2025
Phase II Trial of Pembrolizumab in Combination With Bevacizumab for Untreated Melanoma Brain Metastases.
Weiss S, Djureinovic D, Wei W, Tran T, Austin M, Markowitz J, Eroglu Z, Khushalani N, Hegde U, Cohen J, Sznol M, Anderson G, Johnson B, Piteo C, Mahajan A, Adeniran A, Jilaveanu L, Goldberg S, Chiang V, Forsyth P, Kluger H. Phase II Trial of Pembrolizumab in Combination With Bevacizumab for Untreated Melanoma Brain Metastases. Journal Of Clinical Oncology 2025, jco2402219. PMID: 40048689, DOI: 10.1200/jco-24-02219.Peer-Reviewed Original ResearchMelanoma brain metastasesOverall survivalBrain metastasesAnti-vascular endothelial growth factor therapyMedian intracranial progression-free survivalFour-year OS ratesIntracranial progression-free survivalResponse rateCirculating angiopoietin-2Median overall survivalTrial of pembrolizumabYears of pembrolizumabDose of bevacizumabProgression-free survivalPhase II trialGrowth factor therapyAdverse event ratesAssociated with responseOS ratesPD-1Radiation necrosisLocal therapyOn-therapyMetastatic tumorsFactor therapyThe Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients
Antonios J, Adenu-Mensah N, Theriault B, Millares-Chavez M, Huttner A, Aboian M, Chiang V. The Central Vein Sign as a Radiologic Tool to Predict the Diagnosis of Radiation Necrosis in Intracranial Metastatic Cancer Patients. Clinical And Translational Neuroscience 2025, 9: 10. DOI: 10.3390/ctn9010010.Peer-Reviewed Original ResearchCentral vein signRadiation necrosisTumor progressionDiagnosis of radiation necrosisDifferentiate RNCerebral radiation necrosisIntracranial metastatic diseaseCancer therapy responseMetastatic cancer patientsNon-invasive markerMetastatic diseaseSurgical biopsyTherapy responsePredictive markerPatient cohortPrimary treatmentRadiological toolsCancer patientsRadiological imagingTreatment decisionsPerivascular spacesPatientsTreatmentNecrosisMarkers
2024
RADT-45. INTEGRATION OF FUNCTIONAL MAGNETIC RESONANCE IMAGING INTO STEREOTACTIC RADIOSURGERY PLANNING TO REDUCE SYMPTOMATIC RADIATION NECROSIS
Gui C, Jenabi M, Daly J, Gillick C, Bradley T, Sze E, Maldonado R, Tiwari A, Stember J, Mankuzhy N, Yamada Y, Pike L, Pasquini L, Peck K, Ballangrud-Popovic Å, Holodny A, Imber B. RADT-45. INTEGRATION OF FUNCTIONAL MAGNETIC RESONANCE IMAGING INTO STEREOTACTIC RADIOSURGERY PLANNING TO REDUCE SYMPTOMATIC RADIATION NECROSIS. Neuro-Oncology 2024, 26: viii83-viii83. PMCID: PMC11554023, DOI: 10.1093/neuonc/noae165.0329.Peer-Reviewed Original ResearchStereotactic radiosurgerySymptomatic RNRadiation necrosisBrain metastasesNeurological symptomsDosimetric analysisTarget coverageComplications of stereotactic radiosurgeryMonths of SRSSacrificing target coverageSymptomatic radiation necrosisUnresectable brain metastasesMonths post-SRSEloquent cortical areasFunctional magnetic resonance imagingFocal neurological symptomsMagnetic resonance imagingRadiosurgery planningPost-SRSSRS plansPrimary motorEloquent areasNeurological functionPatientsResonance imagingTumors Affect the Metabolic Connectivity of the Human Brain Measured by 18F-FDG PET
Pasquini L, Jenabi M, Graham M, Peck K, Schöder H, Holodny A, Krebs S. Tumors Affect the Metabolic Connectivity of the Human Brain Measured by 18F-FDG PET. Clinical Nuclear Medicine 2024, 49: 822-829. PMID: 38693648, PMCID: PMC11300165, DOI: 10.1097/rlu.0000000000005227.Peer-Reviewed Original ResearchConceptsHealthy controlsTemporal tumorF-FDGFrontal tumorF-FDG PET/MRIKarnofsky performance scoreF-FDG PETHigh-grade gliomasLow-grade gliomasLow KPSRadiation necrosisActive tumorMetabolic brain networkMetabolic connectivityHigher KPSBrain metabolic connectivityHemispheric tumorsLow-gradeSignificant hemispheric differencesSynaptic activityTumorPatientsBetweenness centralityLeft hemisphere tumorsGlucose metabolism154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery
Robert S, Kiziltug E, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 154 Elucidating the Immune Landscape of Radiation Necrosis Through Single Cell Analysis of Recurrent Brain Lesions in Patients After Stereotactic Radio Surgery. Neurosurgery 2024, 70: 35-36. DOI: 10.1227/neu.0000000000002809_154.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingInterferon-stimulated genesStereotactic radiosurgeryNatural killerMyeloid cellsImmune cellsRadiosurgical treatment of brain metastasesTreatment of brain metastasesCD4+ T cellsExpression of immune cellsMorbid side effectsTreatment of RNSubpopulations of myeloid cellsStereotactic radio surgeryMetastatic brain tumorsInvasive brain biopsyCellular immune profilesInflammatory immune responseCSF of patientsRN patientsBrain metastasesCD8+Immunotherapy optionsMetastatic tumors
2023
Stereotactic Radiosurgery for Women Older than 65 with Breast Cancer Brain Metastases
Upadhyay R, Klamer B, Perlow H, White J, Bazan J, Jhawar S, Blakaj D, Grecula J, Arnett A, Mestres-Villanueva M, Healy E, Thomas E, Chakravarti A, Raval R, Lustberg M, Williams N, Palmer J, Beyer S. Stereotactic Radiosurgery for Women Older than 65 with Breast Cancer Brain Metastases. Cancers 2023, 16: 137. PMID: 38201564, PMCID: PMC10778270, DOI: 10.3390/cancers16010137.Peer-Reviewed Original ResearchIntracranial progression-free survivalProgression-free survivalBreast cancer patientsBrain metastasesOverall survivalYounger patientsCancer patientsRadiation necrosisOlder womenOlder patientsPositive diseaseSystemic therapyMultivariable analysisTreatment patternsBiopsy-proven breast cancer patientsCox proportional hazards regression methodsIncidence of BMOlder breast cancer patientsSingle-institutional retrospective reviewTreatment-related adverse eventsAge groupsBreast cancer brain metastasesMetastatic breast cancer patientsWorse progression-free survivalProportional hazards regression methodsSURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES
Strowd R, Chan M, Tatter S, Chiang V, Fecci P, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. SURG-32. EFFICACY OF LASER INTERSTITIAL THERMAL THERAPY (LITT) FOR BIOPSY-PROVEN RADIATION NECROSIS IN RADIOGRAPHICALLY RECURRENT BRAIN METASTASES. Neuro-Oncology 2023, 25: v269-v269. PMCID: PMC10640195, DOI: 10.1093/neuonc/noad179.1031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesRadiographic progressionKaplan-MeierStereotactic radiosurgeryLocal controlMedian Karnofsky performance statusFuture radiographic progressionRadiotherapeutic treatment optionsResults Ninety patientsBrain metastasis patientsMulti-center registryRecurrent brain metastasesMedian hospitalization timeLesional progressionMultivariable FineNinety patientsSymptom controlCumulative incidenceMetastasis patientsPerformance statusSystemic therapyJS09.5.A18F-FLUCICLOVINE PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY: IMAGE INTERPRETATION CRITERIA RESULTS FROM PURSUE, A PROSPECTIVE PHASE 2 TRIAL
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. JS09.5.A18F-FLUCICLOVINE PET FOR DETECTION OF RECURRENT BRAIN METASTASES AFTER RADIATION THERAPY: IMAGE INTERPRETATION CRITERIA RESULTS FROM PURSUE, A PROSPECTIVE PHASE 2 TRIAL. Neuro-Oncology 2023, 25: ii12-ii13. PMCID: PMC10489492, DOI: 10.1093/neuonc/noad137.034.Peer-Reviewed Original ResearchRecurrent brain metastasesImage interpretation criteriaBrain metastasesRadiation therapyLesion uptakeDiagnostic performancePredictive valueProspective phase 2 trialSolid tumor brain metastasesTumor brain metastasesPhase 2 trialInterpretation criteriaNegative predictive valueLow background uptakePositive predictive valueExcellent diagnostic performanceBM recurrencePost-MRIPrimary endpointSecondary endpointsRadiation necrosisReference lesionsUnnecessary surgeryHistopathological analysisInitial cohortEvaluating the diagnostic performance of 18F-fluciclovine for detection of recurrent brain metastases after radiation therapy: Results from a prospective phase 2 trial.
