2019
Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases.
Singh C, Qian JM, Yu JB, Chiang VL. Local tumor response and survival outcomes after combined stereotactic radiosurgery and immunotherapy in non-small cell lung cancer with brain metastases. Journal Of Neurosurgery 2019, 132: 512-517. PMID: 30771783, DOI: 10.3171/2018.10.jns181371.Peer-Reviewed Original ResearchConceptsAnti-PD-1 therapyKarnofsky performance statusBrain metastasesLung cancer patientsStereotactic radiosurgeryCT groupIT groupCancer patientsNon-small cell lung cancer patientsNon-small cell lung cancerCell lung cancer patientsAntibody-positive patientsGraded Prognostic AssessmentCox regression analysisCell lung cancerMedian survival timeLocal tumor responseWhole study groupMann-Whitney U testTerms of survivalLesional responseMedian survivalPerformance statusWorse survivalComplete response
2018
Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool
Sperduto PW, Deegan BJ, Li J, Jethwa KR, Brown PD, Lockney N, Beal K, Rana NG, Attia A, Tseng CL, Sahgal A, Shanley R, Sperduto WA, Lou E, Zahra A, Buatti JM, Yu JB, Chiang V, Molitoris JK, Masucci L, Roberge D, Shi DD, Shih HA, Olson A, Kirkpatrick JP, Braunstein S, Sneed P, Mehta MP. Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool. Neuro-Oncology 2018, 20: 1652-1660. PMID: 30418657, PMCID: PMC6231200, DOI: 10.1093/neuonc/noy099.Peer-Reviewed Original ResearchConceptsPrognostic assessment toolsBrain metastasesRenal cell carcinomaMedian survivalPrognostic factorsAdditional significant prognostic factorsRenal cell carcinoma patientsRetrospective institutional review boardNew brain metastasesKarnofsky performance statusOverall median survivalCell carcinoma patientsSignificant prognostic factorsFuture clinical trialsClinical decision makingInstitutional review boardAssessment toolPerformance statusCommon complicationExtracranial metastasesHazard ratioCarcinoma patientsContemporary cohortRCC patientsWorse prognosis
2017
Consensus Contouring Guidelines for Postoperative Completely Resected Cavity Stereotactic Radiosurgery for Brain Metastases
Soliman H, Ruschin M, Angelov L, Brown PD, Chiang VLS, Kirkpatrick JP, Lo SS, Mahajan A, Oh KS, Sheehan JP, Soltys SG, Sahgal A. Consensus Contouring Guidelines for Postoperative Completely Resected Cavity Stereotactic Radiosurgery for Brain Metastases. International Journal Of Radiation Oncology • Biology • Physics 2017, 100: 436-442. PMID: 29157748, DOI: 10.1016/j.ijrobp.2017.09.047.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsCombined Modality TherapyConsensusHumansMagnetic Resonance ImagingPractice Guidelines as TopicRadiosurgeryConceptsCavity stereotactic radiosurgeryStereotactic radiosurgeryBrain metastasesClinical scenariosSurgical cavity volumePreoperative magnetic resonanceClinical target volumeMicroscopic disease extensionDifferent clinical scenariosSTAPLE contoursSurgical resectionTreatment optionsAdjacent sinusesDisease extensionContouring guidelinesSurgical tractPreoperative locationDural contactClinical dataBone flapClinical practiceSRS treatmentTarget volumeVolume delineationConsensus contoursEstimating Survival in Patients With Lung Cancer and Brain Metastases: An Update of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA)
Sperduto PW, Yang TJ, Beal K, Pan H, Brown PD, Bangdiwala A, Shanley R, Yeh N, Gaspar LE, Braunstein S, Sneed P, Boyle J, Kirkpatrick JP, Mak KS, Shih HA, Engelman A, Roberge D, Arvold ND, Alexander B, Awad MM, Contessa J, Chiang V, Hardie J, Ma D, Lou E, Sperduto W, Mehta MP. Estimating Survival in Patients With Lung Cancer and Brain Metastases: An Update of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA). JAMA Oncology 2017, 3: 827-831. PMID: 27892978, PMCID: PMC5824323, DOI: 10.1001/jamaoncol.2016.3834.Peer-Reviewed Original ResearchConceptsDiagnosis-Specific Graded Prognostic AssessmentBrain metastasesGraded Prognostic AssessmentFuture clinical trialsLung cancerLung-molGPAMedian survivalPrognostic factorsHazard ratioClinical trialsMAIN OUTCOMEPrognostic assessmentLung-molGPA scoreOverall median survivalKarnofsky performance statusMultiple Cox regressionSignificant prognostic factorsCell lung cancerRetrospective database analysisCancer-related mortalityLog-rank testHeterogeneous patient populationClinical decision makingExtracranial metastasesOverall survivalManagement of Brain Metastases in Tyrosine Kinase Inhibitor–Naïve Epidermal Growth Factor Receptor–Mutant Non–Small-Cell Lung Cancer: A Retrospective Multi-Institutional Analysis
