bluuebunny/crossref_metadata_2025_split huggingface dataset:
NCMP-14. HIGH GLIOMA PROLIFERATION SIGNIFICANTLY CORRELATES WITH LANGUAGE DEFICITS REGARDLESS OF MRI LESION SUBTYPE
Authors: Dada Abraham , Aabedi Alexander , Kaur Jasleen , Ahn EunSeon , Brang David , Hervey-Jumper Shawn 
Published: November 2023

Abstract

BACKGROUND
We recently demonstrated that glioma-infiltrated cortex engages in task-specific computations but may encode less information while doing so. The mechanistic underpinnings of glioma burden and its behavioral impact remains unknown

OBJECTIVE
To investigate the relationship between glioma burden and degree of cognitive impairments.

METHODS
One-hundred-eight patients with newly diagnosed WHO 2-4 diffuse glioma were recruited from a UCSF prospective registry. MRI FLAIR and T1 post-gadolinium tumor volume masks were demarcated. A “Composite” mask was generated from the sum of T1 post-gadolinium and FLAIR volume masks. Participants completed language assessments using the Quick Aphasia Battery (QAB). Glioma burden was determined by tumor-specific marker expression (IDH-1 mutation and P53) and glioma proliferation (Ki-67 and MIB-1 proliferation index). For each mask type, support-vector regression voxel-lesion symptom mapping (SVR-LSM) and linear regression analyses were performed to identify anatomic regions of interest (ROI) and glioma-specific factors associated with lower QAB scores.

RESULTS
SVR-LSM analysis by mask type revealed significant clusters in the left superior temporal gyrus: composite lesions within a cluster of 41,762 voxels and T1 post-gadolinium lesions within a cluster of 42,570 voxels. Both were independently predictive of lower QAB scores. SVR-LSM analysis of FLAIR masks failed to produce any significant clusters. Multivariate linear regression analysis of composite lesions was utilized to control for composite lesion voxel volume, glioma grade, and tumor-specific marker expression. The presence of voxels overlapping with the composite lesion ROI scores (beta = -0.13; p &lt; 0.001), and, relative to a low glioma proliferation group (&lt; 2%), glioma proliferation between 31-50% (beta = -2.00, p = 0.044) were independently and significantly predictive of lower QAB scores.

CONCLUSION
Relative to a low glioma proliferation group (&lt; 2%), glioma proliferation between 31-50% significantly predicts language impairments, with a linear relationship between voxel overlap with ROI and impairment severity.
NCMP-21. AQP4-MOG DOUBLE-POSITIVE PARANEOPLASTIC NEUROLOGICAL SYNDROME IN A PATIENT WITH TRIPLE NEGATIVE BREAST CANCER
Authors: Siddiqui Amna , Ross Dylan , Jani Ronak , Prabhu Vikram , Lo Shelly , Wainwright Derek , Rouse Stasia , Refaat Tamer , Zhu Yirong , Thakkar Jigisha 
Published: November 2023

Abstract
We report a rare case of paraneoplastic neurological syndrome (PNS) with dual seropositivity of anti-aquaporin-4 (AQP-4) and myelin oligodendrocyte glycoprotein (MOG) antibodies in a 40 year-old lady with metastatic triple negative breast cancer with involvement of mediastinal, right axillary, and supraclavicular lymph nodes. She received multiple lines of anti-neoplastic treatment including immunotherapy with pembrolizumab as well as chemotherapy with taxol, carboplatin, gemcitabine, capecitabine, cytoxan, sacituzumab and nevalbine. Paraneoplastic meningoencephalomyelitis developed 2 years after diagnosis of breast cancer and 1 year after discontinuation of immunotherapy with pembrolizumab. She first developed longitudinally extending transverse myelitis extending from T11-12 that symptomatically improved with high dose intravenous methylprednisolone. One month later she developed left optic neuritis and meningoencephalitis with new enhancing lesions in the brain and spinal leptomeninges. Cerebrospinal fluid (CSF) analysis during both episodes revealed normal glucose, protein, elevated white blood cell count. Cytology was negative for malignancy. CSF was positive for neuromyelitis optica (NMO) IgG antibody APQ-4 and autoimmune myelopathy panel was positive for MOG antibody. Patient had significant clinical and radiographic improvement after completion of plasmapheresis and intravenous immunoglobulin. There was resolution of pleocytosis on repeat CSF testing. She did not have recurrence of paraneoplastic syndrome with maintenance rituximab every six months and daily low dose prednisone. She succumbed to progressive systemic metastatic disease 4.5 years after her breast cancer diagnosis. This case demonstrates that these antibodies can occur concurrently and cause clinical features like both neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disease (MOGAD) in a patient with a singular type of cancer. We highlight the importance of testing for paraneoplastic etiology in cancer patients with radiographic menigoencephalomyelitis or meningitis with atypical symptoms of meningeal carcinomatosis and/or CSF profile negative for leptomeningeal carcinomatosis.
NCMP-27. CHARACTERISTICS OF RADIATION-INDUCED BRAIN TUMORS AFTER CRANIAL IRRADIATION
Authors: Onishi Shumpei , Yamasaki Fumiyuki , Kinoshita Yasuyuki , Takayasu Takeshi , Yonezawa Ushio , Taguchi Akira , Ozono Iori , Khairunnisa Novita Ikbar , Horie Nobutaka 
Published: November 2023

