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 treatmentSelected-Lesion Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases
Theriault B, Singh C, 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 Stereotactic Radiosurgery (SL-SRS) as a Novel Strategy in the Treatment of Patients With Multiple Brain Metastases. Cureus 2023, 15: e45457. PMID: 37859877, PMCID: PMC10583225, DOI: 10.7759/cureus.45457.Peer-Reviewed Original ResearchWhole brain radiotherapyInternational Radiosurgery Research FoundationPrior whole brain radiotherapyBrain metastasesStereotactic radiosurgeryCommon reasonAsymptomatic brain metastasesNon-eloquent locationsSystemic treatment optionsMultiple brain metastasesPoor functional statusTreatment of patientsCentral nervous systemAttributable symptomsExtracranial diseaseSystemic therapyUntreated lesionsMedical oncologySystemic diseaseFunctional statusTreatment optionsClinical trialsSingle lesionLesion locationIntracranial lesions
2022
Breast Cancer Subtypes and Incidence of Brain Metastases in the SEER Database
Kinslow C, Knisely J, Cheng S, Connolly E, Wang T, Yu J. Breast Cancer Subtypes and Incidence of Brain Metastases in the SEER Database. International Journal Of Radiation Oncology • Biology • Physics 2022, 114: e6. DOI: 10.1016/j.ijrobp.2022.07.685.Peer-Reviewed Original ResearchMetachronous brain metastasesSynchronous brain metastasesBreast cancer subtypesIncidence of brain metastasesBrain metastasesBreast cancerCancer subtypesTNBC patientsBreast cancer diagnosisFrequency of brain metastasesPresence of brain metastasesPrevalence of brain metastasesHER2+ breast cancerTime of initial diagnosisSubtypes of breast cancerIncreasing proportion of patientsOccult brain metastasesSEER-18 databaseBrain metastasis diagnosisMetastatic breast cancerProportion of patientsFrequency of subtypesBreast cancer patientsCancer diagnosisIdentifier numberAn interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma
Hasanov E, Yeboa D, Tucker M, Swanson T, Beckham T, Rini B, Ene C, Hasanov M, Derks S, Smits M, Dudani S, Heng D, Brastianos P, Bex A, Hanalioglu S, Weinberg J, Hirsch L, Carlo M, Aizer A, Brown P, Bilen M, Chang E, Jaboin J, Brugarolas J, Choueiri T, Atkins M, McGregor B, Halasz L, Patel T, Soltys S, McDermott D, Elder J, Baskaya M, Yu J, Timmerman R, Kim M, Mut M, Markert J, Beal K, Tannir N, Samandouras G, Lang F, Giles R, Jonasch E. An interdisciplinary consensus on the management of brain metastases in patients with renal cell carcinoma. CA A Cancer Journal For Clinicians 2022, 72: 454-489. PMID: 35708940, DOI: 10.3322/caac.21729.Peer-Reviewed Original ResearchConceptsRenal cell carcinomaManagement of brain metastasesBrain metastasesCell carcinomaManifestation of renal cell carcinomaResistance to systemic treatmentMultimodal treatment strategiesGuiding treatment decisionsSystemic treatmentCurrent management strategiesPoor prognosisMetastasis tumorsImmune biologyBrain metastasis tumorsRadiation treatmentTreatment strategiesInternational group of expertsCarcinomaMetastasisTreatment decisionsConsensus statementPatientsInterdisciplinary consensusUnmet patient needsLiterature reviewPractice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole Brain Radiation Therapy
Jairam V, Park HS, Yu JB, Bindra RS, Contessa JN, Jethwa KR. Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole Brain Radiation Therapy. Advances In Radiation Oncology 2022, 7: 100949. PMID: 35521071, PMCID: PMC9065721, DOI: 10.1016/j.adro.2022.100949.Peer-Reviewed Original ResearchWhole-brain radiation therapyBrain radiation therapyRadiation oncologistsPractice patternsRadiation therapyHA-WBRTNeurocognitive declineCommon reasonHippocampal avoidance whole brain radiation therapyNational practice patternsDeleterious cognitive effectsRoutine clinical practiceNeurocognitive preservationBrain metastasesTreatment delayProvider characteristicsEffective treatmentCurrent evidencePearson χMemantineClinical practicePatientsPrior authorizationMajority of respondentsTherapy
2021
Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole-Brain Radiation Therapy