Magnuson WJ, Lester-Coll NH, Wu AJ, Yang TJ, Lockney NA, Gerber NK, Beal K, Amini A, Patil T, Kavanagh BD, Camidge DR, Braunstein SE, Boreta LC, Balasubramanian SK, Ahluwalia MS, Rana NG, Attia A, Gettinger SN, Contessa JN, Yu JB, Chiang VL. Management of Brain Metastases in Tyrosine Kinase Inhibitor–Naïve Epidermal Growth Factor Receptor–Mutant Non–Small-Cell Lung Cancer: A Retrospective Multi-Institutional Analysis. Journal Of Clinical Oncology 2017, 35: jco.2016.69.714. PMID: 28113019, DOI: 10.1200/jco.2016.69.7144.Peer-Reviewed Original ResearchMeSH KeywordsAgedAntineoplastic AgentsBrain NeoplasmsCarcinoma, Non-Small-Cell LungCombined Modality TherapyCranial IrradiationDisease-Free SurvivalErbB ReceptorsErlotinib HydrochlorideFemaleHumansLung NeoplasmsMaleMiddle AgedProtein Kinase InhibitorsRadiosurgeryRetrospective StudiesSalvage TherapySurvival RateConceptsWhole brain radiotherapyMulti-institutional analysisEGFR-mutant NSCLCBrain metastasesEGFR-TKIStereotactic radiosurgeryTyrosine kinase inhibitorsOverall survivalEpidermal growth factor receptorGrowth factor receptorIntracranial progressionLung cancerMutant non-small cell lung cancerEGFR-TKI resistance mutationNon-small cell lung cancerIntracranial progression-free survivalRetrospective multi-institutional analysisDeferral of radiotherapyEGFR-TKI useSimilar prognostic featuresUpfront EGFR-TKIProgression-free survivalFactor receptorInferior overall survivalCell lung cancer
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 reductionPossible Interaction of Anti–PD-1 Therapy with the Effects of Radiosurgery on Brain Metastases
Alomari AK, Cohen J, Vortmeyer AO, Chiang A, Gettinger S, Goldberg S, Kluger HM, Chiang VL. Possible Interaction of Anti–PD-1 Therapy with the Effects of Radiosurgery on Brain Metastases. Cancer Immunology Research 2016, 4: 481-487. PMID: 26994250, DOI: 10.1158/2326-6066.cir-15-0238.Peer-Reviewed Original ResearchConceptsStereotactic radiosurgeryBrain metastasesInitiation of immunotherapyPD-1 mAbImmune-modulating therapyModalities of treatmentRadiologic progressionSurgical resectionSystemic therapyDeath-1Radiologic findingsMetastatic malignancyReactive astrocytosisPathologic examinationTreatment regimensHistopathologic examinationWall infiltrationT lymphocytesPatientsTumor progressionMonoclonal antibodiesBiologic interactionsRadiation-induced changesImmunotherapyMalignancy
2015
Lung Cancer Brain Metastases
Goldberg SB, Contessa JN, Omay SB, Chiang V. Lung Cancer Brain Metastases. The Cancer Journal 2015, 21: 398-403. PMID: 26389765, DOI: 10.1097/ppo.0000000000000146.Peer-Reviewed Original ResearchConceptsLung cancer brain metastasesCancer brain metastasesBrain metastasesCentral nervous systemLung cancerSystemic therapyNervous systemIntracranial disease burdenOverall cancer prognosisSystemic therapy optionsExtracranial diseaseSelect patientsLocal therapySignificant morbidityTumor histologyIntracranial metastasesTherapy optionsDisease burdenSurgical techniqueAppropriate treatmentDurable benefitEffective treatmentCancer prognosisPatientsMetastasisEvolution of multidisciplinary brain metastasis management: case study and literature review.
Colaco R, Martin P, Chiang V. Evolution of multidisciplinary brain metastasis management: case study and literature review. The Yale Journal Of Biology And Medicine 2015, 88: 157-65. PMID: 26029014, PMCID: PMC4445437.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsCarcinoma, Non-Small-Cell LungCase ManagementChemoradiotherapyCombined Modality TherapyFemaleHumansMiddle AgedPatient Care TeamRadiosurgeryTreatment OutcomeConceptsBrain metastasesManagement of BMProgression-free survivalLocal tumor controlLong-term survivorsNeurocognitive side effectsBrain metastasis managementSymptom reliefTumor burdenTumor controlCancer patientsTreatment modalitiesMetastasis managementSide effectsRadiation modalitiesFunctional independenceContemporary managementPatientsLiterature reviewSurvivalModalitiesOverall qualityCoordinated approachManagementPrognosis
2013
Advances in therapy for melanoma brain metastases
Flanigan JC, Jilaveanu LB, Chiang VL, Kluger HM. Advances in therapy for melanoma brain metastases. Clinics In Dermatology 2013, 31: 264-281. PMID: 23608446, DOI: 10.1016/j.clindermatol.2012.08.008.Peer-Reviewed Original Research
2012
Radiosurgery for melanoma brain metastases in the ipilimumab era and the possibility of longer survival.