Abstract

INTRODUCTION
The use of radiation therapy (RT) improves the outcome of cancer patients, while additionally increasing the risk of radiation-induced neoplasms in cancer survivors. The most common radiation-induced brain tumors (RIBT) are gliomas (RIG), meningiomas (RIM), and sarcomas (RIS). To investigate the characteristics of RIBT, we reviewed our case series and all relevant cases from the literature review.

METHODS
From our case series and literature review, we identified 920 RIBT patients who received cranial irradiation. We analyzed the age at irradiation for primary disease. The latency period from irradiation to the development of each RIBT and the median overall survival (OS) of RIBT were analyzed with Kaplan–Meier method.

RESULTS
Among RIBT patients, 23.2 % were irradiated less than 5 years, and 41.6% were irradiated in the first decade. The median age (interquartile range) at cranial irradiation were 9 (4.35 - 16) years in RIM patients, 9 (5 - 23) years in RIG patients, and 27 (13.7 - 40) years in RIS patients. The latency periods from irradiation to the development of RIM was significantly longer than RIG and RIS (RIM: 21 years, RIG: 9 years, RIS: 10 years; p &lt; 0.0001). The median OS was significantly longer in patients with RIM than in those with RIG and RIS (RIM: not reached, RIG: 11 months, RIS 11 months; p &lt; 0.0001).

CONCLUSIONS
RIG and RIS had a poor prognosis, while RIM had a relatively better prognosis. Because RIBTs develop more than a decade after cranial irradiation, long-term follow-up is crucial.
NCMP-29. THE NATURAL HISTORY OF NEUROLYMPHOMATOSIS
Authors: Xu Elizabeth , Ho Quan , Liu Ashley , Gautam Shiva , Wong Eric 
Published: November 2023

Abstract
Neurolymphomatosis is a rare lymphoid malignancy of the peripheral nervous system. Patients suffer from debilitating neurological deficits due to lymphoma invasion into one or more peripheral nerves and the natural history of this disease is still poorly understood. We performed a PubMed search and extracted data on year of publication, age, gender, type of lymphoma, nerves involved, imaging modalities, treatment received, and survival times. Kaplan-Meier statistics were used to determine outcome parameters over time and compare prognostic factors. Multiple comparisons were done to determine differences among groups. Our search identified 559 patients from 286 articles. Median age was 61 years (range 2-92) from 326 males, 222 females, and 11 with unspecified gender. Median overall survival (OS) was 12.0 months (range 10.0-15.0) for the entire cohort. Most frequent histologies were diffuse large B-cell lymphoma, unspecified T-cell lymphoma, and unspecified B-cell lymphoma, involving the brachial plexus, cranial nerves, and sciatic nerve. None had molecular profiling. There was a progressive lengthening of OS in successive decades, from 0.5 (95%CI 0.0-0.8) to 26.4 (95%CI 18.0-34.8) months from 1951-2022 (r2=0.9432, p&lt; 0.001). Time from first treatment to progression also increased from 2.0 (95%CI N/A) to 28.3 (95%CI 23.1-33.5) months (r2=0.6923, p&lt; 0.001). However, time from symptom onset to diagnosis remained unchanged during this period (r2=0.6206, p=0.277). Patients were most frequently treated with methotrexate-based chemotherapies (n=81), rituximab-based chemotherapies (n=176), and/or radiation (n=79). Only 12 received 3 or more regimens. Primary neurolymphomatosis had a better prognosis than secondary neurolymphomatosis, median OS 15.0 (95%CI 11.0-33.0) vs. 10.0 (95%CI 10.0-10.0) months (p=0.016). No OS difference was noted between B- and T-cell disease (p=0.4393), while patients with low-grade B-cell neurolymphomatosis did better than those with Burkitt's lymphoma (p≤0.001). Outcome for patients with neurolymphomatosis has improved over time. But timely diagnosis remains a major problem that needs improvement.
NCOG-02. MANAGEMENT OF PATIENTS WITH MELANOMA BRAIN METASTASES AND PRIOR SYSTEMIC TREATMENT EXPOSURE: A SINGLE-CENTER EXPERIENCE
Authors: Muniz Thiago P , Jablonska Paola A , Saibil Samuel D , Spreafico Anna , Hogg David , Shultz David , Butler Marcus O 
Published: November 2023

