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Biomedicines
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Comprehensive Overview of Treatments for the Most Common Adult Central...
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Comprehensive Overview of Treatments for the Most Common Adult Central Nervous System Neoplasms

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 42524

Special Issue Editor

Dr. David Cory Adamson

E-Mail Website
Guest Editor
1. Associate Professor of Neurosurgery, Emory University, Atlanta, GA, USA
2. Chief of Neurosurgery, Atlanta VA Medical Center, Decatur, GA, USA
Interests: malignant glioma; glioblastoma; glioma migration; glioma genomics; glioma molecular biology; glioma surgery

Special Issue Information

Dear Colleagues，

This Special Issue will provide the reader with a comprehensive review of all the major intracranial central nervous system neoplasms seen in adults. It will begin with an epidemiological overview of the breadth of neoplasms encountered in the brain, followed by a discussion of distinguishing radiographic features that play a large role in diagnosis. Individual chapters will be devoted to the most common neoplasms where clinical presentations, treatments, outcomes, and current areas of research will be thoroughly presented.

  1. Epidemiology of intracranial central nervous system neoplasms.
  2. Key radiographic features used in the diagnosis of CNS neoplasms.
  3. Meningioma clinical presentation, treatments, outcomes, and current areas of research.
  4. Pituitary adenoma clinical presentation, treatments, outcomes, and current areas of research.
  5. Lower grade glioma clinical presentation, treatments, outcomes, and current areas of research.
  6. Higher grade glioma clinical presentation, treatments, outcomes, and current areas of research.
  7. Vestibular schwannoma clinical presentation, treatments, outcomes, and current areas of research.
  8. Secondary metastatic CNS neoplasm clinical presentation, treatments, outcomes, and current areas of research.

Dr. David Cory Adamson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • central nervous system neoplasm
  • meningioma
  • pituitary adenoma
  • low grade glioma
  • high grade glioma
  • glioblastoma
  • vestibular schwannoma
  • metastatic central nervous system neoplasms

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Published Papers (5 papers)

