2022
Brain metastatic outgrowth and osimertinib resistance are potentiated by RhoA in EGFR-mutant lung cancer
Adua S, Arnal-Estapé A, Zhao M, Qi B, Liu Z, Kravitz C, Hulme H, Strittmatter N, López-Giráldez F, Chande S, Albert A, Melnick M, Hu B, Politi K, Chiang V, Colclough N, Goodwin R, Cross D, Smith P, Nguyen D. Brain metastatic outgrowth and osimertinib resistance are potentiated by RhoA in EGFR-mutant lung cancer. Nature Communications 2022, 13: 7690. PMID: 36509758, PMCID: PMC9744876, DOI: 10.1038/s41467-022-34889-z.Peer-Reviewed Original ResearchConceptsGene expression programsRas homolog family member ACancer cellsFamily member AEpidermal growth factor receptorExpression programsMetastatic cancer cellsSRF signalingGrowth factor receptorTumor microenvironmentLung cancerFunctional linkExtracellular lamininDrug-resistant cancer cellsMutant non-small cell lung cancerNon-small cell lung cancerCentral nervous system relapseMolecular studiesMember AEGFR-mutant lung cancerFactor receptorNervous system relapseCell lung cancerDisseminated tumor cellsBrain tumor microenvironment
2020
Laser interstitial thermal therapy for treatment of cerebral radiation necrosis
Hong CS, Beckta JM, Kundishora AJ, Elsamadicy AA, Chiang VL. Laser interstitial thermal therapy for treatment of cerebral radiation necrosis. International Journal Of Hyperthermia 2020, 37: 68-76. PMID: 32672119, DOI: 10.1080/02656736.2020.1760362.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsHumansHyperthermia, InducedLaser TherapyLasersNecrosisNeoplasm Recurrence, LocalRadiation InjuriesRadiosurgeryConceptsLaser interstitial thermal therapyInterstitial thermal therapyRadiation necrosisRecurrent tumorsCerebral radiation necrosisPeri-operative morbidityBrain metastasis patientsFirst-line therapyAlternative surgical optionReal-time imaging guidanceOpen surgical resectionPersistence of symptomsTreatment of patientsDeep-seated lesionsTissue inflammatory responseAmenable lesionsChronic steroidsBrain metastasesMetastasis patientsSurgical resectionSymptomatic patientsMedical managementSurgical optionsSurgical historyIntracranial pathologyLaser Interstitial Thermotherapy for Treatment of Symptomatic Peritumoral Edema After Radiosurgery for Meningioma
Hong CS, Beckta JM, Kundishora AJ, Elsamadicy AA, Chiang VL. Laser Interstitial Thermotherapy for Treatment of Symptomatic Peritumoral Edema After Radiosurgery for Meningioma. World Neurosurgery 2020, 136: 295-300. PMID: 32001396, DOI: 10.1016/j.wneu.2020.01.143.Peer-Reviewed Original ResearchConceptsSymptomatic peritumoral edemaPeritumoral edemaLaser interstitial thermotherapySurgical resectionGrade IOpen surgical resectionEffective therapeutic modalityViable alternative treatmentInterstitial thermotherapyExperienced resolutionCorticosteroid therapyIntraoperative biopsyRefractory casesConservative managementMost patientsLesion recurrenceMedical therapyRadiation necrosisUnderlying lesionSurgical interventionWound infectionTherapeutic modalitiesRadiosurgical treatmentAlternative treatmentFrontotemporal lesions[11C]Methionine and [11C]PBR28 as PET Imaging Tracers to Differentiate Metastatic Tumor Recurrence or Radiation Necrosis
Tran TT, Gallezot JD, Jilaveanu LB, Zito C, Turcu G, Lim K, Nabulsi N, Huang H, Huttner A, Kluger HM, Chiang VL, Carson R. [11C]Methionine and [11C]PBR28 as PET Imaging Tracers to Differentiate Metastatic Tumor Recurrence or Radiation Necrosis. Molecular Imaging 2020, 19: 1536012120968669. PMID: 33147119, PMCID: PMC7649862, DOI: 10.1177/1536012120968669.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsHumansMethionineNecrosisNeoplasm Recurrence, LocalPositron-Emission TomographyRadiation InjuriesReceptors, GABAConceptsRadiation necrosisTumor regrowthStereotactic radiosurgeryBrain metastasesPET tracersHigh amino acid uptakeMetastatic tumor recurrenceLung cancer cellsSpecific PET tracersPET imaging tracerTumor recurrenceAmino acid uptakeImaging tracerReliable markerDiagnostic imagingLack of specificityAcid uptakeCancer cellsSpecific markersMethionine levelsTranslocator proteinSequential imagingInflammationMetastasisDual tracer
2019
Complications associated with immunotherapy for brain metastases.