Abstract
Although systemic therapy (ST) for melanoma patients with untreated brain metastases (BrM) has activity, ST options for patients with melanoma BrM that develop on or after ST are limited. In this single-center retrospective study, we describe the characteristics and survival outcomes of patients aged &gt; 18 years with metastatic melanoma and who developed BrM &gt; 90 days after their first dose of checkpoint inhibitor (CPI) or targeted therapy (TT). Relevant clinical data and data on ST prior to and after BrM diagnosis were collected. MRIs were reviewed to assess intracranial progression-free survival (IC-PFS) as per RANO-BM criteria. The primary outcome was overall survival (OS). Cox regression model was applied to identify factors associated with OS. Between 2010 and 2019, we identified 103 patients with median age 56 (29-92) years, 69 (67%) of whom were male; 57 (55%) had BRAF V600-mutant tumors. Ninety-four (91%) had no known BrM at the time of first-line therapy. Median number of BrM was 3 (1-58), median number of prior ST was 1 (1-5), 75 (73%) had prior CPI exposure and 70 (68%) were on concurrent CPI or TT at the time of BrM diagnosis. Local treatments included SRS in 43 (42%) and WBRT in 46 (44%) patients. From BrM diagnosis, median IC-PFS and OS were 3.5 (95% CI 2.6-4.3) and 6.9 (95% CI 5.2-8.6) months, respectively. Adverse prognostic factors were: BRAF wild-type (HR 2.04, 95% CI 1.15-3.64), ECOG 2-4 (HR 3.55, 95% CI 1.93-6.53), and increasing number of prior ST (HR 1.62, 95% CI 1.23-2.13). CPI therapy that was continued, started, or restarted after BrM was associated with improved median OS compared to non-ICI therapy (9.9 vs. 3.5 months, HR 0.45, 95% CI 0.27-0.74). In conclusion, our data support development of CPI-based trials for patients who experience progression with BrM on or after modern ST.
NCOG-04. WHOLE-BRAIN STRUCTURAL CONNECTIVITY PREDICTS COGNITIVE DEFICITS IN PRETREATED PATIENTS WITH CNS WHO GRADE 3 OR 4 GLIOMAS
Authors: Friedrich Michel , Stoffels Gabriele , Filss Christian , Lohmann Philipp , Mottaghy Felix , Lucas Carolin Weiss , Ruge Maximilian , Shah Nadim , Caspers Svenja , Langen Karl-Josef , Fink Gereon , Galldiks Norbert , Kocher Martin 
Published: November 2023

Abstract

BACKGROUND
Glioma patients frequently suffer from cognitive dysfunction potentially caused by tumor invasion or treatment effects. We hypothesized that cognitive functioning in pretreated glioma patients critically depends on the maintained structural connectivity of multiple brain networks. PATIENTS AND

METHODS
The study included 121 pretreated glioma patients (median age, 52 years; median ECOG score, 1; CNS WHO grade, 3 or 4) who had biopsy or resection plus chemoradiation as first-line therapy. Cognitive performance was assessed by ten tests in five main cognitive domains after a median time of 14 months (range, 1-214 months) after treatment initiation. Hybrid amino acid PET/MRI using the tracer O-(2-[18F]fluoroethyl)-L-tyrosine, a network-based cortical parcellation, and advanced tractography tools were used to generate whole-brain fiber count-weighted connectivity matrices. These matrices were applied to a machine learning-based model to identify predictive fiber connections, essential cortical nodes, and the networks underlying cognitive performance in the evaluated domains.

RESULTS
Compared to healthy controls (n=121), the cognitive scores were significantly lower in nine cognitive tests. For each test, a subset of connections between nodes (median number, 254; range, 32-542) was identified whose fiber count sum was related to the actual scores in a linear model (median R2, 0.37; range, 0.16-0.44). Leave-one-out cross-validation confirmed the model's generalizability in 7 of 10 tests (median correlation coefficient for predicted vs. observed scores, 0.47; range, 0.39-0.57). Critically involved cortical regions (≥ 10 adjacent predictive edges) included predominantly left-sided cortical nodes of the visual, somatomotor, dorsal/ventral attention, and default mode networks. Highly critical nodes (≥ 15-20 edges) included the default-mode network’s left temporal and bilateral posterior cingulate cortex.

