2020
An integrated disease-specific graded prognostic assessment scale for melanoma: contributions of KPS, CITV, number of metastases, and BRAF mutation status
Ahluwalia M, Ali MA, Joshi RS, Park ES, Taha B, McCutcheon I, Chiang V, Hong A, Sinclair G, Bartek J, Chen CC. An integrated disease-specific graded prognostic assessment scale for melanoma: contributions of KPS, CITV, number of metastases, and BRAF mutation status. Neuro-Oncology Advances 2020, 3: vdaa152. PMID: 33506199, PMCID: PMC7810198, DOI: 10.1093/noajnl/vdaa152.Peer-Reviewed Original ResearchCumulative intracranial tumor volumeNumber of metastasesBRAF mutation statusMelanoma brain metastasesBrain metastasesStereotactic radiosurgeryMutation statusPrognostic scalesMelanoma patientsSurvival prognosticationIndependent cohortMultivariate Cox proportional hazards modelCox proportional hazards modelIntracranial tumor volumePrognostic assessment scaleMulti-institutional collaborationNet reclassification indexProportional hazards modelBM patientsMainstay therapyPatient characteristicsTumor characteristicsPrognostic importancePrognostic utilityReclassification index
2019
Frequent Use of Local Therapy Underscores Need for Multidisciplinary Care in the Management of Patients With Melanoma Brain Metastases Treated With PD-1 Inhibitors
Qian JM, Yu JB, Mahajan A, Goldberg SB, Kluger HM, Chiang VLS. Frequent Use of Local Therapy Underscores Need for Multidisciplinary Care in the Management of Patients With Melanoma Brain Metastases Treated With PD-1 Inhibitors. International Journal Of Radiation Oncology • Biology • Physics 2019, 105: 1113-1118. PMID: 31479702, DOI: 10.1016/j.ijrobp.2019.08.053.Peer-Reviewed Original ResearchConceptsBrain metastasesLocal therapyNeurologic safetyMelanoma patientsProspective phase 2 trialProgressive brain metastasesSerial brain imagingMelanoma brain metastasesPD-1 inhibitorsPhase 2 trialRapid disease progressionManagement of patientsNeurologic symptomsMultidisciplinary careTrial enrollmentCystic changesClinical trialsDisease progressionPatientsLesion sizeMetastasisMultidisciplinary teamTumor growthTherapyClinical decisionRADI-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 exitImmunotherapyPatientsPerilesional 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
SURG-20. LASER-INTERSTITIAL THERMAL THERAPY VERSUS CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY
Hong C, Deng J, Vera A, Chiang V. SURG-20. LASER-INTERSTITIAL THERMAL THERAPY VERSUS CRANIOTOMY FOR TREATMENT OF RADIATION NECROSIS OR RECURRENT TUMOR IN BRAIN METASTASES FAILING RADIOSURGERY. Neuro-Oncology 2018, 20: vi254-vi255. PMCID: PMC6216306, DOI: 10.1093/neuonc/noy148.1056.Peer-Reviewed Original ResearchLaser interstitial thermal therapyProgression-free survivalRe-growing tumorRadiation necrosisBrain metastasesMelanoma patientsSingle-surgeon retrospective studyImproved progression-free survivalLocal progression-free survivalPre-operative symptomsLog-rank testSteroid dosingSteroid taperNeurological outcomeOverall survivalRecurrent tumorsUnderwent craniotomyRetrospective studySingle institutionSubgroup analysisSurgery dateSurvival advantageCraniotomyPatientsLocal control
2017
Estimating Survival in Melanoma Patients With Brain Metastases: An Update of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA)
