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Adherence to the 2022 Down Syndrome Guidelines in Children Less Than 18 Years of Age in the Greater Lehigh Valley Area
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The Influence of Renal Function on 30-Day Post-Coronary Artery Bypass Graft Surgery Readmissions
Get PDFA National Hospital Review and Community Survey: Assessing Fall Risk Concern and Fall Prevention Program Awareness Among Older Adults
Get PDFInconsistency in Physician Orders for Life-Sustaining Treatment (POLST) Documentation, an Opportunity for Improvement
Get PDFMulticenter basket trial for Central Nervous System tumors identifies activity of the CDK4/6 inhibitor abemaciclib in recurrent meningioma.
No full textBACKGROUND: Central nervous system (CNS) tumors are associated with considerable morbidity and high mortality. Cyclin-dependent kinases (CDKs) regulate cell division in cancer, and CDK4/6 inhibitors are used for the treatment of breast cancer, representing an attractive therapy for different tumor types.
METHODS: Here, we report mature results of a multicenter basket trial exploring the CDK4/6 inhibitor abemaciclib in patients with recurrent CNS tumors, including patients with glioma, primary CNS lymphoma, meningioma, and ependymoma. We expanded our cohort of meningioma patients based on preliminary evidence for activity. Patients were treated with 200mg oral abemaciclib twice daily for days 1-28, following FDA recommendations for breast cancer. Primary outcomes included radiographic response rates and progression free survival (PFS) at 6 months post-treatment. We also evaluated overall survival (OS) and toxicity. Exploratory outcomes included next-generation sequencing of tumor biopsies.
RESULTS: Most cohorts did not demonstrate activity with the exception of the cohort of patients with recurrent meningioma, including patients with grade 2 or 3 disease (19/22 meningioma patients). In that group, the median PFS was 15 months (95% CI: 6.5, not reached) and median OS was 32.9 months (95% CI: 10.7, not reached), the 6-month PFS was 68.2% (95% CI: 51.3%, 90.7%). All 22 patients were evaluable for radiographic response, showing stable disease in 16/22 (73%) and progressive disease in 6/22 patients (27%).
CONCLUSION: Our data suggests that abemaciclib improves PFS and OS in patients with advanced meningioma. The 6-month PFS with abemaciclib in this study (68.2%) exceeded RANO proposed benchmarks for activity (49%).Trial registration: NCT03220646
Optical coherence tomography in endovascular neurosurgery: current applications and future directions.
No full textOptical Coherence Tomography (OCT), initially introduced in 1991, has demonstrated efficacy in diagnosing pathologies of the retina, optic nerve, and coronary vessels. Recently, there has been growing research interest in the application of OCT in endovascular neurosurgery, with studies exploring its utility across a range of intracranial and extracranial endovascular diseases. The current review aims to synthesize available literature on the use of OCT in endovascular neurosurgery, encompassing both clinical and preclinical models. 57 studies met the inclusion criteria and were included in the qualitative analysis. These studies were stratified into different categories based on diseases studied. OCT has been utilized to evaluate the in vivo microanatomy of intracranial and extracranial vasculature, assess treatment efficacy and device apposition, and monitor patient outcomes. The results consistently demonstrate greater accuracy and stronger correlation with patient outcomes compared to contemporary imaging techniques. However, limitations such as the large size of current OCT-integrated probes and the lack of standardized workflows hinder the broader adoption of this technology
