PURPOSE:This study was conducted to investigate the incidence of ERBB1 amplification and overexpression in samples of diffusely infiltrative (WHO grades Ⅱ-Ⅳ) pediatric brain stem glioma (BSG) and determine the relat...PURPOSE:This study was conducted to investigate the incidence of ERBB1 amplification and overexpression in samples of diffusely infiltrative (WHO grades Ⅱ-Ⅳ) pediatric brain stem glioma (BSG) and determine the relationship of these abnormalities to expression and mutation of TP53 and tumor grade. Experimental Design: After central pathology review, the incidence of ERBB1 amplification and overexpression was determined in 28 samples (18 surgical biopsy and 10 postmortem specimens) of BSG using quantitative PCR and immunohistochemistry,展开更多
The Stupp protocol has become standard of care for the treatment of glioblastoma (GBM) (since its publication in 2005) and has led to some limited survival improvements. This protocol, consists of radiotherapy and con...The Stupp protocol has become standard of care for the treatment of glioblastoma (GBM) (since its publication in 2005) and has led to some limited survival improvements. This protocol, consists of radiotherapy and concomitant chemotherapy with temozolomide, an alkylating agent. Temozolomide + radiation, compared to radiation alone had added in average 3 months additional life span, 16 percent improved survival at 2 years. That said since 2005, the standard of care has not changed in regards to the treatment of early diagnosed aggressive or multifocal GBM, and unfortunately the expected survival is still poor with 75 percent of patients dying in less than 2 years and average survival of 15 months. In patients with multifocal tumors (such as the case below) the average survival is even worse with less than 4 months at her age [1]. Here we present a case study of a patient with advanced multifocal, and rapidly progressing Glioblastoma Multiforme treated with STUPP protocol in combination with IV Quercetin. The patient experienced improved quality of life and response, compared to historical data. It is our recommendation to investigate such combinational approach in patients with Glioblastoma, as in our case it proved to be safe and effective with improved quality of life and performance as well as clinical response and survival.展开更多
Glioma treatments are faced with challenges, including the inability to fully eliminate cancer stem cells, the immunosuppressive tumor microenvironment, and the blood brain barrier. Although progress has been made wit...Glioma treatments are faced with challenges, including the inability to fully eliminate cancer stem cells, the immunosuppressive tumor microenvironment, and the blood brain barrier. Although progress has been made with surgical, radiation, and chemotherapies, prognosis for patients remains poor. Rapidly emerging immunotherapies may be able to address the challenges that conventional techniques cannot. Immunotherapies manipulate the patient's immune system to selectively combat malignancies. Therapies often work to enhance T-cell and natural killer (NK) cell function, which can both eliminate tumor cells and enhance remission. Vaccines encourage in vivo development of anti-tumor T-cells and NK cells, while adoptive transfer techniques focus on engineering immune cells ex vivo before reintroducing them to patients. Vaccine and adoptive transfer therapies have been shown to induce enhanced immune responses in patients but have not always correlated with improved outcomes, likely because of the tumor immunosuppressive microenvironment. Checkpoint inhibitors can impair these tumor immunosuppressive capabilities. Although no one treatment has been able to consistently eliminate gliomas and maintain remission, combinations of vaccines or adoptive transfer techniques in conjunction with immune checkpoint inhibitors offers promise.展开更多
文摘PURPOSE:This study was conducted to investigate the incidence of ERBB1 amplification and overexpression in samples of diffusely infiltrative (WHO grades Ⅱ-Ⅳ) pediatric brain stem glioma (BSG) and determine the relationship of these abnormalities to expression and mutation of TP53 and tumor grade. Experimental Design: After central pathology review, the incidence of ERBB1 amplification and overexpression was determined in 28 samples (18 surgical biopsy and 10 postmortem specimens) of BSG using quantitative PCR and immunohistochemistry,
文摘The Stupp protocol has become standard of care for the treatment of glioblastoma (GBM) (since its publication in 2005) and has led to some limited survival improvements. This protocol, consists of radiotherapy and concomitant chemotherapy with temozolomide, an alkylating agent. Temozolomide + radiation, compared to radiation alone had added in average 3 months additional life span, 16 percent improved survival at 2 years. That said since 2005, the standard of care has not changed in regards to the treatment of early diagnosed aggressive or multifocal GBM, and unfortunately the expected survival is still poor with 75 percent of patients dying in less than 2 years and average survival of 15 months. In patients with multifocal tumors (such as the case below) the average survival is even worse with less than 4 months at her age [1]. Here we present a case study of a patient with advanced multifocal, and rapidly progressing Glioblastoma Multiforme treated with STUPP protocol in combination with IV Quercetin. The patient experienced improved quality of life and response, compared to historical data. It is our recommendation to investigate such combinational approach in patients with Glioblastoma, as in our case it proved to be safe and effective with improved quality of life and performance as well as clinical response and survival.
文摘Glioma treatments are faced with challenges, including the inability to fully eliminate cancer stem cells, the immunosuppressive tumor microenvironment, and the blood brain barrier. Although progress has been made with surgical, radiation, and chemotherapies, prognosis for patients remains poor. Rapidly emerging immunotherapies may be able to address the challenges that conventional techniques cannot. Immunotherapies manipulate the patient's immune system to selectively combat malignancies. Therapies often work to enhance T-cell and natural killer (NK) cell function, which can both eliminate tumor cells and enhance remission. Vaccines encourage in vivo development of anti-tumor T-cells and NK cells, while adoptive transfer techniques focus on engineering immune cells ex vivo before reintroducing them to patients. Vaccine and adoptive transfer therapies have been shown to induce enhanced immune responses in patients but have not always correlated with improved outcomes, likely because of the tumor immunosuppressive microenvironment. Checkpoint inhibitors can impair these tumor immunosuppressive capabilities. Although no one treatment has been able to consistently eliminate gliomas and maintain remission, combinations of vaccines or adoptive transfer techniques in conjunction with immune checkpoint inhibitors offers promise.