Jairam V, Park H, Yu J, Bindra R, Contessa J, Jethwa K. Practice Patterns Related to Mitigation of Neurocognitive Decline in Patients Receiving Whole-Brain Radiation Therapy. International Journal Of Radiation Oncology • Biology • Physics 2021, 111: e569. DOI: 10.1016/j.ijrobp.2021.07.1536.Peer-Reviewed Original ResearchWhole-brain radiation therapyWhole brain radiotherapyRadiation oncologistsPractice patternsBrain radiotherapyWBRT patientsNeurocognitive declineRadiation therapyCommon reasonCurrent evidenceHippocampal-avoidance whole-brain radiotherapyN-methyl-D-aspartate receptor antagonistConventional whole brain radiotherapyBrain radiation therapyNational practice patternsDeleterious cognitive effectsRoutine clinical practiceT-testMATERIAL/METHODSStudent's t-testMost radiation oncologistsIntracranial controlNeurocognitive preservationBrain metastasesMedication costsOutcomes of Stereotactic Radiosurgery and Immunotherapy in Renal Cell Carcinoma Patients With Brain Metastases
Uezono H, Nam D, Kluger HM, Sznol M, Hurwitz M, Yu JB, Chiang VL. Outcomes of Stereotactic Radiosurgery and Immunotherapy in Renal Cell Carcinoma Patients With Brain Metastases. American Journal Of Clinical Oncology 2021, 44: 495-501. PMID: 34432667, DOI: 10.1097/coc.0000000000000849.Peer-Reviewed Original ResearchConceptsImmune checkpoint inhibitorsRCC brain metastasesBrain metastasesRenal cell carcinomaStereotactic radiosurgeryOverall survivalUse of ICIsCentral nervous system toxicityRenal cell carcinoma patientsImpact of immunotherapyLocal control outcomesMedian overall survivalCell carcinoma patientsKaplan-Meier curvesNervous system toxicityBetter median OSLog-rank testMann-Whitney U testMargin doseMedian OSNonimmunotherapy groupSRS doseCheckpoint inhibitorsImmunotherapy groupCarcinoma patients
2020
Outcomes Of Stereotactic Radiosurgery And Immunotherapy In Renal Cell Carcinoma With Brain Metastases
Uezono H, Nam D, Yu J, Chiang V. Outcomes Of Stereotactic Radiosurgery And Immunotherapy In Renal Cell Carcinoma With Brain Metastases. International Journal Of Radiation Oncology • Biology • Physics 2020, 108: e734. DOI: 10.1016/j.ijrobp.2020.07.133.Peer-Reviewed Original ResearchNationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation
Lee V, Jairam V, Yu J, Park H. Nationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation. International Journal Of Radiation Oncology • Biology • Physics 2020, 108: e687-e688. DOI: 10.1016/j.ijrobp.2020.07.2045.Peer-Reviewed Original ResearchNationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation
Park H, Lee V, Jairam V, Yu J. Nationwide Patterns of Hemorrhagic Stroke among Patients Hospitalized with Brain Metastases: Influence of Primary Cancer Diagnosis and Anticoagulation. International Journal Of Radiation Oncology • Biology • Physics 2020, 108: e52-e53. DOI: 10.1016/j.ijrobp.2020.02.593.Peer-Reviewed Original ResearchEvaluation of First-line Radiosurgery vs Whole-Brain Radiotherapy for Small Cell Lung Cancer Brain Metastases
Rusthoven CG, Yamamoto M, Bernhardt D, Smith DE, Gao D, Serizawa T, Yomo S, Aiyama H, Higuchi Y, Shuto T, Akabane A, Sato Y, Niranjan A, Faramand AM, Lunsford LD, McInerney J, Tuanquin LC, Zacharia BE, Chiang V, Singh C, Yu JB, Braunstein S, Mathieu D, Touchette CJ, Lee CC, Yang HC, Aizer AA, Cagney DN, Chan MD, Kondziolka D, Bernstein K, Silverman JS, Grills IS, Siddiqui ZA, Yuan JC, Sheehan JP, Cordeiro D, Nosaki K, Seto T, Deibert CP, Verma V, Day S, Halasz LM, Warnick RE, Trifiletti DM, Palmer JD, Attia A, Li B, Cifarelli CP, Brown PD, Vargo JA, Combs SE, Kessel KA, Rieken S, Patel S, Guckenberger M, Andratschke N, Kavanagh BD, Robin TP. Evaluation of First-line Radiosurgery vs Whole-Brain Radiotherapy for Small Cell Lung Cancer Brain Metastases. JAMA Oncology 2020, 6: 1028-1037. PMID: 32496550, PMCID: PMC7273318, DOI: 10.1001/jamaoncol.2020.1271.Peer-Reviewed Original ResearchConceptsWhole brain radiotherapyProgression-free survivalSmall-cell lung cancer (SCLC) brain metastasesCell lung cancer brain metastasesCNS progression-free survivalLung cancer brain metastasesPropensity score-matched analysisMedian overall survivalCancer brain metastasesBrain metastasesOverall survivalStereotactic radiosurgeryCentral nervous system (CNS) progression-free survivalMedian CNS progression-free survivalSRS outcomesCentral nervous system progressionSmall cell lung cancerLimited brain metastasesMulticenter cohort studyDisease control statusCell lung cancerSingle-arm trialStandard of careLeptomeningeal progressionWBRT cohortNationwide patterns of hemorrhagic stroke among patients hospitalized with brain metastases: influence of primary cancer diagnosis and anticoagulation
