2023
Selected-Lesion SRS as a Novel Strategy in Treatment of Patients with Multiple Brain Metastases
Singh C, Theriault B, An Y, Yu J, Knisely J, Shepard M, Wegner R, Warnick R, Peker S, Samanci Y, Trifiletti D, Lee C, Yang H, Bernstein K, Kondziolka D, Tripathi M, Mathieu D, Mantziaris G, Pikis S, Sheehan J, Chiang V. Selected-Lesion SRS as a Novel Strategy in Treatment of Patients with Multiple Brain Metastases. International Journal Of Radiation Oncology • Biology • Physics 2023, 117: e150-e151. DOI: 10.1016/j.ijrobp.2023.06.971.Peer-Reviewed Original ResearchWhole-brain radiation therapyTreatment of patientsSystemic diseaseBrain metastasesLesion locationIntracranial lesionsPrior whole-brain radiation therapyMultiple brain metastasesBrain radiation therapyUntreated brain metastasesBrain metastasis treatmentCurrent practice patternsSigns/symptomsPresence of symptomsMATERIAL/METHODSImmunotherapy optionsSystemic therapyUntreated lesionsMedical oncologyPerilesional edemaDrug optionsClinical trialsPractice patternsClinical indicationsMetastasis treatment
2020
Pembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial
Goldberg SB, Schalper KA, Gettinger SN, Mahajan A, Herbst RS, Chiang AC, Lilenbaum R, Wilson FH, Omay SB, Yu JB, Jilaveanu L, Tran T, Pavlik K, Rowen E, Gerrish H, Komlo A, Gupta R, Wyatt H, Ribeiro M, Kluger Y, Zhou G, Wei W, Chiang VL, Kluger HM. Pembrolizumab for management of patients with NSCLC and brain metastases: long-term results and biomarker analysis from a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2020, 21: 655-663. PMID: 32251621, PMCID: PMC7380514, DOI: 10.1016/s1470-2045(20)30111-x.Peer-Reviewed Original ResearchConceptsBrain metastasis responseYale Cancer CenterPD-L1 expressionPhase 2 trialUntreated brain metastasesBrain metastasesAdrenal insufficiencyAdverse eventsMetastasis responseCNS diseaseCancer CenterCohort 2Cohort 1Eastern Cooperative Oncology Group performance statusTreatment-related serious adverse eventsModified Response Evaluation CriteriaStage IV NSCLCTreatment-related deathsAcute kidney injuryPD-1 blockadeSerious adverse eventsSolid Tumors criteriaPhase 2 studyProportion of patientsResponse Evaluation Criteria
2019
Perilesional edema in brain metastases: potential causes and implications for treatment with immune therapy
Tran TT, Mahajan A, Chiang VL, Goldberg SB, Nguyen DX, Jilaveanu LB, Kluger HM. Perilesional edema in brain metastases: potential causes and implications for treatment with immune therapy. Journal For ImmunoTherapy Of Cancer 2019, 7: 200. PMID: 31362777, PMCID: PMC6668163, DOI: 10.1186/s40425-019-0684-z.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAntibodies, Monoclonal, HumanizedAntigens, CD34Antineoplastic Agents, ImmunologicalBlood-Brain BarrierBrain EdemaBrain NeoplasmsCarcinoma, Non-Small-Cell LungClinical Trials, Phase II as TopicDrug Administration ScheduleHumansLung NeoplasmsMelanomaRetrospective StudiesTight JunctionsTreatment OutcomeTumor Cells, CulturedConceptsMelanoma brain metastasesBrain metastasesPerilesional edemaVessel densityEdema volumeSensitive tumorsBlood-brain barrier model systemNon-small cell lungTight junction resistancePhase II clinical trialSignificant perilesional edemaUntreated brain metastasesBlood-brain barrierPre-clinical modelsDegree of edemaTumor mass effectPotential causesMelanoma brainShort-term cultureExtracranial metastasesImmune therapyMelanoma patientsSignificant morbidityCell lungLarge tumors