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Review

15 pages, 1652 KiB  
Review
Typical Pediatric Brain Tumors Occurring in Adults—Differences in Management and Outcome
by Ladina Greuter, Raphael Guzman and Jehuda Soleman
Biomedicines 2021, 9(4), 356; https://doi.org/10.3390/biomedicines9040356 - 30 Mar 2021
Cited by 15 | Viewed by 3810
Abstract
Adult brain tumors mostly distinguish themselves from their pediatric counterparts. However, some typical pediatric brain tumors also occur in adults. The aim of this review is to describe the differences between classification, treatment, and outcome of medulloblastoma, pilocytic astrocytoma, and craniopharyngioma in adults [...] Read more.
Adult brain tumors mostly distinguish themselves from their pediatric counterparts. However, some typical pediatric brain tumors also occur in adults. The aim of this review is to describe the differences between classification, treatment, and outcome of medulloblastoma, pilocytic astrocytoma, and craniopharyngioma in adults and children. Medulloblastoma is a WHO IV posterior fossa tumor, divided into four different molecular subgroups, namely sonic hedgehog (SHH), wingless (WNT), Group 3, and Group 4. They show a different age-specific distribution, creating specific outcome patterns, with a 5-year overall survival of 25–83% in adults and 50–90% in children. Pilocytic astrocytoma, a WHO I tumor, mostly found in the supratentorial brain in adults, occurs in the cerebellum in children. Complete resection improves prognosis, and 5-year overall survival is around 85% in adults and >90% in children. Craniopharyngioma typically occurs in the sellar compartment leading to endocrine or visual field deficits by invasion of the surrounding structures. Treatment aims for a gross total resection in adults, while in children, preservation of the hypothalamus is of paramount importance to ensure endocrine development during puberty. Five-year overall survival is approximately 90%. Most treatment regimens for these tumors stem from pediatric trials and are translated to adults. Treatment is warranted in an interdisciplinary setting specialized in pediatric and adult brain tumors. Full article
(This article belongs to the Special Issue Comprehensive Overview of Treatments for the Most Common Adult Central Nervous System Neoplasms)
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13 pages, 1896 KiB  
Review
Current FDA-Approved Therapies for High-Grade Malignant Gliomas
by Jacob P. Fisher and David C. Adamson
Biomedicines 2021, 9(3), 324; https://doi.org/10.3390/biomedicines9030324 - 22 Mar 2021
Cited by 166 | Viewed by 10839
Abstract
The standard of care (SOC) for high-grade gliomas (HGG) is maximally safe surgical resection, followed by concurrent radiation therapy (RT) and temozolomide (TMZ) for 6 weeks, then adjuvant TMZ for 6 months. Before this SOC was established, glioblastoma (GBM) patients typically lived for [...] Read more.
The standard of care (SOC) for high-grade gliomas (HGG) is maximally safe surgical resection, followed by concurrent radiation therapy (RT) and temozolomide (TMZ) for 6 weeks, then adjuvant TMZ for 6 months. Before this SOC was established, glioblastoma (GBM) patients typically lived for less than one year after diagnosis, and no adjuvant chemotherapy had demonstrated significant survival benefits compared with radiation alone. In 2005, the Stupp et al. randomized controlled trial (RCT) on newly diagnosed GBM patients concluded that RT plus TMZ compared to RT alone significantly improved overall survival (OS) (14.6 vs. 12.1 months) and progression-free survival (PFS) at 6 months (PFS6) (53.9% vs. 36.4%). Outside of TMZ, there are four drugs and one device FDA-approved for the treatment of HGGs: lomustine, intravenous carmustine, carmustine wafer implants, bevacizumab (BVZ), and tumor treatment fields (TTFields). These treatments are now mainly used to treat recurrent HGGs and symptoms. TTFields is the only treatment that has been shown to improve OS (20.5 vs. 15.6 months) and PFS6 (56% vs. 37%) in comparison to the current SOC. TTFields is the newest addition to this list of FDA-approved treatments, but has not been universally accepted yet as part of SOC. Full article
(This article belongs to the Special Issue Comprehensive Overview of Treatments for the Most Common Adult Central Nervous System Neoplasms)
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23 pages, 3747 KiB  
Review
Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions
by Christian Ogasawara, Brandon D. Philbrick and D. Cory Adamson
Biomedicines 2021, 9(3), 319; https://doi.org/10.3390/biomedicines9030319 - 21 Mar 2021
Cited by 112 | Viewed by 19125
Abstract
Meningiomas are the most common intracranial tumor, making up more than a third of all primary central nervous system (CNS) tumors. They are mostly benign tumors that can be observed or preferentially treated with gross total resection that provides good outcomes. Meningiomas with [...] Read more.