Lee V, Jairam V, Yu JB, Park HS. Nationwide patterns of hemorrhagic stroke among patients hospitalized with brain metastases: influence of primary cancer diagnosis and anticoagulation. Scientific Reports 2020, 10: 10084. PMID: 32572113, PMCID: PMC7308286, DOI: 10.1038/s41598-020-67316-8.Peer-Reviewed Original ResearchConceptsBrain metastasesLong-term anticoagulationIntracerebral hemorrhageKidney cancerHigh riskUtilization Project Nationwide Inpatient SampleDiagnosis of ICHHospital-related characteristicsRisks of anticoagulationPrimary cancer diagnosisMultivariable logistic regressionNationwide Inpatient SampleLonger lengthDiagnosis of melanomaMann-Whitney UHemorrhagic strokeNeurologic dysfunctionConcurrent diagnosisSignificant morbiditySecondary diagnosisInpatient SampleBaseline differencesDecreased qualityAnticoagulationHealthcare costsPembrolizumab 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 CriteriaBeyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases From 1985 to Today
Sperduto PW, Mesko S, Li J, Cagney D, Aizer A, Lin NU, Nesbit E, Kruser TJ, Chan J, Braunstein S, Lee J, Kirkpatrick JP, Breen W, Brown PD, Shi D, Shih HA, Soliman H, Sahgal A, Shanley R, Sperduto W, Lou E, Everett A, Boggs DH, Masucci L, Roberge D, Remick J, Plichta K, Buatti JM, Jain S, Gaspar LE, Wu CC, Wang TJC, Bryant J, Chuong M, Yu J, Chiang V, Nakano T, Aoyama H, Mehta MP. Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases From 1985 to Today. International Journal Of Radiation Oncology • Biology • Physics 2020, 107: 334-343. PMID: 32084525, PMCID: PMC7276246, DOI: 10.1016/j.ijrobp.2020.01.051.Peer-Reviewed Original ResearchConceptsDiagnosis-specific prognostic factorsHuman epidermal receptor 2Prognostic factorsMedian survivalBreast-GPABrain metastasesBreast cancerCohort BCohort APrognostic indexReceptor 2Tumor subtypesBreast cancer brain metastasesKaplan-Meier survival estimatesCancer brain metastasesGraded Prognostic AssessmentKarnofsky performance statusLarge contemporary cohortLog-rank testFuture clinical trialsNew prognostic factorsGPA 0Extracranial metastasesPerformance statusBetter prognosisEstrogen/progesterone receptor and HER2 discordance between primary tumor and brain metastases in breast cancer and its effect on treatment and survival
Sperduto PW, Mesko S, Li J, Cagney D, Aizer A, Lin NU, Nesbit E, Kruser TJ, Chan J, Braunstein S, Lee J, Kirkpatrick JP, Breen W, Brown PD, Shi D, Shih HA, Soliman H, Sahgal A, Shanley R, Sperduto W, Lou E, Everett A, Boggs DH, Masucci L, Roberge D, Remick J, Plichta K, Buatti JM, Jain S, Gaspar LE, Wu CC, Wang TJC, Bryant J, Chuong M, Yu J, Chiang V, Nakano T, Aoyama H, Mehta MP. Estrogen/progesterone receptor and HER2 discordance between primary tumor and brain metastases in breast cancer and its effect on treatment and survival. Neuro-Oncology 2020, 22: 1359-1367. PMID: 32034917, PMCID: PMC7523450, DOI: 10.1093/neuonc/noaa025.Peer-Reviewed Original ResearchConceptsBreast cancer brain metastasesHuman epidermal growth factor receptor 2Primary tumorProgesterone receptorMedian survivalEstrogen receptorBrain metastasesDiscordance rateHER2-negative primary tumorsEstrogen/progesterone receptorsEpidermal growth factor receptor 2Time of metastasisCancer brain metastasesGrowth factor receptor 2Breast cancer treatmentIncidence of discordanceFactor receptor 2Subsequent treatmentBCBM patientsHER2 discordanceReceptor discordanceMost patientsReceptor statusInitial diagnosisHER2 statusMulti-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small cell lung cancer without prior brain-directed radiotherapy.
