivers. Research has shown that one’s social environment is a major contributor to health outcomes. However, in this population, study of the social environment is a gap in the literature.

METHODS
We examined the personal social networks of 25 adult glioblastoma patients at one time between initial diagnosis and first cycle of adjuvant chemotherapy from March to September 2023. We additionally collected demographic, tumor measures, and the European Organization for Research and Treatment of Cancer Quality-of-Life for Patients with Brain Tumors (EORTC QLQ-BN20) and the Harvard Human Flourishing Index (HFI) measures.

RESULTS
The average age was 64.5 years old, 56% were female, and 84% had a Karnofsky Performance Status (KPS) of 70 or higher. Patients had large network sizes (mean of 8.8). Patients reported high levels of flourishing despite the challenging diagnosis. Flourishing was statistically significantly associated with lower network constraint (networks in which alters are less likely to be connected to each other) in a patient’s social network (p=0.046) and less lower extremity weakness (p=0.025), controlling for age, gender, income, tumor at size of diagnosis, and KPS.

CONCLUSION
Our study indicates personal social networks with more contacts who are not connected to each other are associated with greater flourishing. Quantifying the social networks of patients with glioblastoma has implications as an objective measure for supportive care trials. Moreover, standard quality-of-life measures may not adequately capture what it means to meaningfully live and flourish. Therefore, future studies should include how social networks and flourishing change over the course of illness and how this may also impact overall survival.
QOL-10. AN ASSESSMENT TOOL FOR MEASURING CAREGIVERS’ DEATH ANXIETY IN PRIMARY BRAIN TUMOR: A CONFIRMATORY FACTOR ANALYSIS
Authors: Willis Kelcie , Mladen Samantha , Rodin Gary , Loughan Ashlee , Braun Sarah 
Published: November 2024

Abstract

BACKGROUND
Caregivers of patients with primary brain tumor describe significant emotional distress regarding their loved one’s impending trajectory and eventual mortality—a construct known as death anxiety. Our team adapted a pre-existing, validated scale for patients with advanced cancer (the Death and Dying Distress Scale; DADDS) to measure this latent variable in caregivers of patients with primary brain tumors. Our adapted scale (DADDS-CG) demonstrated preliminarily strong internal consistency and construct validity. We now seek to confirm the factor structure, internal consistency, and convergent validity of the DADDS-CG in a second sample of neuro-oncology caregivers in accordance with best practices of measure development.

METHODS
Caregivers of those with primary brain tumors (N=221) completed an online battery of self-report questionnaires, including the 15-item Death and Dying Distress Scale-Caregiving (DADDS-CG), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9). To verify the two-factor structure of the DADDS-CG, we used confirmatory factor analysis. Cronbach’s alpha measured internal consistency, Pearson correlations assessed convergent validity, and descriptive statistics determined the prevalence of death anxiety.

RESULTS
Caregivers (Mage=46.2) were primarily White (85.5%) female (72.4%) spouses (75.6%). The two-factor model demonstrated adequate fit (X2/df=4.24; CFI-.89; NFI=.87; RMSEA=.06), suggesting two correlated subscales of death anxiety: Finitude and Dying (r=.80). The DADDS-CG demonstrated strong internal consistency (a=.95) and was moderately correlated with the GAD-7 (r=.73) and PHQ-9 (r=.68), suggesting adequate convergent validity. Mean scores fell within the moderate range (M=40.5, SD=18.7), with 20.8%, 36.2%, and 43.0% of caregivers reporting low, moderate, and severe death anxiety, respectively.

CONCLUSION
The DADDS-CG is a valid and reliable assessment tool for measuring death anxiety in caregivers of those with primary brain tumors. Given the high prevalence of death anxiety, future investigations are needed to understand caregiver’s death anxiety throughout the disease trajectory and to inform intervention development for neuro-oncology caregivers.
QOL-19. IMPROVING SLEEP IN THOSE WITH PRIMARY BRAIN TUMORS (PBT): A GLIMPSE INTO THE CAREGIVER’S PERSPECTIVE FOLLOWING COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I)
Authors: Loughan Ashlee , Lanoye Autumn , Willis Kelcie , Fox Amber , Zukas Alicia 
Published: November 2024

Abstract

BACKGROUND
Sleep disturbance is commonly endorsed by individuals diagnosed with primary brain tumor (PBT), yet few providers in neuro-oncology assess for sleep disturbance, and even less recommend the gold standard treatment for insomnia: Cognitive Behavioral Therapy for Insomnia (CBT-I). In our pilot of a group-based, six-session, telehealth-delivered CBT-I program, PBT patients (N=44) demonstrated clinically significant improvements in self-reported insomnia, fatigue, and sleep quality. The aim of this secondary analysis was to examine informal caregivers’ perspectives of the CBT-I intervention and its impact on patients sleep.

