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Abstract
Patients with breast or prostate cancer routinely referred for bone scintigraphy were evaluated for the presence of skeletal pain, as determined by a self administered questionnaire. Pain was a common finding, whether or not metastatic disease was present, and occurred in over half of patients. Although most patients with bone metastases did report bone pain, a significant fraction (21% of breast and 22% of prostate patients) were asymptomatic. A distinct minority of individual anatomic regions of metastasis were painful: pain was reported in 23 % of sites of breast metastases and 15% of metastatic prostate cancer sites. Of all sites at which pain was present, metastases were demonstrated in only about one half. These results indicate that pain is not a reliable indicator of the presence of location of metastatic bone disease.
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Hochberg F, Gardiner C, Gho YS, Gupta D, Hill A, Lötvall J, Quesenberry P, Rajendran L, Rak J, Tahara H, Taylor D, Théry C, Wauben M. Obituary. J Extracell Vesicles 2014; 3:23842. [PMID: 26077417 PMCID: PMC3914122 DOI: 10.3402/jev.v3.23842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Aghi M, Vogelbaum MA, Jolly DJ, Robbins JM, Ostertag D, Ibanez CE, Gruber HE, Kasahara N, Bankiewicz K, Cloughesy TF, Chang SM, Butowski N, Kesari S, Chen C, Mikkelsen T, Landolfi J, Chiocca EA, Elder JB, Foltz G, Pertschuk D, Anaizi A, Taylor C, Kosty J, Zimmer L, Theodosopoulos P, Anaizi A, Gantwerker E, Pensak M, Theodosopoulos P, Anaizi A, Grewal S, Theodosopoulos P, Zimmer L, Anaizi A, Pensak M, Theodosopoulos P, Arakawa Y, Kang Y, Murata D, Fujimoto KI, Miyamoto S, Blagia M, Paulis M, Orunesu G, Serra S, Akers J, Ramakrishnan V, Kim R, Skog J, Nakano I, Pingle S, Kalinina J, Kesari S, Breakfield X, Hochberg F, Van Meir E, Carter B, Chen C, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran F, Calaminus G, Hamer PDW, Hendriks E, Mandonnet E, Barkhof F, Zwinderman K, Duffau H, Esquenazi Y, Johnson J, Tandon N, Esquenazi Y, Friedman E, Lin Y, Zhu JJ, Tandon N, Fujimaki T, Kobayashi M, Wakiya K, Ohta M, Adachi J, Fukuoka K, Suzuki T, Yanagisawa T, Matsutani M, Mishima K, Sasaki J, Nishikawa R, Hoffermann M, Bruckmann L, Ali KM, Asslaber M, Payer F, von Campe G, Jungk C, Beigel B, Abb V, Herold-Mende C, Unterberg A, Kim JH, Cho YH, Kim CJ, Mardor Y, Nissim O, Grober Y, Guez D, Last D, Daniels D, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Zach L, Marupudi N, Mittal S, Michaud K, Cantin L, Cottin S, Dandurand C, Mohammadi A, Hawasli A, Rodriguez A, Schroeder J, Laxton A, Elson P, Tatter S, Barnett G, Leuthardt E, Moriuchi S, Dehara M, Fukunaga T, Hagiwara Y, Soda H, Imakita M, Nitta M, Maruyama T, Iseki H, Ikuta S, Tamura M, Chernov M, Okamoto S, Okada Y, Muragaki Y, Ohue S, Kohno S, Inoue A, Yamashita D, Kumon Y, Ohnishi T, Oppido P, Villani V, Vidiri A, Pace A, Pompili A, Carapella C, Orringer D, Lau D, Niknafs Y, Piquer J, Llacer JL, Rovira V, Riesgo P, Cremades A, Rotta R, Levine N, Prabhu S, Sawaya R, Weinberg J, Rao G, Tummala S, Tilley C, Rovin R, Kassam A, Schwartz C, Romagna A, Thon N, Tonn JC, Schwarz SB, Kreth FW, Sonoda Y, Shibahara I, Saito R, Kanamori M, Kumabe T, Tominaga T, Steele C, Lawrence J, Rovin R, Winn R, Rachinger W, Simon M, Dutzmann S, Feigl G, Kremenevskaya N, Thon N, Tonn JC, Whelan H, Kelly M, Jogel S, Kaufmann B, Foy A, Lew S, Quirk B, Yong RL, Wu T, Mihatov N, Shen MJ, Brown MA, Zaghloul KA, Park GE, Park JK. SURGICAL THERAPIES. Neuro Oncol 2013; 15:iii217-iii225. [PMCID: PMC3823906 DOI: 10.1093/neuonc/not191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
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Chheda M, Wen P, Hochberg F, Chi A, Drappatz J, Yang D, Eichler A, Beroukhim R, Norden A, Gerstner E, Batchelor T. Phase I Trial of Vandetanib Plus Sirolimus in Adults with Recurrent Glioblastoma (P04.180). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Ly I, Pine A, Stemmer-Rachamimov A, Hochberg F, Dietrich J. Clinical, Histopathologic, and Magnetic Resonance Imaging (MRI) Findings in Gliomatosis Cerebri (P03.139). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p03.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Carter B, Hochberg F, Breakefield X, Balaj L, Sivaraman S, Curry W, Kalkanis SN, Loguidice L, Russo LM, Noerhelm M, Skog J. Use of exosome analysis to reveal glioma-specific genetic changes in patient serum. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.2061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hu J, Wen PY, Abrey LE, Fadul C, Drappatz J, Salem N, Amato A, Carminati P, Supko J, Hochberg F. Phase II trial of oral gimatecan in adults with recurrent glioblastoma. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2009 Background: Gimatecan is a highly lipophilic oral camptothecin analogue with impressive preclinical activity in glioma models. Methods: We conducted a multicenter two-stage phase II trial to evaluate the efficacy of gimatecan in adults with recurrent glioblastoma. Eligibility criteria included ≤1 prior treatment for recurrent disease, age ≥18, ECOG performance status 0 or 1, and normal organ function. Patients taking enzyme-inducing anti-seizure medications were excluded. Gimatecan 1.22 mg/m2 was given orally once daily for 5 consecutive days during each 28-day cycle. Radiographic response was evaluated by MRI after every second cycle. The primary endpoint of the study was 6 months PFS. A Simon's 2-stage design was used in which 19 patients were evaluated in the first stage, with an additional 36 patients accrued if > 4 patients in stage 1 achieved 6 month PFS. Results: A total of 29 patients were enrolled in the study, with median age of 58 years (range, 25–77 years); 58.6% female; all of whom had received prior surgery, radiation therapy, and at least one regimen of chemotherapy. The daily dose was reduced to 1.0 mg/m2 after four of the first 10 patients experienced grade 4 hematologic toxicity. One patient was removed from trial due to toxicity (grade 3 leukopenia and thrombocytopenia). Treatment delay occurred in 11 patients (38%) and dose reduction was necessary in eight patients (28%). Treatment-related grade 3/4 toxicities included thrombocytopenia (17.2%), leukopenia (17.2%), and neutropenia (10.3%). Only 1/19 patients treated with 1.0 mg/m2/day experienced grade 3/4 hematologic toxicity. The 18% reduction in the daily dose resulted in a 19% decrease in the concentration of total gimatecan in plasma prior to administration of the fifth daily dose (56 ± 23 vs. 45 ± 20 ng/mL) and a 33% decrease in the AUC for dose 5 (8.0±4.8 vs. 5.3±4.2 ng*h/mL). Only one patient had a partial radiographic response by the modified Macdonald criteria and stable disease was the best response in 13 patients. All other patients had progressive disease after two cycles of therapy. Only three patients (12%) were progression-free at 6 months. Median time to progression was 12.0 weeks (95% CI: 7.0, 17.0). Conclusions: Treatment with single-agent gimatecan 1.0 mg/m2/day for 5 days, repeated every 28-days showed minimal efficacy. [Table: see text]
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Affiliation(s)
- J. Hu
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - P. Y. Wen
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - L. E. Abrey
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - C. Fadul
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - J. Drappatz
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - N. Salem
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - A. Amato
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - P. Carminati
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - J. Supko
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - F. Hochberg
- Massachusetts General Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Dana-Farber Cancer Institute/Brigham and Women's Cancer Center, Boston, MA; Memorial Sloan-Kettering Cancer Center, New York, NY; Dartmouth-Hitchcock Medical Center, Lebanon, NH; Sigma-Tau Research, Inc., Gaithersburg, MD; Sigma-Tau Industrie Farmaceutiche Reiunite S.p.A., Pomezia, Italy; Dana-Farber Cancer Institute/Harvard Cancer Center, Boston, MA; Massachusetts General Hospital, Boston, MA
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9
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Lee JW, Houtchens M, Hochberg F, Price B, M L, Cunnane M, Pfannl R, MacCollin M. Glioblastoma multiforme presenting as bilateral internal auditory canal tumors. J Neurol 2006; 253:522-4. [PMID: 16541215 DOI: 10.1007/s00415-005-0990-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Revised: 07/11/2005] [Accepted: 07/19/2005] [Indexed: 11/26/2022]
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10
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Shah G, Kesari S, Xu R, Henson J, Batchelor T, Hochberg F, Oneill A, Levy B, Bradshaw J, Wen PY. Comparison of 1D, 2D, 3D and volumetric parameters in measuring tumor response in high-grade gliomas in adults. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Shah
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - S. Kesari
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - R. Xu
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - J. Henson
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - T. Batchelor
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - F. Hochberg
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - A. Oneill
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - B. Levy
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - J. Bradshaw
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
| | - P. Y. Wen