Meningiomas are the most common intracranial tumor, making up more than a third of all primary central nervous system (CNS) tumors. They are mostly benign tumors that can be observed or preferentially treated with gross total resection that provides good outcomes. Meningiomas with complicated histology or in compromising locations has proved to be a challenge in treating and predicting prognostic outcomes. Advances in genomics and molecular characteristics of meningiomas have uncovered potential use for more accurate grading and prediction of prognosis and recurrence. With the study and detection of genomic aberrancies, specific biologic targets are now being trialed for possible management of meningiomas that are not responsive to standard surgery and radiotherapy treatment. This review summarizes current epidemiology, etiology, molecular characteristics, diagnosis, treatments, and current treatment trials. Full article
(This article belongs to the Special Issue Comprehensive Overview of Treatments for the Most Common Adult Central Nervous System Neoplasms)
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22 pages, 2110 KiB  
Review
Clinically Explored Virus-Based Therapies for the Treatment of Recurrent High-Grade Glioma in Adults
by Amanda V. Immidisetti, Chibueze D. Nwagwu, David C. Adamson, Nitesh V. Patel and Anne-Marie Carbonell
Biomedicines 2021, 9(2), 138; https://doi.org/10.3390/biomedicines9020138 - 1 Feb 2021
Cited by 11 | Viewed by 3659
Abstract
As new treatment modalities are being explored in neuro-oncology, viruses are emerging as a promising class of therapeutics. Virotherapy consists of the introduction of either wild-type or engineered viruses to the site of disease, where they exert an antitumor effect. These viruses can [...] Read more.
As new treatment modalities are being explored in neuro-oncology, viruses are emerging as a promising class of therapeutics. Virotherapy consists of the introduction of either wild-type or engineered viruses to the site of disease, where they exert an antitumor effect. These viruses can either be non-lytic, in which case they are used to deliver gene therapy, or lytic, which induces tumor cell lysis and subsequent host immunologic response. Replication-competent viruses can then go on to further infect and lyse neighboring glioma cells. This treatment paradigm is being explored extensively in both preclinical and clinical studies for a variety of indications. Virus-based therapies are advantageous due to the natural susceptibility of glioma cells to viral infection, which improves therapeutic selectivity. Furthermore, lytic viruses expose glioma antigens to the host immune system and subsequently stimulate an immune response that specifically targets tumor cells. This review surveys the current landscape of oncolytic virotherapy clinical trials in high-grade glioma, summarizes preclinical experiences, identifies challenges associated with this modality across multiple trials, and highlights the potential to integrate this therapeutic strategy into promising combinatory approaches. Full article
(This article belongs to the Special Issue Comprehensive Overview of Treatments for the Most Common Adult Central Nervous System Neoplasms)
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27 pages, 1249 KiB  
Review
Proton and Heavy Particle Intracranial Radiosurgery
by Eric J. Lehrer, Arpan V. Prabhu, Kunal K. Sindhu, Stanislav Lazarev, Henry Ruiz-Garcia, Jennifer L. Peterson, Chris Beltran, Keith Furutani, David Schlesinger, Jason P. Sheehan and Daniel M. Trifiletti
Biomedicines 2021, 9(1), 31; https://doi.org/10.3390/biomedicines9010031 - 3 Jan 2021
Cited by 22 | Viewed by 4272
Abstract
Stereotactic radiosurgery (SRS) involves the delivery of a highly conformal ablative dose of radiation to both benign and malignant targets. This has traditionally been accomplished in a single fraction; however, fractionated approaches involving five or fewer treatments have been delivered for larger lesions, [...] Read more.
Stereotactic radiosurgery (SRS) involves the delivery of a highly conformal ablative dose of radiation to both benign and malignant targets. This has traditionally been accomplished in a single fraction; however, fractionated approaches involving five or fewer treatments have been delivered for larger lesions, as well as lesions in close proximity to radiosensitive structures. The clinical utilization of SRS has overwhelmingly involved photon-based sources via dedicated radiosurgery platforms (e.g., Gamma Knife® and Cyberknife®) or specialized linear accelerators. While photon-based methods have been shown to be highly effective, advancements are sought for improved dose precision, treatment duration, and radiobiologic effect, among others, particularly in the setting of repeat irradiation. Particle-based techniques (e.g., protons and carbon ions) may improve many of these shortcomings. Specifically, the presence of a Bragg Peak with particle therapy at target depth allows for marked minimization of distal dose delivery, thus mitigating the risk of toxicity to organs at risk. Carbon ions also exhibit a higher linear energy transfer than photons and protons, allowing for greater relative biological effectiveness. While the data are limited, utilization of proton radiosurgery in the setting of brain metastases has been shown to demonstrate 1-year local control rates >90%, which are comparable to that of photon-based radiosurgery. Prospective studies are needed to further validate the safety and efficacy of this treatment modality. We aim to provide a comprehensive overview of clinical evidence in the use of particle therapy-based radiosurgery. Full article
(This article belongs to the Special Issue Comprehensive Overview of Treatments for the Most Common Adult Central Nervous System Neoplasms)
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