Spinal cord astrocytomas: progresses in experimental and clinical investigations for developing recovery neurobiology-based novel therapies

Teng, Yang D.; Abd-El-Barr, Muhammad M.; Wang, Lei; Hajiali, Hadi; Wu, Liqun; Zafonte, Ross

doi:10.1016/j.expneurol.2018.09.010

Cited by 17 publications

(28 citation statements)

References 162 publications

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“…There are currently limited treatment options available for SCAs. Surgery serves as the initial treatment modality; however, complete resection is often not possible due to the infiltrative nature of astrocytoma [1,4]. Although post-operative spinal radiation has been adopted worldwide to prevent recurrence, its exact role in SCA management remained controversial because low-grade SCAs may benefit minimally from radiotherapy due to low spontaneous recurrence rates while high-grade SCAs generally have low sensitivity to radiation [1,4].…”

Section: Introductionmentioning

confidence: 99%

“…Surgery serves as the initial treatment modality; however, complete resection is often not possible due to the infiltrative nature of astrocytoma [1,4]. Although post-operative spinal radiation has been adopted worldwide to prevent recurrence, its exact role in SCA management remained controversial because low-grade SCAs may benefit minimally from radiotherapy due to low spontaneous recurrence rates while high-grade SCAs generally have low sensitivity to radiation [1,4]. Likewise, established chemotherapy regimens such as temozolomide, administered alone or in combination with bevacizumab, are also considered to have limited value in treating SCAs since they have not been systematically examined or validated in large prospective studies [4].…”

Section: Introductionmentioning

confidence: 99%

“…Although post-operative spinal radiation has been adopted worldwide to prevent recurrence, its exact role in SCA management remained controversial because low-grade SCAs may benefit minimally from radiotherapy due to low spontaneous recurrence rates while high-grade SCAs generally have low sensitivity to radiation [1,4]. Likewise, established chemotherapy regimens such as temozolomide, administered alone or in combination with bevacizumab, are also considered to have limited value in treating SCAs since they have not been systematically examined or validated in large prospective studies [4]. Multi-modality therapy is, therefore, of paramount importance in such a scenario and next-generation sequencing (NGS)-guided targeted therapy may serve as a last resort for certain patients.…”

Section: Introductionmentioning

confidence: 99%

“…Spinal cord astrocytoma (SCA) comprises 2.1% of all adult primary spinal cord tumors, which in turn, accounts for 2–4% of all CNS tumors [ 2 , 3 ]. The prognosis of SCA patients depends on the tumor grade (grade I-IV according to World Health Organization criteria) and duration of symptoms before diagnosis, where high-grade ones are usually highly aggressive and may cause neurological deficiency or even death [ 4 ]. There are currently limited treatment options available for SCAs.…”

Section: Introductionmentioning

confidence: 99%

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A refractory case of CDK4-amplified spinal astrocytoma achieving complete response upon treatment with a Palbociclib-based regimen:a case report

Lin

et al. 2020

BMC Cancer

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Background: Spinal cord astrocytoma is a rare neoplasm, and patients usually recur within months after surgery. There is currently a lack of consensus regarding post-operative treatment. Clinical data on the activity of systemic treatment like chemoradiotherapy and anti-angiogenic agents also remained scant. Next-generation sequencing (NGS)-based genomic profiling thus may help identify potential treatment options for a subset of patients that harbor actionable genetic alterations. Case presentation: We reported for the first time a refractory case of grade III spinal cord astrocytoma that underwent two surgeries but eventually progressed following post-operative chemoradiotherapy plus bevacizumab. Hybridization capture-based NGS using a 381-gene panel disclosed cyclin dependent kinase 4 (CDK4) amplification and after receiving a triplet regimen containg palbociclib for 15 months, the patient achieved complete response. Conclusions: This case demonstrated the importance of genetic profiling and the benefit of a multi-modality treatment strategy in cancer management.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A refractory case of CDK4-amplified spinal astrocytoma achieving complete response upon treatment with a Palbociclib-based regimen:a case report

Lin

et al. 2020

BMC Cancer

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“…A glioma is a tumour produced by glial cells and is the most common primary malignant tumour in the central nervous system, accounting for ~30% of the tumours in this region (1,2). Astrocytoma is one of the most aggressive gliomas, with a poor prognosis (3,4).…”

Section: Introductionmentioning

confidence: 99%

Advantages of gross total resection in patients with astrocytoma: A population‑based study

Mao

2020

Oncol Lett

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The present study aimed to investigate the association between surgical methods and survival outcomes in patients with astrocytoma. Patients diagnosed with astrocytoma between January 2004 and December 2015 were identified using the Surveillance, Epidemiology and End Results database. Kaplan-Meier curves and Cox regression were used to analyze the effects of surgical methods on overall survival (OS) and cancer-specific survival (CSS). Among 42,224 eligible patients with astrocytoma, 11,427 (27.1%) patients did not receive surgery, 7,661 (18.1%) received excisional biopsy (EB), 5,520 (13.1%) received a subtotal resection (STR), 6,037 (14.3%) received a gross resection (GR), 5,314 (12.6%) received a partial resection (PR) and 6,265 (14.8%) received a gross total resection (GTR). Patients who underwent GR had the longest survival time (17.00 months). However, over time, the proportion of patients who underwent STR or GR increased, whereas the proportion of patients who did not undergo surgery, PR or GTR decreased. Furthermore, surgical method was an independent prognostic factor for OS and CSS for the patients with astrocytoma. Multivariate Cox regression showed that GTR was associated with the more favorable OS [hazard ratio (HR), 0.80; 95% confidence interval (CI), 0.77-0.83; P<0.001] and CSS (HR, 0.80; 95% CI, 0.77-0.83; P<0.001) times compared with EB. Moreover, similar results were observed in subgroup analyses based on summary stage and grade. In the present study, it was demonstrated that GTR was one of the effective surgical methods for improved OS and CSS time in patients with astrocytoma. However, among the American astrocytoma population, the proportion of patients who underwent GTR decreased. It is necessary to further advocate for the efficacy of GTR.

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Pilomyxoid astrocytoma of the thoracic spinal cord: Extremely rare case report of over 70‐year‐old patient

Abousabie¹,

Kostic²,

Janićijević³

et al. 2021

Clinical Case Reports

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Spinal cord astrocytomas: progresses in experimental and clinical investigations for developing recovery neurobiology-based novel therapies

Cited by 17 publications

References 162 publications

A refractory case of CDK4-amplified spinal astrocytoma achieving complete response upon treatment with a Palbociclib-based regimen:a case report

A refractory case of CDK4-amplified spinal astrocytoma achieving complete response upon treatment with a Palbociclib-based regimen:a case report

Advantages of gross total resection in patients with astrocytoma: A population‑based study

Pilomyxoid astrocytoma of the thoracic spinal cord: Extremely rare case report of over 70‐year‐old patient

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