Knisely JP, Yu JB, Flanigan J, Sznol M, Kluger HM, Chiang VL. Radiosurgery for melanoma brain metastases in the ipilimumab era and the possibility of longer survival. Journal Of Neurosurgery 2012, 117: 227-33. PMID: 22702482, PMCID: PMC6098938, DOI: 10.3171/2012.5.jns111929.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAntibodies, MonoclonalAntineoplastic AgentsBrain NeoplasmsCombined Modality TherapyCompassionate Use TrialsDisease-Free SurvivalFemaleHumansIpilimumabMaleMelanomaMiddle AgedNeoplasm StagingPrognosisProportional Hazards ModelsRadiosurgeryRetreatmentRetrospective StudiesConceptsMelanoma brain metastasesBrain metastasesPerformance statusMedian survivalDiagnosis-Specific Graded Prognostic Assessment (DS-GPA) scoreInstitutional review board-approved chart reviewSurvival rateGraded Prognostic Assessment scoreBrain metastasis diagnosisPrognostic assessment scoreSurvival of patientsNumber of metastasesDS-GPA scoreRadiation therapy usePrimary disease locationBrain oligometastasesIpilimumab groupIpilimumab useSalvage WBRTChart reviewOverall survivalPatient ageSystemic therapyTherapy useClinical variablesManagement of Brain Metastases Surgery, Radiation, or Both?
Patel TR, Knisely JP, Chiang VL. Management of Brain Metastases Surgery, Radiation, or Both? Hematology/Oncology Clinics Of North America 2012, 26: 933-947. PMID: 22794291, DOI: 10.1016/j.hoc.2012.04.008.Peer-Reviewed Original Research
2011
Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update
Park HS, Chiang VL, Knisely JP, Raldow AC, Yu JB. Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update. Expert Review Of Anticancer Therapy 2011, 11: 1731-1738. PMID: 22050022, DOI: 10.1586/era.11.165.Peer-Reviewed Original ResearchMeSH KeywordsBrain NeoplasmsClinical Trials, Phase III as TopicCombined Modality TherapyHumansRadiosurgeryRandomized Controlled Trials as TopicConceptsWhole-brain radiation therapyStereotactic radiosurgeryBrain metastasesAddition of SRSUse of SRSMD Anderson Cancer CenterWhole brain radiotherapyLocal tumor controlStandard of careAnderson Cancer CenterNormal brain tissueNonrandomized evidenceLimited metastasesOligometastatic diseaseCancer CenterTumor controlRelative sparingRadiation therapyBrain tissueMetastasisSingle fractionNormal tissuesPatientsRadiosurgeryTrials
2009
Diagnosis-Specific Prognostic Factors, Indexes, and Treatment Outcomes for Patients With Newly Diagnosed Brain Metastases: A Multi-Institutional Analysis of 4,259 Patients
Sperduto PW, Chao ST, Sneed PK, Luo X, Suh J, Roberge D, Bhatt A, Jensen AW, Brown PD, Shih H, Kirkpatrick J, Schwer A, Gaspar LE, Fiveash JB, Chiang V, Knisely J, Sperduto CM, Mehta M. Diagnosis-Specific Prognostic Factors, Indexes, and Treatment Outcomes for Patients With Newly Diagnosed Brain Metastases: A Multi-Institutional Analysis of 4,259 Patients. International Journal Of Radiation Oncology • Biology • Physics 2009, 77: 655-661. PMID: 19942357, DOI: 10.1016/j.ijrobp.2009.08.025.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAnalysis of VarianceBrain NeoplasmsCarcinoma, Non-Small-Cell LungCarcinoma, Renal CellCombined Modality TherapyGastrointestinal NeoplasmsHumansKarnofsky Performance StatusKidney NeoplasmsLung NeoplasmsMelanomaMiddle AgedPrognosisRetrospective StudiesSelection BiasSkin NeoplasmsSmall Cell Lung CarcinomaTreatment OutcomeConceptsSignificant prognostic factorsKarnofsky performance statusDiagnosis-specific prognostic factorsNumber of BMSmall cell lung cancerBrain metastasesPrognostic factorsCell lung cancerLung cancerPerformance statusBM patientsRandomized trialsGastrointestinal cancerOnly significant prognostic factorRecurrent brain metastasesFuture randomized trialsRenal cell cancerDS-GPA scoreRenal cell carcinomaExtracranial metastasesMedian survivalCell cancerHistologic typePrognostic indexCell carcinoma