CONCLUSION
These results suggest that the cognitive performance of pretreated glioma patients is strongly related to structural connectivity between multiple brain networks and depends on the integrity of known network hubs also involved in other neurological disorders.
NCOG-09. EXAMINING THE CLINICAL UTILITY OF NEXT GENERATION SEQUENCING IN ADULT GLIOBLASTOMA – A SINGLE CENTER RETROSPECTIVE STUDY
Authors: Lomax Jerica , Taylor Thomas , Kong Xiao-Tang , Bota Daniela 
Published: November 2023

Abstract

BACKGROUND
Over the last 2 decades, the use of molecular targeted therapy has revolutionized the cancer treatment landscape and transformed the outcomes and disease prognoses of several cancer entities. The success of targeted therapy is closely tied to the advent of commercially available next generation sequencing (NGS) which has expanded our understanding and knowledge of the genetic drivers and mutations present in a variety of tumors. Unfortunately, in glioblastoma (GBM), the overall effectiveness of targeted therapies remains limited.1 Nonetheless, NGS for GBM patients has been integrated into the standard practice of many neuro-oncologists and is encouraged by the National Comprehensive Cancer Network (NCCN) Guidelines. The purpose of this retrospective chart review is to evaluate how NGS is incorporated into the management of glioblastoma at a single center academic institution.

METHODS
We identified 85 patients with pathologically confirmed GBM who had NGS done from January 2014-March 2021. The clinical records of all patients were reviewed to denote the frequency of clinical trial enrollment or off-label use of targeted therapy based on the results of NGS. We also denoted the time point in the disease course when NGS was ordered and the trend of frequency of ordering NGS from January 2014-December 2020.

RESULTS
28.2% (95% CI 19 to 39.1%) of patients received treatment based on the results of NGS. 8% were enrolled in a clinical trial and 20% were treated with off-label use of targeted therapy at the time of disease progression. There was no statistically significant survival difference seen between patients who had treatment done based on results of NGS compared to those who did not.

CONCLUSION
NGS results are used to guide treatment or clinical trial enrollment in a significant number of glioblastoma patients, however, the clinical efficacy of this treatment is yet to be determined.
NCOG-13. OUTCOMES OF CNS WHO GRADE 2 OLIGODENDROGLIOMA IN ADULT PATIENTS ; IMPACT OF ADJUVANT TREATMENT ON OVERALL RESULTS
Authors: Byeon Yukyeng , Song Sang Woo , Lee Chaejin 
Published: November 2023

Abstract

OBJECTIVE
Patients with oligodendroglioma (ODG), isocitrate dehydrogenase (IDH)-mutant, 1p19q codeleted, CNS WHO grade 2 have a median overall survival of longer than 10 years. Patients with ODG who are high-risk by RTOG criteria are offered radiation in combination with procarbazine, lomustine, and vincristine (PCV). The study aims to analyze the patient’s outcomes and assess the efficacy of postoperative treatment.

METHODS
A total of 138 adult patients who underwent resection for newly diagnosed grade 2 ODG between 1994 and 2021 were enrolled. Sixty-three (45.7%) were observed after gross total resection (GTR) or near total resection (NTR), 5 (0.4%) received adjuvant treatment after GTR or NTR, 37 (26.8%) were observed after subtotal resection (STR) or biopsy, and 33 (24.0%) received adjuvant treatment after STR or biopsy. The study analyzed progression-free survival (PFS), overall survival (OS), and risk variables.

RESULTS
Out of the 138 patients, 38 (27%) patients received adjuvant treatment, with 30 of them (78.9%) underwent radiotherapy only, 6 (15.8%) underwent radiochemotherapy, and 2 (5.3%) received chemotherapy alone. The median PFS was 6.8 years. Multivariate analysis revealed STR or biopsy (p=0.04), initial MR imaging enhancement (p=0.002), and postoperative observation(p=0.006) were associated with poorer PFS outcomes. The 5-year overall survival rate was 95.5% and the 10-year overall survival was 76.1%. Poor OS prognosis was associated with STR or biopsy (p=0.03), preoperative seizure (p=0.002), and initial MR imaging enhancement (p&lt; 0.001).