Tran TT, Jilaveanu LB, Omuro A, Chiang VL, Huttner A, Kluger HM. Complications associated with immunotherapy for brain metastases. Current Opinion In Neurology 2019, 32: 907-916. PMID: 31577604, PMCID: PMC7398556, DOI: 10.1097/wco.0000000000000756.Peer-Reviewed Original ResearchMeSH KeywordsAntineoplastic AgentsBrain NeoplasmsHumansImmunologic FactorsImmunotherapyNeoplasm MetastasisNeoplasm Recurrence, LocalNeurotoxicity SyndromesConceptsBrain metastasesNeurologic toxicityImmune therapyPhase 2 clinical trialCheckpoint inhibitor therapyImmune checkpoint inhibitorsMultiple phase 2 clinical trialsTreatment-related morbidityBrain metastatic diseaseSymptomatic edemaCheckpoint inhibitorsAdverse eventsDurable responsesMedian survivalMetastatic diseaseInhibitor therapyMore patientsIntracranial activityPatient groupRadiation necrosisClinical trialsTherapy trialsMultidisciplinary teamMetastasisPatientsMulti-institutional validation of brain metastasis velocity, a recently defined predictor of outcomes following stereotactic radiosurgery
McTyre ER, Soike MH, Farris M, Ayala-Peacock DN, Hepel JT, Page BR, Shen C, Kleinberg L, Contessa JN, Corso C, Chiang V, Henson-Masters A, Cramer CK, Ruiz J, Pasche B, Watabe K, D'Agostino R, Su J, Laxton AW, Tatter SB, Fiveash JB, Ahluwalia M, Kotecha R, Chao ST, Braunstein SE, Attia A, Chung C, Chan MD. Multi-institutional validation of brain metastasis velocity, a recently defined predictor of outcomes following stereotactic radiosurgery. Radiotherapy And Oncology 2019, 142: 168-174. PMID: 31526671, DOI: 10.1016/j.radonc.2019.08.011.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain NeoplasmsFemaleHumansMaleMelanomaMiddle AgedNeoplasm Recurrence, LocalNeoplasmsPrognosisRadiosurgeryRetrospective StudiesRisk FactorsSalvage TherapyConceptsBrain metastasis velocityDistant brain failureMedian overall survivalOverall survivalBrain metastasesPredictors of OSInitial brain metastasesNew brain metastasesWhole brain radiationKaplan-Meier methodHigh-risk groupPredictors of outcomeProportional hazards methodsMulti-institutional settingMulti-institutional validationMultivariate regression modelingInitial SRSBrain radiationSalvage modalityInitial treatmentBrain failureRecurrence rateValidation cohortBMV groupMelanoma histologyStereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review
Alattar AA, Bartek J, Chiang VL, Mohammadi AM, Barnett GH, Sloan A, Chen CC. Stereotactic Laser Ablation as Treatment of Brain Metastases Recurring after Stereotactic Radiosurgery: A Systematic Literature Review. World Neurosurgery 2019, 128: 134-142. PMID: 31051303, DOI: 10.1016/j.wneu.2019.04.200.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsHumansLaser TherapyMetastasectomyNeoplasm Recurrence, LocalRadiosurgeryStereotaxic TechniquesConceptsStereotactic laser ablationLocal controlContrast-enhancing volumeBrain metastasesFluid-attenuated inversion recovery volumeMalignant cerebral edemaPermanent neurologic injuryPreoperative lesion volumeMedian hospital stayDuration of therapyPotential treatment optionPercentage of tumorsHours of treatmentHospital stayNeurologic outcomePeriprocedural managementCerebral edemaCommon complicationMedian survivalNeurologic deficitsNeurologic injuryOverall survivalClinical courseTreatment optionsOptimal treatmentLaser-interstitial thermal therapy compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain metastases failing radiosurgery
Hong CS, Deng D, Vera A, Chiang VL. Laser-interstitial thermal therapy compared to craniotomy for treatment of radiation necrosis or recurrent tumor in brain metastases failing radiosurgery. Journal Of Neuro-Oncology 2019, 142: 309-317. PMID: 30656529, DOI: 10.1007/s11060-019-03097-z.Peer-Reviewed Original ResearchConceptsLaser interstitial thermal therapyProgression-free survivalBrain metastasesRadiation necrosisOverall survivalStereotactic radiosurgeryRecurrent tumorsSingle-institution chart reviewPost-operative salvageResultsOf 75 patientsPre-operative symptomsViable alternative treatmentRe-growing tumorSteroid taperNeurological outcomeChart reviewSymptom reliefUnderwent craniotomySubgroup analysisTumor lesionsAlternative treatmentCraniotomyLocal controlMetastasisPatients
2018
Laser ablation after stereotactic radiosurgery: a multicenter prospective study in patients with metastatic brain tumors and radiation necrosis.