Sperduto PW, Jiang W, Brown PD, Braunstein S, Sneed P, Wattson DA, Shih HA, Bangdiwala A, Shanley R, Lockney NA, Beal K, Lou E, Amatruda T, Sperduto WA, Kirkpatrick JP, Yeh N, Gaspar LE, Molitoris JK, Masucci L, Roberge D, Yu J, Chiang V, Mehta M. Estimating Survival in Melanoma Patients With Brain Metastases: An Update of the Graded Prognostic Assessment for Melanoma Using Molecular Markers (Melanoma-molGPA). International Journal Of Radiation Oncology • Biology • Physics 2017, 99: 812-816. PMID: 29063850, PMCID: PMC6925529, DOI: 10.1016/j.ijrobp.2017.06.2454.Peer-Reviewed Original ResearchConceptsDiagnosis-Specific Graded Prognostic AssessmentGraded Prognostic AssessmentSignificant prognostic factorsBrain metastasesMelanoma-molGPAPrognostic factorsMelanoma patientsPrognostic assessmentMultiple Cox regressionMedian survival timeRetrospective database analysisLog-rank testHeterogeneous patient populationClinical decision makingTreatment eraHazard ratioMedian survivalMultivariable analysisWorse prognosisCox regressionPatient populationSurvival timePatientsMetastasisCurrent cohortCumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases
Hirshman BR, Wilson BR, Ali MA, Schupper AJ, Proudfoot JA, Goetsch SJ, Carter BS, Sinclair G, Bartek J, Chiang V, Fogarty G, Hong A, Chen CC. Cumulative Intracranial Tumor Volume Augments the Prognostic Value of Diagnosis-Specific Graded Prognostic Assessment Model for Survival in Patients with Melanoma Cerebral Metastases. Neurosurgery 2017, 83: 237-244. PMID: 28973506, DOI: 10.1093/neuros/nyx380.Peer-Reviewed Original ResearchConceptsCumulative intracranial tumor volumeIntracranial tumor volumeMelanoma brain metastasesBrain metastasesPrognostic valueDS-GPATumor volumeStereotactic radiosurgeryIndependent cohortKey prognostic variablesPrognostic assessment modelPrognostic assessment scaleKarnofsky performance statusNet reclassification indexCerebral metastasesPerformance statusMelanoma patientsPrognostic utilityIntracranial metastasesReclassification indexPrognostic accuracyPrognostic scalesPrognostic variablesPatientsMelanoma cohortThe Prognostic Value of BRAF, C-KIT, and NRAS Mutations in Melanoma Patients With Brain Metastases
Sperduto PW, Jiang W, Brown PD, Braunstein S, Sneed P, Wattson DA, Shih HA, Bangdiwala A, Shanley R, Lockney NA, Beal K, Lou E, Amatruda T, Sperduto WA, Kirkpatrick JP, Yeh N, Gaspar LE, Molitoris JK, Masucci L, Roberge D, Yu J, Chiang V, Mehta M. The Prognostic Value of BRAF, C-KIT, and NRAS Mutations in Melanoma Patients With Brain Metastases. International Journal Of Radiation Oncology • Biology • Physics 2017, 98: 1069-1077. PMID: 28721890, PMCID: PMC6925531, DOI: 10.1016/j.ijrobp.2017.03.030.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntineoplastic AgentsBrain NeoplasmsFemaleGenes, rasHumansImmunotherapyLinear ModelsMaleMelanomaMiddle AgedMolecular Targeted TherapyMutationPrognosisProportional Hazards ModelsProto-Oncogene Proteins B-rafProto-Oncogene Proteins c-kitRetrospective StudiesStatistics, NonparametricTime FactorsConceptsBRAF-negative patientsBRAF-positive patientsBrain metastasesMedian survivalC-kit mutationsMelanoma patientsPrimary diagnosisWhole-brain radiation therapyOverall median survivalMulti-institutional databaseGene mutation statusOverall survivalInitial treatmentMedian timeTreatment patternsClinical parametersBRAF statusPrognostic valueNRAS mutationsRadiation therapyPatientsMutation statusMetastasisC-kitMEK inhibitors
2016
Timing and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery
Qian JM, Yu JB, Kluger HM, Chiang VL. Timing and type of immune checkpoint therapy affect the early radiographic response of melanoma brain metastases to stereotactic radiosurgery. Cancer 2016, 122: 3051-3058. PMID: 27285122, PMCID: PMC5030143, DOI: 10.1002/cncr.30138.Peer-Reviewed Original ResearchConceptsMedian percent reductionImmune checkpoint therapyLesional responseStereotactic radiosurgeryCheckpoint therapyLesion volumeAnti-cytotoxic T-lymphocyte-associated protein 4Anti-programmed cell death protein 1T-lymphocyte-associated protein 4Anti-PD-1 therapyGreater median percent reductionsCell death protein 1Administration of immunotherapyWeeks of immunotherapyMelanoma brain metastasesDeath protein 1Type of immunotherapyWilcoxon rank sum testRank sum testNonconcurrent therapyBrain metastasesMelanoma patientsTreatment of cancerSingle institutionPercent reduction