CONCLUSIONS
: GTR and NTR is essential for achieving prolonged PFS and OS in ODG patients. Postoperative treatment is associated with favorable PFS outcomes but does not significantly affect OS. For an accurate diagnosis and appropriate treatment, the utmost care should be taken to avoid underestimating the results of the biopsy.
NCOG-17. RETROSPECTIVE REVIEW OF THE TREATMENT OF VENOUS THROMBOEMBOLISM IN GLIOBLASTOMA PATIENTS RECEIVING BEVACIZUMAB
Authors: Lomax Jerica , Kong Xiao-Tang 
Published: November 2023

Abstract
Patients with malignant gliomas have an inherently high risk of venous thromboembolism (VTE).1 Bevacizumab is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody commonly used in the treatment of recurrent high-grade gliomas and is known to increase the risk of VTE as well as intracranial hemorrhage.2 Anticoagulation (AC) for VTE also increases the risk intracranial hemorrhage in patients with malignant brain tumors.3 This makes the treatment of VTE in patients with GBM receiving bevacizumab therapy particularly challenging. Here we completed a single center retrospective chart review of patients with glioblastoma (GBM) treated concurrently with anticoagulation for VTE and bevacizumab therapy. The purpose of this review was to assess the safety of concurrent use of these therapies and to note any statistically significant difference in the incidence of hemorrhagic complications between patients treated with anticoagulation at therapeutic versus prophylactic dosing. METHODS: 144 patients with a diagnosis of high-grade glioma and were treated at UCI from 1/1/2019 through 1/1/2022 were screened for the study. 13 GBM patients on treatment with bevacizumab and concurrent anticoagulation were included. Clinical records of these patients were reviewed for the incidence of intracranial hemorrhage or any clinically significant bleeding. RESULTS: The incidence of ICH in GBM patients on concurrent therapy with bevacizumab and anticoagulation was 7.7% and the incidence of other minor bleeding complications was 7.7%. ICH and other minor bleeding was exclusively seen in patients on therapeutic anticoagulant dosing. No bleeding complications were noted in patients on prophylactic AC dosing. CONCLUSION: There is a risk of ICH in patients receiving both bevacizumab and anticoagulation, however compared to historical data, the incidence reported in our study is less than the incidence of ICH in GBM patients on anticoagulation alone. Our study suggests that it is relatively safe to treat patients with these therapies simultaneously.
NCOG-18. CLINICAL CHARACTERISTICS OF H3.G34 DIFFUSE HEMISPHERIC GLIOMA: A CASE SERIES AND REVIEW OF THE LITERATURE
Authors: Williams Andrew , Neth Bryan , Campian Jian , Keating Gesina , Kizilbash Sani H , Lachance Daniel , Ruff Michael , Schwartz Jonathan , Uhm Joon , Atkinson John , Burns Terry , Daniels David , Nesvick Cody , Parney Ian , Breen William , Brown Paul , Mahajan Anita , Yan Elizabeth , Sener Ugur 
Published: November 2023

Abstract

BACKGROUND
Diffuse hemispheric glioma (DHG) is an uncommon infiltrating glioma, defined in the World Health Organization 2021 guidelines by a mutation in the H3F3A gene at codon 34 (H3.G34). DHG primarily affects children and young adults. Due to its rarity, there is paucity of knowledge regarding factors affecting overall survival (OS). We retrospectively assessed our institutional experience and present a review of the literature.

METHODS
We searched our institution’s pathology records to identify six cases of DHG. Demographic, clinical, diagnostic, treatment, and outcome data were recorded. We next searched for published articles regarding DHG cases via PubMed through May 2023. Four-hundred-fifty-four published individual cases of H3.G34 glioma were identified, 204 of which were hemispheric/supratentorial tumors with OS data reported, providing a combined 210 cases for analysis. 132 of these cases included MGMT promoter methylation status. 111 included extent of surgical resection. Kaplan-Meier and Cox regression survival analysis was performed.

RESULTS
Age range for DHG patients was 7-66 years (median 17). Median OS was 18.5 months (95% CI, 17-25). Greater extent of surgical resection and presence of MGMT promoter methylation were associated with better prognosis. Median OS for biopsy alone was 12 months (95% CI, 10-NA), subtotal resection was 16 months (95% CI, 14-23), and gross total resection was 27 months (95% CI 23-NA) – log-rank p&lt; 0.001. OS for MGMT promoter unmethylated was 14 months (95% CI 12-22), MGMT promoter methylated was 24 months (95% CI, 17-30) – log-rank p=0.028. Contrary to previous reports, patient age was not found to impact prognosis (using 18, 21, and 40 years as cutoffs or as a continuous variable with Cox regression).

CONCLUSION
Extent of surgical resection and MGMT promoter methylation status are important prognostic factors for DHG. Unlike many primary brain tumors, survival does not appear to be significantly impacted by age.