Ahluwalia M, Barnett GH, Deng D, Tatter SB, Laxton AW, Mohammadi AM, Leuthardt E, Chamoun R, Judy K, Asher A, Essig M, Dietrich J, Chiang VL. Laser ablation after stereotactic radiosurgery: a multicenter prospective study in patients with metastatic brain tumors and radiation necrosis. Journal Of Neurosurgery 2018, 130: 804-811. PMID: 29726782, DOI: 10.3171/2017.11.jns171273.Peer-Reviewed Original ResearchMeSH KeywordsAblation TechniquesAdultAgedBrain NeoplasmsFemaleHumansKarnofsky Performance StatusLaser TherapyMagnetic Resonance ImagingMaleMiddle AgedNecrosisNeoplasm Recurrence, LocalPostoperative ComplicationsProgression-Free SurvivalProspective StudiesQuality of LifeRadiation InjuriesRadiosurgeryTreatment OutcomeConceptsProgression-free survivalQuality of lifeKarnofsky Performance ScaleMulticenter prospective studyKPS scoreRecurrent tumorsStereotactic radiosurgeryOverall survivalProspective studyRadiation necrosisNeuro-Oncology Brain Metastases criteriaLocal progression-free survivalMedian KPS scoreSteroid sparing effectMetastatic brain tumorsLength of stayPercent of subjectsDuration of survivalOverall event rateSignificant differencesMajority of casesMetastasis (TNM) criteriaOS advantageProgression patientsBrain metastases
2017
Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram
Ayala-Peacock DN, Attia A, Braunstein SE, Ahluwalia MS, Hepel J, Chung C, Contessa J, McTyre E, Peiffer AM, Lucas JT, Isom S, Pajewski NM, Kotecha R, Stavas MJ, Page BR, Kleinberg L, Shen C, Taylor RB, Onyeuku NE, Hyde AT, Gorovets D, Chao ST, Corso C, Ruiz J, Watabe K, Tatter SB, Zadeh G, Chiang VLS, Fiveash JB, Chan MD. Prediction of new brain metastases after radiosurgery: validation and analysis of performance of a multi-institutional nomogram. Journal Of Neuro-Oncology 2017, 135: 403-411. PMID: 28828698, PMCID: PMC5667906, DOI: 10.1007/s11060-017-2588-4.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, LocalNomogramsRadiosurgeryRetrospective StudiesRisk FactorsSurvival AnalysisConceptsDistant brain failureWhole brain radiotherapyNew brain metastasesBrain metastasesStereotactic radiosurgeryRisk of DBFEarly whole brain radiotherapyPrognostic modelUpfront whole brain radiotherapyMulti-institutional nomogramNumber of metastasesHigh-risk thresholdSRS monotherapyMargin doseBrain radiotherapyBrain failureContemporary cohortPrognostic indexMelanoma histologyRelative riskAcademic centersMetastasisPatientsValidation datasetAbsolute number
2016
Novel biomarker identification using metabolomic profiling to differentiate radiation necrosis and recurrent tumor following Gamma Knife radiosurgery.
