The Alcatraz‐Strategy: a roadmap to break the connectivity barrier in malignant brain tumours

Molecular Oncology, Год журнала: 2024, Номер unknown

Опубликована: Апрель 3, 2024

In recent years, the discovery of functional and communicative cellular tumour networks has led to a new understanding malignant primary brain tumours. this review, authors shed light on diverse nature cell‐to‐cell connections in tumours propose an innovative treatment approach address detrimental connectivity these networks. The proposed therapeutic outlook revolves around three main strategies: (a) supramarginal resection removing substantial portion communicating cell front far beyond gadolinium‐enhancing mass, (b) morphological isolation at single level disrupting structural contacts facilitated by elongated membrane protrusions known as microtubes (TMs), (c) blocking TM‐mediated intercellular cytosolic exchange inhibiting neuronal excitatory input into network. We draw analogy between Alcatraz Federal Penitentiary, where inmates faced impassable sea barrier experienced both spatial within individual cells. Based current translational efforts ongoing clinical trials, we Alcatraz‐Strategy promising framework tackle harmful effects

Язык: Английский

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Value of intralesional and perilesional radiomics for predicting the bioactivity of hepatic alveolar echinococcosis

Frontiers in Oncology, Год журнала: 2024, Номер 14

Опубликована: Июнь 27, 2024

To investigate the value of intralesional and perilesional radiomics based on computed tomography (CT) in predicting bioactivity hepatic alveolar echinococcosis (HAE). In this retrospective study, 131 patients who underwent surgical resection diagnosed HAE pathology were included (bioactive, n=69; bioinactive, n=62). All randomly assigned to training cohort (n=78) validation (n=53) a 6:4 ratio. The gross lesion volume (GLV), (PLV), combined (GPLV) features extracted CT images portal vein phase. Feature selection was performed by intra-class correlation coefficient (ICC), univariate analysis, least absolute shrinkage operator (LASSO). Radiomics models established support vector machine (SVM). Radscore best model clinical independent predictors establish nomogram. Receiver operating characteristic curve (ROC) decision curves used evaluate predictive performance nomogram model. cohort, area under ROC (AUC) GLV, PLV, GPLV radiomic 0.774, 0.729, 0.868, respectively. among three cohort. Calcification type fibrinogen (p<0.05). AUC nomogram-model-based signatures 0.914 0.833 analysis showed that had greater benefits compared with single or shows prediction HAE. including tissue can significantly improve efficacy bioactivity.

Язык: Английский

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Seizure Management and Prophylaxis Considerations in Patients with Brain Tumors

Current Oncology Reports, Год журнала: 2023, Номер 25(7), С. 787 - 792

Опубликована: Апрель 18, 2023

The article gives an overview of the current knowledge in management tumor related epilepsy, including systematic reviews and consensus statements as well recent insight into a potentially more individualized treatment approach.Tumor molecular markers IDH1 mutation MGMT methylation status may provide future targets. Seizure control should be included metric assessing efficacy treatment. Prophylactic is recommended all brain patients after first seizure. Epilepsy has profound effect on quality life this patient group. clinician tailor choice seizure prophylactic to individual patient, with goal limiting adverse effects, avoiding interactions obtaining high degree freedom. Status epilepticus associated inferior survival must treated promptly. A multidisciplinary team treat tumors epilepsy.

Язык: Английский

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Gliomagenesis, Epileptogenesis, and Remodeling of Neural Circuits: Relevance for Novel Treatment Strategies in Low- and High-Grade Gliomas

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(16), С. 8953 - 8953

Опубликована: Авг. 16, 2024

Gliomas present a complex challenge in neuro-oncology, often accompanied by the debilitating complication of epilepsy. Understanding biological interaction and common pathways between gliomagenesis epileptogenesis is crucial for improving current understanding tumorigenesis also developing effective management strategies. Shared genetic molecular mechanisms, such as IDH mutations dysregulated glutamate signaling, contribute to both tumor progression seizure development. Targeting these pathways, through direct inhibition mutant enzymes or modulation receptors, holds promise patient outcomes. Additionally, advancements surgical techniques, like supratotal resection guided connectomics, offer opportunities maximally safe enhanced control. Advanced imaging modalities further aid identifying epileptogenic foci tailoring treatment approaches based on tumor's metabolic characteristics. This review aims explore interplay gliomagenesis, epileptogenesis, neural circuit remodeling, offering insights into shared innovative strategies improve outcomes patients with gliomas associated

Язык: Английский

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Maximal Extent of Resection, Including Supramaximal Resection, for Diffuse Gliomas

Advances in Oncology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

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Gene mutations linked to drug-resistant epilepsy in astrocytoma

Frontiers in Neurology, Год журнала: 2025, Номер 16

Опубликована: Март 4, 2025

Introduction Epilepsy is common in gliomas, particularly astrocytomas, even patients who have undergone total tumor resection. Resistance to antiseizure drugs presents a significant challenge managing epilepsy. Seizure outcomes after brain surgery for drug-resistant epilepsy (DRE) are heterogeneous and difficult predict using models that evaluate current clinical, imaging, electrophysiological variables. This study aimed investigate possible correlations between genetic mutations resistance whole-exome sequencing. Methods Tumor samples from medical biobank were subjected sequencing, the contribution of 64 genes previous report was analyzed. Results Fifteen had DRE. Compared showed drug responsiveness, DRE group exhibited glutamate receptor ( GRIA1 , GRIK5 GRIN2B or GRIN2C ), ATRX glutamate-S-transferase gene. No differences found groups terms BRAF Olig2 Ki-67, IDH, PIK3CA, p 53 GRM BCL2A . Discussion These findings suggest somatic gene closely linked Identifying molecular basis crucial improving management