Kotecha R, Chiang V, Tom M, Nabavizadeh A, Zan E, Peddi S, Sulman E, Siegel B, Huang J, Brem S, Ware M, Kesari S, Parent E, Pope W, Holmes R, Chau A, Teoh E, Chao S, Aboian M. Evaluating the diagnostic performance of 18F-fluciclovine for detection of recurrent brain metastases after radiation therapy: Results from a prospective phase 2 trial. Journal Of Clinical Oncology 2023, 41: 2001-2001. DOI: 10.1200/jco.2023.41.16_suppl.2001.Peer-Reviewed Original ResearchRecurrent brain metastasesImage interpretation criteriaF-fluciclovine PETF-fluciclovine uptakeBrain metastasesF-fluciclovineRadiation therapyDiagnostic performanceHistopathological analysisSUV maxFirst prospective multicenter trialProspective phase 2 trialSolid tumor brain metastasesTumor brain metastasesPhase 2 trialProspective multicenter trialIndependent blinded readersFluciclovine uptakePost-MRIPrimary endpointSecondary endpointsMulticenter trialRadiation necrosisRecurrent tumorsFuture trials465 Defining the Immune Profile of Radiation Necrosis Through Single-cell Analysis of Intracranial Lesions
Robert S, Lu B, Arnal-Estape A, Nguyen D, Chiang V. 465 Defining the Immune Profile of Radiation Necrosis Through Single-cell Analysis of Intracranial Lesions. Neurosurgery 2023, 69: 97-98. DOI: 10.1227/neu.0000000000002375_465.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingImmune profileNatural killer (NK) cellsIncidence of radiation necrosisManagement of brain metastasesMetastatic brain tumor patientsMorbid side effectsTreatment of RNRecurrent metastatic diseaseExpression of Foxp3Cytotoxic T cellsInvasive brain biopsyCellular immune profilesInterleukin-7 receptorBrain tumor patientsBrain metastasesMetastatic diseaseMetastatic tumorsImmune landscapeIntraoperative samplesPatient survivalT cellsBrain biopsyIntracranial lesionsOutcomes of intraventricular 131-I-omburtamab and external beam radiotherapy in patients with recurrent medulloblastoma and ependymoma
Tringale K, Wolden S, Karajannis M, Haque S, Pasquini L, Yildirim O, Rosenblum M, Benhamida J, Cheung N, Souweidane M, Basu E, Pandit-Taskar N, Zanzonico P, Humm J, Kramer K. Outcomes of intraventricular 131-I-omburtamab and external beam radiotherapy in patients with recurrent medulloblastoma and ependymoma. Journal Of Neuro-Oncology 2023, 162: 69-78. PMID: 36853490, PMCID: PMC10050019, DOI: 10.1007/s11060-022-04235-w.Peer-Reviewed Original ResearchConceptsExternal beam radiotherapyCompartmental radioimmunotherapyOverall survivalCraniospinal axisBeam radiotherapyRecurrent medulloblastomaCases of radiation necrosisAssociated with progression-freeRecurrent primary brain tumorsCases of radionecrosisImprove survival outcomesMedium follow-upProspective clinical trialKaplan-Meier analysisPredictors of responseExtent of diseasePatterns of failurePrimary brain tumorNED statusUpfront therapyProgression-freeRadiation necrosisConclusionFor patientsEpendymoma patientsMultimodal therapyEfficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases
Chan M, Tatter S, Chiang V, Fecci P, Strowd R, Prabhu S, Hadjipanayis C, Kirkpatrick J, Sun D, Sinicrope K, Mohammadi A, Sevak P, Abram S, Kim A, Leuthardt E, Chao S, Phillips J, Lacroix M, Williams B, Placantonakis D, Silverman J, Baumgartner J, Piccioni D, Laxton A. Efficacy of laser interstitial thermal therapy for biopsy-proven radiation necrosis in radiographically recurrent brain metastases. Neuro-Oncology Advances 2023, 5: vdad031. PMID: 37114245, PMCID: PMC10129388, DOI: 10.1093/noajnl/vdad031.Peer-Reviewed Original ResearchLaser interstitial thermal therapyKarnofsky performance statusRadiation necrosisInterstitial thermal therapyBrain metastasesLocal controlMedian Karnofsky performance statusRecurrent brain metastasesMedian hospitalization timeLow patient morbidityLesional progressionMultivariable FineCumulative incidenceOverall survivalPerformance statusSymptom controlHospitalization timeSystemic therapyMedian timeNeurological deathSymptom managementKaplan-MeierPatient morbiditySeizure prevalenceUS Centers