Miccio JA, Barsky A, Gao S, Verma V, Noticewala SS, Jairam V, Johnson SB, Yu JB, Hansen JE, Aneja S, An Y, Decker RH, Bulent Omay S, Li J, Kurtz GA, Alonso-Basanta M, Lee JYK, Chiang VL, Park HS. Multi-institutional retrospective review of stereotactic radiosurgery for brain metastasis in patients with small cell lung cancer without prior brain-directed radiotherapy. Journal Of Radiosurgery And SBRT 2020, 7: 19-27. PMID: 32802575, PMCID: PMC7406345.Peer-Reviewed Original ResearchWhole brain radiotherapyBrain metastasesOverall survivalNeurologic deathSmall-cell lung cancer (SCLC) brain metastasesCell lung cancer brain metastasesLung cancer brain metastasesSalvage whole brain radiotherapyMulti-institutional retrospective reviewSmall cell lung cancerMost SCLC patientsSCLC brain metastasesTime of SRSMedian overall survivalCancer brain metastasesCell lung cancerIntracranial progressionSCLC patientsUpfront radiosurgeryBrain radiationBrain radiotherapySelect patientsRetrospective reviewLung cancerStereotactic radiosurgery
2019
RADI-34. USE OF LOW-DOSE STEREOTACTIC RADIOSURGERY FOR ADVANCED BRAIN METASTASES
Yang D, Yu J, Chiang V. RADI-34. USE OF LOW-DOSE STEREOTACTIC RADIOSURGERY FOR ADVANCED BRAIN METASTASES. Neuro-Oncology Advances 2019, 1: i28-i28. PMCID: PMC7213353, DOI: 10.1093/noajnl/vdz014.126.Peer-Reviewed Original ResearchGamma Knife stereotactic radiosurgeryBrain metastasesStereotactic radiosurgeryOverall survivalDisease progressionTime to disease progressionBRAF V600E tumorsMutation-targeted therapiesMedian overall survivalMetastatic melanoma patientsTreat brain metastasesPoor performance statusTumor controlMelanoma patientsSystemic therapyAdvanced diseasePerformance statusRe-treatmentTesticular cancerComposite endpointMetastasisSystemic agentsStudy exitImmunotherapyPatientsTumor subtype and other prognostic factors in breast cancer patients with brain metastases: The updated graded prognostic assessment (Breast-GPA).
Sperduto P, Mesko S, Cagney D, Nesbit E, Chan J, Lee J, Breen W, Shi D, Soliman H, Shanley R, Everett A, Masucci L, Remick J, Plichta K, Jain S, Wu C, Bryant J, Yu J, Nakano T, Mehta M. Tumor subtype and other prognostic factors in breast cancer patients with brain metastases: The updated graded prognostic assessment (Breast-GPA). Journal Of Clinical Oncology 2019, 37: 1079-1079. DOI: 10.1200/jco.2019.37.15_suppl.1079.Peer-Reviewed Original ResearchBrain metastasesPrognostic factorsMedian survivalTumor subtypesBreast cancer patientsBreast-GPAExtracranial metastasesCohort ALuminal BLuminal AImproved survivalCancer patientsComplication of breast cancerKaplan-Meier survival estimatesBrain radiation therapyLog-rank testRadiation therapyBasal tumorsPrognostic indexCohort BFatal complicationRetrospective databaseTreatment patternsPrognostic assessmentBreast cancerResults of a pilot/phase II study of gamma knife radiosurgery for brain metastases and implications for future prospective clinical trials
Yu J, Singh C, Bindra R, Contessa J, Husain Z, Hansen J, Park H, Roberts K, Bond J, Tien C, Guo F, Colaco R, Housri N, Magnuson W, Mahajan A, Omay S, Chiang V. Results of a pilot/phase II study of gamma knife radiosurgery for brain metastases and implications for future prospective clinical trials. Journal Of Radiation Oncology 2019, 8: 39-46. DOI: 10.1007/s13566-018-0370-7.Peer-Reviewed Original ResearchYale-New Haven HospitalPhase II studyBrain metastasesClinical trialsII studyKnife radiosurgeryLocal controlPre-defined primary endpointWhole-brain radiation treatmentFuture prospective clinical trialsEvaluable brain metastasesSymptomatic radiation necrosisMedian patient ageLocal control ratePhase 2 studyGood local controlProspective clinical trialsNumber of metastasesLarge clinical trialsProportional hazards regressionFuture clinical trialsGamma knife radiosurgeryImportant clinical variablesStandard clinical practiceNew Haven Hospital
2018
A Pilot/Phase II Study of Stereotactic Radiosurgery for Brain Metastases Using Rational Dose Selection
Yu J, Singh C, Bindra R, Contessa J, Husain Z, Hansen J, Park H, Roberts K, Bond J, Tien C, Guo F, Colaco R, Housri N, Magnuson W, Omay B, Chiang V. A Pilot/Phase II Study of Stereotactic Radiosurgery for Brain Metastases Using Rational Dose Selection. International Journal Of Radiation Oncology • Biology • Physics 2018, 102: e372-e373. DOI: 10.1016/j.ijrobp.2018.07.1113.Peer-Reviewed Original Research