2018
Long-Term Survival of Patients With Melanoma With Active Brain Metastases Treated With Pembrolizumab on a Phase II Trial
Kluger HM, Chiang V, Mahajan A, Zito CR, Sznol M, Tran T, Weiss SA, Cohen JV, Yu J, Hegde U, Perrotti E, Anderson G, Ralabate A, Kluger Y, Wei W, Goldberg SB, Jilaveanu LB. Long-Term Survival of Patients With Melanoma With Active Brain Metastases Treated With Pembrolizumab on a Phase II Trial. Journal Of Clinical Oncology 2018, 37: 52-60. PMID: 30407895, PMCID: PMC6354772, DOI: 10.1200/jco.18.00204.Peer-Reviewed Original ResearchConceptsBrain metastasis responseBrain metastasesMetastasis responseAdverse eventsAnti-programmed cell death-1 (PD-1) agentsDeath ligand 1 (PD-L1) expressionModified Response Evaluation CriteriaPhase II clinical trialActive brain metastasesAsymptomatic brain metastasesCD8 cell densityNeurologic adverse eventsPembrolizumab-treated patientsUse of pembrolizumabMelanoma brain metastasesPrimary end pointLigand 1 expressionPhase II trialResponse Evaluation CriteriaT-cell infiltratesUntreated brain metastasesDeath ligand 1Two-year survivalOverall survival timeResult of progression
2017
Comparing available criteria for measuring brain metastasis response to immunotherapy
Qian JM, Mahajan A, Yu JB, Tsiouris AJ, Goldberg SB, Kluger HM, Chiang VL. Comparing available criteria for measuring brain metastasis response to immunotherapy. Journal Of Neuro-Oncology 2017, 132: 479-485. PMID: 28275886, DOI: 10.1007/s11060-017-2398-8.Peer-Reviewed Original ResearchConceptsRECIST 1.1Brain lesionsBrain metastasesDurable responsesAdditional patientsNeuro-Oncology Working GroupBrain metastasis responseBrain metastasis patientsUntreated brain metastasesStandardized response criteriaBrain lesion sizeHigh-grade gliomasSimilar clinical trialsHigh-resolution MRIMetastasis patientsMetastasis responseOngoing trialsClinical trialsNovel therapiesResponse assessmentDiscordant casesLesion sizePatientsResponse rateLongest diameter
2016
Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial
Goldberg SB, Gettinger SN, Mahajan A, Chiang AC, Herbst RS, Sznol M, Tsiouris AJ, Cohen J, Vortmeyer A, Jilaveanu L, Yu J, Hegde U, Speaker S, Madura M, Ralabate A, Rivera A, Rowen E, Gerrish H, Yao X, Chiang V, Kluger HM. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2016, 17: 976-983. PMID: 27267608, PMCID: PMC5526047, DOI: 10.1016/s1470-2045(16)30053-5.Peer-Reviewed Original ResearchConceptsProgressive brain metastasesUntreated brain metastasesBrain metastasis responseYale Cancer CenterBrain metastasesPhase 2 trialCell lung cancerAdverse eventsMetastasis responseCancer CenterLung cancerMelanoma cohortGrade 3 colitisGrade 3 fatigueGrade 3 pneumonitisPD-1 axisAcute kidney injuryNeurological adverse eventsPD-1 inhibitorsAcceptable safety profilePD-L1 expressionSystemic immunotherapyKidney injuryPrimary endpointNSCLC cohort
2015
Activity and safety of pembrolizumab in patients with metastatic non-small cell lung cancer with untreated brain metastases.
Goldberg S, Gettinger S, Mahajan A, Herbst R, Chiang A, Tsiouris A, Vortmeyer A, Jilaveanu L, Speaker S, Madura M, Rowen E, Gerrish H, Knapp-Perry E, Yao X, Chiang V, Kluger H. Activity and safety of pembrolizumab in patients with metastatic non-small cell lung cancer with untreated brain metastases. Journal Of Clinical Oncology 2015, 33: 8035-8035. DOI: 10.1200/jco.2015.33.15_suppl.8035.Peer-Reviewed Original Research