2022
IMMU-01. DEFINING THE IMMUNE PROFILE OF RADIATION NECROSIS THROUGH SINGLE-CELL ANALYSIS OF INTRACRANIAL LESIONS
Robert S, Lu B, Kiziltug E, Estape A, Nguyen D, Chiang V. IMMU-01. DEFINING THE IMMUNE PROFILE OF RADIATION NECROSIS THROUGH SINGLE-CELL ANALYSIS OF INTRACRANIAL LESIONS. Neuro-Oncology 2022, 24: vii131-vii131. DOI: 10.1093/neuonc/noac209.499.Peer-Reviewed Original ResearchRadiation necrosisFluorescence-activated cell sortingNatural killer (NK) cellsIncidence of radiation necrosisManagement of brain metastasesMetastatic brain tumor patientsMorbid side effectsTreatment of RNRecurrent metastatic diseaseExpression of Foxp3Invasive brain biopsyCellular immune profilesInterleukin-7 receptorBrain tumor patientsNeuroimmune profileBrain metastasesMetastatic diseaseCytotoxic TMetastatic tumorsImmune landscapeIntraoperative samplesImprove patient diagnosisImmune profilePatient survivalBrain biopsyHistological changes associated with laser interstitial thermal therapy for radiation necrosis: illustrative cases
Fomchenko EI, Leelatian N, Darbinyan A, Huttner AJ, Chiang VL. Histological changes associated with laser interstitial thermal therapy for radiation necrosis: illustrative cases. Journal Of Neurosurgery Case Lessons 2022, 4: case21373. PMID: 35855352, PMCID: PMC9257400, DOI: 10.3171/case21373.Peer-Reviewed Original ResearchLaser interstitial thermal therapyRadiation necrosisInterstitial thermal therapyBrain metastasesAssociated cerebral edemaStage IV diseaseUse of immunotherapyPredictors of responseOngoing immunotherapySurgical decompressionCerebral edemaPerilesional edemaSurgical approachClinical historyLung cancerNeurological compromiseGood patientHistological changesStereotactic radiosurgeryPatientsEarly reductionSized lesionsImmunotherapyTherapyThermal therapy513 Surveilling Cerebrospinal Fluid Protein Biomarkers in Brain Metastasis
Cheok S, Arnal-Estape A, Wei W, Nguyen D, Chiang V. 513 Surveilling Cerebrospinal Fluid Protein Biomarkers in Brain Metastasis. Neurosurgery 2022, 68: 129-129. DOI: 10.1227/neu.0000000000001880_513.Peer-Reviewed Original ResearchBrain metastasesCerebrospinal fluidIntraparenchymal diseaseCentral nervous system pathologyCerebrospinal fluid (CSF) protein biomarkersIntraparenchymal brain metastasesManagement of patientsNormal pressure hydrocephalusNervous system pathologyCurrent diagnostic standardNon-malignant samplesWarrants further explorationCSF profilePressure hydrocephalusRadiation necrosisLung cancerSimilar pathogenesisBrain parenchymaInflammatory diseasesIntracranial diseaseBreast cancerClinical dataCSF leakTreatment responsePatientsEmerging Studies of Melanoma Brain Metastasis
Caulfield JI, Kluger HM. Emerging Studies of Melanoma Brain Metastasis. Current Oncology Reports 2022, 24: 585-594. PMID: 35212922, DOI: 10.1007/s11912-022-01237-9.Peer-Reviewed Original ResearchConceptsMelanoma brain metastasesBrain metastasesClinical studiesTreatment approachesRecent FindingsClinical trialsImmune checkpoint inhibitorsAdditional treatment approachesRecent preclinical studiesNew treatment approachesCentral nervous systemBrain disseminationCheckpoint inhibitorsSignificant morbidityPerilesional edemaRadiation necrosisPatient populationClinical challengePreclinical studiesNervous systemSolid tumorsEmerging studiesMetastasisTumor microenvironmentDisease controlTumor homing
2021
Recognition and Management of Adverse Radiation Effects