METHODS
Caregivers (N=15, Mage=47.2±14; 53% female; 80% spouses; 93% cohabitating) of patients with PBT and insomnia completed a semi-structured exit interview, following their loved ones’ participation in CBT-I. Descriptive analysis included: perceived improvement in patient and caregiver sleep (rating 1-10; 1=no improvement, 10=great improvement), perceived benefits and drawbacks of CBT-I (open-ended), and caregivers’ recommendation of CBT-I to others with PBT and insomnia (Y/N).

RESULTS
Most caregivers (73%) noticed a moderate-to-great improvement (≥5/10) in the patient’s sleep and 20% endorsed improvements in their own sleep, following CBT-I. Observed patient benefits included: increased sleep, energy, motivation for change, use of a sleep regimen, and support. Caregivers noted minimal drawbacks of CBT-I, though some found the inflexible sleep schedule disrupted family plans and others wished to be more actively involved in the intervention. Nearly all (87%) would recommend CBT-I to others with PBT and insomnia.

CONCLUSIONS
Findings suggest that caregivers observed benefit in the patients’ sleep following a brief behavioral intervention for insomnia, further supporting the acceptability of CBT-I for patients with PBT and insomnia. Future directions include a randomized, two-arm pilot of CBT-I and encouraging caregiver participation in the intervention, both to increase their understanding of CBT-I intervention components for maximum benefit in the patient and to possibly improve their own sleep.
QOL-20. NATIONAL BRAIN TUMOR SOCIETY BRAIN TUMOR QUALITY OF LIFE RESEARCH AGENDA
Authors: Leach Danielle , Kwan Bethany , Salmi Liz , Whaley Morgan , Odom Kristin , Arons David 
Published: November 2024

Abstract

BACKGROUND
QoL is a critical aspect of health care outcomes, particularly in the context of brain tumor treatment and survivorship. There are evidence gaps in optimal strategies for improving QoL among brain tumor patients and care partners. Understanding the multifaceted dimensions of QoL and identifying key areas for brain tumor QoL research can significantly enhance patient care and support. Engaging the brain tumor community in defining QoL outcomes and determining research priorities can help orient research resources to community needs and perspectives.

OBJECTIVE
To summarize the process and outcomes of an NBTS-led collaborative effort to co-design a comprehensive research agenda on QoL for brain tumor patients and care partners, as outlined in the “Brain Tumor QoL Research Agenda.”

METHODS
The agenda was developed through a collaborative effort involving experts in neuro-oncology, patients, care partners, patient advocacy groups, and healthcare professionals over a two-year period. A review of existing literature, patient experiences, and expert opinions informed the identification of key research priorities. A multistakeholder advisory group held monthly meetings where brain tumor QoL was defined. In 2023, we conducted two “Research Roundtables” for adults and pediatric/AYA. The World Cafe method captured data and a survey consensus process to validate findings.

RESULTS
The QoL research agenda delineates a multifaceted framework encompassing domains crucial for understanding and improving QoL in brain tumor patients. Key focus areas include symptom management, psychosocial support, care burden, treatment decision-making, survivorship issues, and health care delivery models. An RFP was released by NBTS with input from stakeholder advisors in April 2024.