Lu AY, Turban JL, Damisah EC, Li J, Alomari AK, Eid T, Vortmeyer AO, Chiang VL. Novel biomarker identification using metabolomic profiling to differentiate radiation necrosis and recurrent tumor following Gamma Knife radiosurgery. Journal Of Neurosurgery 2016, 127: 388-396. PMID: 27885954, DOI: 10.3171/2016.8.jns161395.Peer-Reviewed Original ResearchConceptsGamma knife radiosurgeryRadiation necrosisRecurrent tumorsKnife radiosurgeryBrain metastasesSamples of tumorMetabolic imaging techniquesMetabolite profilesUnique metabolite profilesNovel biomarker identificationBrain biopsyPure tumorEnhancing lesionsSurgical biopsyLevels of metabolitesTumorsNecrosisTumor samplesDifferential metabolite profilesElevated levelsRadiosurgeryNoninvasive imagingComparison groupTissue samplesMetabolomic profiling
2014
Significance of histology in determining management of lesions regrowing after radiosurgery
Nath SK, Sheridan AD, Rauch PJ, Yu JB, Minja FJ, Vortmeyer AO, Chiang VL. Significance of histology in determining management of lesions regrowing after radiosurgery. Journal Of Neuro-Oncology 2014, 117: 303-310. PMID: 24504499, DOI: 10.1007/s11060-014-1389-2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBrain NeoplasmsFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm Recurrence, LocalRadiosurgeryConceptsBrain metastasesTumor cellsLocal controlSignificance of histologyWorse local controlResidual tumor cellsPost-treatment imagingManagement of lesionsOngoing patient managementInflammatory changesClinical outcomesResidual tumorSymptomatic enlargementAmbiguous etiologyHistologic findingsPatient outcomesPatient managementBrain specimensStereotactic radiosurgeryHistopathologic interpretationLesionsTissue specimensResectionPatientsMetastasisRadiologic and histologic consequences of radiosurgery for brain tumors
Alomari A, Rauch PJ, Orsaria M, Minja FJ, Chiang VL, Vortmeyer AO. Radiologic and histologic consequences of radiosurgery for brain tumors. Journal Of Neuro-Oncology 2014, 117: 33-42. PMID: 24442402, DOI: 10.1007/s11060-014-1359-8.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBrainBrain NeoplasmsDemyelinating DiseasesFemaleGliosisHumansMagnetic Resonance ImagingMaleMeningiomaMiddle AgedNecrosisNeoplasm Recurrence, LocalRadiosurgeryConceptsGamma knife radiosurgeryNon-enhancing regionsNon-enhancing areasRecurrent tumorsEncephalopathic changesBrain lesionsRecurrent tumor growthMalignant brain lesionsGadolinium-enhanced MRIHigh clinical relevanceDemyelinating changesSeparate biopsiesNon-enhancing componentsInflammatory demyelinationRadiological changesHistologic consequencesImaging changesReactive astrocytosisHistopathological changesKnife radiosurgeryPathological changesCoagulative necrosisBrain tumorsClinical relevanceHistological results
2013
Rapidly Progressive Epithelioid Malignant Peripheral Nerve Sheath Tumor of the Vestibular Nerve
Kuzmik GA, Michaelides EM, Chiang VL, Nonaka Y, Fukushima T, Vortmeyer AO, Bulsara KR. Rapidly Progressive Epithelioid Malignant Peripheral Nerve Sheath Tumor of the Vestibular Nerve. Otology & Neurotology 2013, 34: 1739-1742. PMID: 23988994, DOI: 10.1097/mao.0b013e31829ab8be.Peer-Reviewed Original ResearchConceptsMalignant peripheral nerve sheath tumorEpithelioid malignant peripheral nerve sheath tumorPeripheral nerve sheath tumorsMagnetic resonance imagingNerve sheath tumorsVestibular nerveSheath tumorsMalignant natureInternal auditory canal massRepeat magnetic resonance imagingGood initial optionSubsequent microsurgical resectionFacial nerve palsyAtypical clinical courseGamma knife radiosurgerySensorineural hearing lossRetroauricular painNerve palsyClinical courseComplete resectionMicrosurgical resectionVestibular schwannomaRare lesionsHistopathologic confirmationKnife radiosurgerySurvival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery
Raldow AC, Chiang VL, Knisely JP, Yu JB. Survival and Intracranial Control of Patients With 5 or More Brain Metastases Treated With Gamma Knife Stereotactic Radiosurgery. American Journal Of Clinical Oncology 2013, 36: 486-490. PMID: 22706180, DOI: 10.1097/coc.0b013e31825494ef.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBrain NeoplasmsFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingNeoplasmsPrognosisRadiosurgeryRetrospective StudiesSurvival RateConceptsKarnofsky performance statusMore brain metastasesMedian overall survivalOverall survivalBrain metastasesRecurrence-free survivalStereotactic radiosurgeryWhole-brain radiation treatmentGamma Knife stereotactic radiosurgeryNumber of metastasesProportional hazards regressionGamma knife treatmentIntracranial controlOnly significant variableFree survivalIntracranial failurePerformance statusHazards regressionSurveillance imagingHistorical controlsDisease progressionRetrospective analysisPatientsFirst treatmentMetastasisStereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery
Torres-Reveron J, Tomasiewicz HC, Shetty A, Amankulor NM, Chiang VL. Stereotactic laser induced thermotherapy (LITT): a novel treatment for brain lesions regrowing after radiosurgery. Journal Of Neuro-Oncology 2013, 113: 495-503. PMID: 23677747, DOI: 10.1007/s11060-013-1142-2.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBrain NeoplasmsFeasibility StudiesFemaleFollow-Up StudiesHumansHyperthermia, InducedImaging, Three-DimensionalLaser TherapyMagnetic Resonance ImagingMaleMiddle AgedNeoplasm Recurrence, LocalNeoplasmsPostoperative ComplicationsPrognosisRadiation InjuriesRadiosurgerySurvival RateConceptsNeurological symptomsBrain metastasesTreatment optionsStereotactic radiosurgeryWhole-brain radiation therapyGamma Knife stereotactic radiosurgeryBrain radiation therapyInitial favorable responseProgressive neurological symptomsAdverse radiation effectsNovel treatment optionsCases steroidsOngoing steroidsSymptom controlPatient comorbiditiesSurgical resectionSymptomatic reliefMetastatic lesionsRecurrent edemaRadiation necrosisBiopsy resultsDisease burdenMinimal morbidityBrain lesionsThermocoagulation proceduresEfficacy and Safety of Higher Dose Stereotactic Radiosurgery for Functional Pituitary Adenomas: A Preliminary Report
Grant RA, Whicker M, Lleva R, Knisely JP, Inzucchi SE, Chiang VL. Efficacy and Safety of Higher Dose Stereotactic Radiosurgery for Functional Pituitary Adenomas: A Preliminary Report. World Neurosurgery 2013, 82: 195-201. PMID: 23385448, DOI: 10.1016/j.wneu.2013.01.127.Peer-Reviewed Original ResearchMeSH KeywordsAdenomaAdolescentAdultAgedDose-Response Relationship, RadiationFemaleFollow-Up StudiesHumansHypopituitarismKaplan-Meier EstimateMagnetic Resonance ImagingMaleMiddle AgedNeoplasm Recurrence, LocalOptic NervePituitary HormonesPituitary NeoplasmsPostoperative ComplicationsProspective StudiesRadiosurgeryRetrospective StudiesSurvival AnalysisTreatment OutcomeYoung AdultConceptsSingle-fraction stereotactic radiosurgeryPituitary adenomasEndocrine remissionMarginal dosesStereotactic radiosurgeryHigh-dose stereotactic radiosurgeryCommon adjuvant therapyHigher marginal doseNew endocrine deficienciesOptic nerve pallorPost-SRS hypopituitarismRadiation-induced hypopituitarismSecretory pituitary adenomasHigh-dose treatmentFunctional pituitary adenomasRadiation-induced sequelaeActive pituitary adenomasFraction stereotactic radiosurgeryHormonal normalizationHormonal remissionAdjuvant therapyCranial neuropathiesMarginal doseEndocrine deficienciesSurgical resection