Cheok S, Hansen J, Chiang V. Recognition and Management of Adverse Radiation Effects. 2021, 391-404. DOI: 10.1201/9781003167464-36.ChaptersAdverse radiation effectsRadiation necrosisStereotactic radiosurgeryRole of SRSImmune-mediated componentLaser interstitial thermotherapyMore brain lesionsBrain metastasesSystemic therapyIntracranial pathologyMalignant pathologyBrain lesionsNecrosisInterstitial thermotherapyPathologyContemporary evidenceBevacizumabCraniotomyMetastasisTherapyLesionsRadiosurgerySteroidsClinical Outcomes of Non-Small Cell Lung Cancer Brain Metastases Treated With Stereotactic Radiosurgery and Immune Checkpoint Inhibitors, EGFR Tyrosine Kinase Inhibitors, Chemotherapy and Immune Checkpoint Inhibitors, or Chemotherapy Alone
Dohm A, Tang J, Mills M, Perez B, Robinson T, Creelan B, Gray J, Etame A, Vogelbaum M, Forsyth P, Yu H, Oliver D, Ahmed K. Clinical Outcomes of Non-Small Cell Lung Cancer Brain Metastases Treated With Stereotactic Radiosurgery and Immune Checkpoint Inhibitors, EGFR Tyrosine Kinase Inhibitors, Chemotherapy and Immune Checkpoint Inhibitors, or Chemotherapy Alone. International Journal Of Radiation Oncology • Biology • Physics 2021, 111: e567. DOI: 10.1016/j.ijrobp.2021.07.1531.Peer-Reviewed Original ResearchEpidermal growth factor receptor tyrosine kinase inhibitorsImmune checkpoint inhibitorsDistant intracranial controlNon-small cell lung cancer brain metastasesCell lung cancer brain metastasesLung cancer brain metastasesTiming of SRSChemotherapy-alone groupNSCLC BM patientsNSCLC brain metastasesBrain metastasesCancer brain metastasesSystemic therapyRadiation necrosisStereotactic radiosurgeryCheckpoint inhibitorsOverall survivalTreatment groupsLocal controlMultivariate analysisBM patientsAlone groupClinical outcomesConventional chemotherapyGrowth factor receptor tyrosine kinase inhibitorsReirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery
Kowalchuk RO, Niranjan A, Lee CC, Yang HC, Liscak R, Guseynova K, Tripathi M, Kumar N, Peker S, Samanci Y, Hess J, Chiang V, Iorio-Morin C, Mathieu D, Pikis S, Wei Z, Lunsford LD, Trifiletti DM, Sheehan JP. Reirradiation With Stereotactic Radiosurgery After Local or Marginal Recurrence of Brain Metastases From Previous Radiosurgery. International Journal Of Radiation Oncology • Biology • Physics 2021, 112: 726-734. PMID: 34644606, DOI: 10.1016/j.ijrobp.2021.10.008.Peer-Reviewed Original ResearchConceptsLocal tumor controlRepeat stereotactic radiosurgeryRadiation necrosisStereotactic radiosurgeryBrain metastasesTumor controlMaximum doseMarginal recurrenceBiopsy-proven non-small cell lung cancerIsodose lineNon-small cell lung cancerRisk of RNPreoperative stereotactic radiosurgeryPrior stereotactic radiosurgerySymptomatic radiation necrosisNeuro-Oncology criteriaCell lung cancerPrescription isodose linePrevious radiosurgeryMargin dosePrimary endpointPrior immunotherapyLung cancerMajor indicationTumor volumeSURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience
Pena-Pino I, Ma J, Hori Y, Fomchenko E, Dusenbery K, Reynolds M, Wilke C, Yuan J, Barnett G, Chiang V, Mohammadi A, Chen C. SURG-02. Stereotactic Laser Ablation (SLA) followed by consolidation stereotactic radiosurgery (SRS) as a treatment strategy for brain metastasis that recurred locally after initial radiosurgery (BMRS): a collaborative institutional experience. Neuro-Oncology Advances 2021, 3: iii23-iii23. PMCID: PMC8351296, DOI: 10.1093/noajnl/vdab071.095.Peer-Reviewed Original ResearchStereotactic laser ablationStereotactic radiosurgeryOverall survivalTreatment strategiesLocal controlDays of SRSSymptomatic radiation necrosisMedian overall survivalSystemic disease progressionRepeat stereotactic radiosurgeryIndependent clinical trialsInitial radiosurgerySteroid therapyBrain metastasesClinical outcomesRadiation necrosisFavorable outcomeClinical trialsDisease progressionFLAIR volumeInstitutional experiencePatientsCE volumeRadiosurgeryLocal failure
This site is protected by hCaptcha and its Privacy Policy and Terms of Service apply