Язык: Английский

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Survival prediction with radiomics for patients with IDH mutated lower-grade glioma

Journal of Neuro-Oncology, Год журнала: 2025, Номер unknown

Опубликована: Март 18, 2025

Abstract Purpose Adult patients with diffuse lower-grade gliomas (dLGG) show heterogeneous survival outcomes, complicating postoperative treatment planning. Treating all early increases the risk of long-term side effects, while delayed may lead to impaired survival. Refinement prognostic models could optimize timing treatment. Conventional radiological features are in dLGG, but MRI carry more information. This study aimed investigate MRI-based radiomics and compare them clinical models. Methods Two were created: a preoperative model (tumor volume) full volume, extent resection, tumor subtype). Radiomics extracted from MRI. The dataset was divided into training set unseen test (70:30). Model performance evaluated on Uno’s concordance index (c-index). Risk groups created by best performing model’s predictions. Results 207 mutated IDH (mIDH) dLGG included. clinical, showed c-indexes 0.70, 0.71 0.75 respectively for overall included four diameter heterogeneity. combined c-index = 0.79. difference between high- low-risk according both statistically significant clinically relevant. Conclusion can capture quantitative information dLGG. Combined promise synergetic effects should be studied further astrocytoma oligodendroglioma separately optimal modelling individual risks.

Язык: Английский

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Non-invasive CT based multiregional radiomics for predicting pathologic complete response to preoperative neoadjuvant chemoimmunotherapy in non-small cell lung cancer

European Journal of Radiology, Год журнала: 2025, Номер 189, С. 112171 - 112171

Опубликована: Май 19, 2025

Язык: Английский

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Repeated Awake Surgical Resection(s) for Recurrent Diffuse Low-Grade Gliomas: Why, When, and How to Reoperate?

Frontiers in Oncology, Год журнала: 2022, Номер 12

Опубликована: Июль 5, 2022

Early maximal surgical resection is the first treatment in diffuse low-grade glioma (DLGG), because reduction of tumor volume delays malignant transformation and extends survival. Awake surgery with intraoperative mapping behavioral monitoring enables to preserve quality life (QoL). However, infiltrative nature DLGG, relapse unavoidable, even after (supra)total resection. Therefore, besides chemotherapy radiotherapy, question reoperation(s) increasingly raised, especially patients DLGG usually enjoy a normal long-lasting projects. Here, purpose review literature emerging field iterative surgeries DLGG. First, long-term follow-up results showed that who underwent multiple had an increased survival (above 17 years) preservation QoL. Second, criteria guiding decision reoperate defining optimal timing are discussed, mainly based on dynamic intercommunication between (including its kinetics pattern regrowth) reactional cerebral reorganization—i.e., mechanisms underpinning reconfiguration within across neural networks enable functional compensation. Third, how adapt medico-surgical strategy this individual spatiotemporal brain interplay detailed, by considering perpetual changes connectome. These data support early reoperation recurrent before onset symptoms transformation. Repeat awake resection(s) should be integrated global management including (neo)adjuvant medical treatments, enhance oncological outcomes. The prediction potential limitation neuroplasticity at each step disease must improved anticipate personalized multistage therapeutic attitudes.

Язык: Английский

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Tumor Multiregional Mean Apparent Propagator (MAP) Features in Evaluating Gliomas—A Comparative Study With Diffusion Kurtosis Imaging (DKI)

Journal of Magnetic Resonance Imaging, Год журнала: 2023, Номер 60(4), С. 1532 - 1546

Опубликована: Дек. 22, 2023

Background Glioma classification affects treatment and prognosis. Reliable imaging methods for preoperatively evaluating gliomas are essential. Purpose To evaluate tumor multiregional mean apparent propagator (MAP) features in glioma diagnosis to compare those with diffusion‐kurtosis (DKI). Study Type Retrospective study. Subjects 70 untreated patients (31 LGGs (low‐grade gliomas), 34 women; age, 47 ± 12 years, training (60%, n = 42) testing cohorts (40%, 28)). Field Strength/Sequence 3‐T, diffusion‐MRI using q‐space Cartesian grid sampling 11 different b ‐values. Assessment Tumor MAP (mean squared displacement (MSD); inverse variance (QIV); non‐Gaussianity (NG); axial/radial (NGAx, NGRad); return‐to‐origin/axis/plane probability (RTOP, RTAP, RTPP)); DKI metrics (axial/mean/radial kurtosis (AK, MK, RK)) on parenchyma (TP) peritumoral areas (PT) histopathologically grading genotyping were assessed. Statistical Tests Mann–Whitney U; Kruskal–Wallis; Benjamini–Hochberg; Bonferroni‐correction; receiver operating curve (ROC) area under (AUC); DeLong's test; Random Forest (RF). P value<0.05 was considered statistically significant after multiple comparisons correction. Results Compared LGGs, MSD, QIV significantly lower TP, whereas NG, NGAx, NGRad, RTOP, RTPP, higher HGGs (high‐grade gliomas) ( ≤ 0.007), as well isocitrate‐dehydrogenase (IDH)‐mutated than IDH‐wildtype 0.039). These trends reversed PT (tumor grades, 0.011; IDH‐mutation status, 0.012). ROC analysis showed that, performed best TP (AUC 0.83), PT, RTPP 0.77) grading. AK 0.77), MSD 0.73) IDH genotyping. Further RF demonstrated good performance 0.91, Accuracy 82%) 0.87, 79%). Data Conclusion could effectively gliomas. The of may be similar while outperform DKI. Level Evidence 4 Technical Efficacy Stage 2

Язык: Английский

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