CONCLUSION
The Brain Tumor QoL Research Agenda created a roadmap for advancing research efforts aimed at enhancing the QoL of individuals affected by brain tumors. By addressing the identified research priorities, healthcare stakeholders can work towards implementing effective interventions and policies to optimize patient outcomes and well-being. This program was funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI Engagement Award (EACB-23261).
QOL-30. DIETARY CONSIDERATIONS FOR PEOPLE WITH NF1: A SYSTEMATIC REVIEW OF THE LITERATURE
Authors: Babaria Rajvi , Yogaratnam Arjun , Makri Stavriani , Romo Carlos 
Published: November 2024

Abstract

BACKGROUND
Neurofibromatosis type 1 (NF1) is a neurocutaneous genetic condition. Limited pre-clinical and clinical data suggests that certain metabolic disturbances, body composition differences and nutritional deficiencies may be more prevalent in people with NF1. Data on the role of dietary patterns in people with NF1 and their effects in NF1-related manifestations is scarce.

METHODS
A systematic literature review was conducted; the MeSH database of PubMed was utilized to identify controlled vocabulary and key words associated with NF1, diet, and nutrition. These terms were combined using boolean operators to query PubMed, Embase, PLOS One, and Cochrane. The inclusion criteria consisted of articles in English, full text available, human studies, published between 2000-2024. The results were screened and key details were extracted.

RESULTS
394 published articles were identified, out of which 15 met the inclusion criteria. 379 papers were excluded due to duplication or not meeting all inclusion criteria. Manuscripts included case reports, case series, retrospective and prospective studies, including a phase 2a clinical trial that only included six participants. Topics included vitamin D and bone metabolism, nutritional supplements, glucose metabolism, and nutritional intake.

CONCLUSIONS
Data regarding the effects of diet or nutritional supplements in people with NF1 is limited. Available studies suggest that a diet composed of therapeutic elements, including but not limited to, medium-chain fatty acids, calcium, and vitamin D, aids in bone growth and density, and muscle lipolysis. A single clinical trial suggests that L-carnitine supplementation is safe and feasible and might result in improved functional muscle performance in children with NF1. These conclusions might only be applicable to a small population of people with NF1 and did not result in conclusive significant clinical benefit. Further research is needed to better comprehend the role that nutrition plays in patients’ quality of life.
RBIO-06. STEREOTACTIC RADIOSURGERY ENHANCES T-CELL RECEPTOR REPERTOIRES AND INDUCES IMMUNOGENICITY IN BRAIN METASTASIS
Authors: Fukumura Kazutaka , Reuben Alexandre , Jiang Peixin , Ferguson Sherise D , Yeboa Debra N , Huse Jason T 
Published: November 2024

Abstract

BACKGROUND
Brain metastasis is a frequent and deadly complication of systemic malignancy. The incidence rate is increasing and the prognosis remains poor, in contrast to recent advances in the management of systemic malignancy. Our previous work revealed an immunosuppressive microenvironment in brain metastasis and correlation between T-cell status and patient outcomes, shared across the primary tumor histologies. Therefore, we hypothesize that induction of immunogenicity has potential to improve brain metastasis patient outcome.

METHODS
Pre-operative stereotactic radiosurgery (SRS) (n = 44) and post-operative SRS (n = 47) brain metastasis specimens were collected from an ongoing clinical trial (MDACC protocol 2018-0552) designed to determine optimal timing of SRS for the treatment of brain metastasis. The patient materials were extracted DNA and RNA, and subjected to T-cell receptor (TCR) repertoire sequencing and mRNA-seq to interrogate radiation-induced immunogenicity.

RESULTS
In a preliminary analysis of the first 21 specimens, Gene Set Enrichment Analysis revealed that SRS significantly enhanced multiple immune-related signaling pathways including interferon response, along with apoptotic pathways, in brain metastasis. We also found that TCR signaling and PD-1 signaling was upregulated by radiotherapy. TCR repertoire analysis further identified increased density and diversity of TCRs induced by SRS treatment. Profiling of the remaining sample set is currently ongoing.

CONCLUSIONS
In light of our previous finding regarding the correlation between immune status and outcomes of patients with brain metastases, reversing immunosuppression in brain metastasis could be a key factor on patient prognosis and treatment. Our TCR repertoire and mRNA sequencing analyses with pre-operative and post-operative SRS brain metastasis cohorts support a role for radiation-induced immunogenicity, pointing to a prospective therapeutic approach for brain metastasis management.
SURG-02. ANAPLASTIC PLEOMORPHIC XANTHOASTROCYTOMA WITH LEPTOMENINGEAL DISSEMINATION PRESENTING WITH CRANIAL NEUROPATHY IN AN ADULT PATIENT: ILLUSTRATIVE CASE AND REVIEW OF THE LITERATURE
Authors: Menaker Simon , Boyke Andre , Bannykh Serguei , Ross Lindsey , Eboli Paula 
Published: November 2024

Abstract

INTRODUCTION
Anaplastic pleomorphic xanthoastrocytomas (APXA) are very rare, grade III malignant astrocytic glial neoplasms first described as a distinct entity in the 2016 World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS). They are generally seen in pediatric and young adult patients as supratentorial lesions with both solid and cystic components and have a high propensity for recurrence despite local treatment. APXAs occasionally demonstrate leptomeningeal dissemination (LMD) but extremely seldom at the time of diagnosis. They are typically treated via surgical resection with adjuvant chemoradiation, although there is no standard of care for adjuvant therapy. Case Presentation: The authors describe the case of a 37-year-old male with a history of seizures since age 11 who presented with four months of worsening headache, increasingly frequent seizures, and diplopia with right cranial nerve III palsy. Imaging at the time of diagnosis of his seizure disorder as a child demonstrated a small left temporal lesion, which remained stable on imaging for over 20 years and was never biopsied, however MRI at current presentation showed significant interval enlargement with intralesional hemorrhage and leptomeningeal enhancement involving the left temporal and parietal lobes, left internal auditory canal, and right oculomotor nerve. He underwent surgical resection with gross total resection achieved and pathology revealed WHO Grade III pleomorphic xanthoastrocytoma with ATG7::RAF1 fusion, 9p21 deletion, and TERT promoter mutation on next generation sequencing. This was followed by adjuvant whole brain radiation with boost and treatment with MEK inhibitor cobimetinib. His postoperative course was remarkable for intermittent speech difficulty and improving right third nerve palsy.

CONCLUSION
We describe the unusual presentation of an already exceedingly rare primary CNS tumor, namely APXA in an adult patient with LMD and cranial neuropathy at the time of diagnosis, and detail tailored adjuvant therapy based on genomic profiling.
SURG-03. GENE EXPRESSION CHANGES ASSOCIATED WITH RECURRENCE AFTER GROSS TOTAL RESECTION OF NEWLY DIAGNOSED WHO GRADE 1 MENINGIOMA
Authors: Morshed Ramin , Nguyen Minh , Youngblood Mark , Perlow Haley , Lucas Calixto-Hope , Patel Akash , Palmer Joshua , Chandler James , Theodosopoulos Philip , Magill Stephen , Chen William , Raleigh David 
Published: November 2024

Abstract
Patients who undergo gross total resection (GTR) of Central Nervous System World Health Organization (WHO) grade 1 meningioma constitute a “low risk” group, but some low risk meningiomas can recur despite reassuring clinical and histological features. In this study, gene expression in newly diagnosed WHO grade 1 meningiomas that had undergone GTR were evaluated for their association with recurrence. This was a retrospective, international, multi-center cohort study that included WHO grade 1 meningiomas that underwent GTR as first treatment. Normalized gene expression values from a previously validated 34-gene panel were evaluated for their association with recurrence. Kaplan-Meier, multivariable Cox proportional hazard analyses, and K-means clustering were performed to assess the association of genes of interest with recurrence and identify molecular subgroups among clinically and histologically low risk meningiomas. 442 patients with WHO grade 1 meningiomas that underwent GTR and had available gene expression profiling data were included in the study. Median follow-up was 5.0 years (interquartile range 2.6-7.7 years), local recurrence occurred in 36 patients (8.1%), 5-year local freedom from recurrence (LFFR) was 90.5%, and median time to recurrence of 2.9 years (range 0.5-10.7 years). Eleven genes were associated with local recurrence, including lower expression of ARID1B, ESR1, LINC02593, PGR, and TMEM30B and higher expression of CDK6, CDKN2C, CKS2, KIF20A, PGK1, and TAGLN. K-means clustering based on these 11 genes distinguished 2 molecular groups of clinically and histologically low risk meningiomas with significant differences in LFFR (HR 2.5, 95% CI 1.2-5.1, p=0.016). In conclusion, gene expression profiling may help to identify newly diagnosed WHO grade 1 meningiomas that have an elevated risk of recurrence despite GTR.