- Brigham and Women's Hospital, Boston, MA; Dana Farber Cancer Institute, Boston, MA; Massachussetts General Hospital, Boston, MA
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11
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Supko JG, Alderson L, Wen P, Cassidy K, Pace S, Obrocea M, Hochberg F. Pharmacokinetics of gimatecan, and orally administered camptothecin analogue, in patients with malignant gliomas. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J. G. Supko
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
| | - L. Alderson
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
| | - P. Wen
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
| | - K. Cassidy
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
| | - S. Pace
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
| | - M. Obrocea
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
| | - F. Hochberg
- Massachusetts General Hospital, Boston, MA; Rhode Island Hospital, Providence, RI; Dana Farber Cancer Institute, Boston, MA; Sigma-Tau Research, Gaithersburg, MD
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12
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Wick W, Hochberg F, O'Sullivan J, Goessling A, Hughes A, Cher L. L-dopa-resistant parkinsonism syndrome following cerebral radiation therapy for neoplasm. Oncol Rep 2000; 7:1367-70. [PMID: 11032946 DOI: 10.3892/or.7.6.1367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A bradykinetic form of parkinsonism, unresponsive to levo-dopa therapy developed in four patients two to eight weeks after completion of external beam irradiation (39.2 Gy to 59.4 Gy) of their intracranial neoplasm. In the absence of other causative factors, we relate the movement disorder to radiation-induced changes within the basal ganglia. At post-mortem examination one patient had putamenal gliosis and thickened vessels with loss of nigral neurons.
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Affiliation(s)
- W Wick
- Department of Neurology, D-72076 Tubingen, Germany.
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13
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Abstract
Among the broad array of genes that have been evaluated for tumor therapy, those encoding prodrug activation enzymes are especially appealing as they directly complement ongoing clinical chemotherapeutic regimes. These enzymes can activate prodrugs that have low inherent toxicity using both bacterial and yeast enzymes, or enhance prodrug activation by mammalian enzymes. The general advantage of the former is the large therapeutic index that can be achieved, and of the latter, the non-immunogenicity (supporting longer periods of prodrug activation) and the fact that the prodrugs will continue to have some efficacy after transgene expression is extinguished. This review article describes 13 different prodrug activation schemes developed over the last 15 years, two of which - activation of ganciclovir by viral thymidine kinase and activation of 5-fluorocytosine to 5-fluorouracil - are currently being evaluated in clinical trials. Essentially all of these prodrug activation enzymes mediate toxicity through disruption of DNA replication, which occurs at differentially high rates in tumor cells compared with most normal cells. In cancer gene therapy, vectors target delivery of therapeutic genes to tumor cells, in contrast to the use of antibodies in antibody-directed prodrug therapy. Vector targeting is usually effected by direct injection into the tumor mass or surrounding tissues, but the efficiency of gene delivery is usually low. Thus it is important that the activated drug is able to act on non-transduced tumor cells. This bystander effect may require cell-to-cell contact or be mediated by facilitated diffusion or extracellular activation to target neighboring tumor cells. Effects at distant sites are believed to be mediated by the immune system, which can be mobilized to recognize tumor antigens by prodrug-activated gene therapy. Prodrug activation schemes can be combined with each other and with other treatments, such as radiation, in a synergistic manner. Use of prodrug wafers for intratumoral drug activation and selective permeabilization of the tumor vasculature to prodrugs and vectors should further increase the value of this new therapeutic modality.
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Affiliation(s)
- M Aghi
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston 02114, USA
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14
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Abstract
Among the broad array of genes that have been evaluated for tumor therapy, those encoding prodrug activation enzymes are especially appealing as they directly complement ongoing clinical chemotherapeutic regimes. These enzymes can activate prodrugs that have low inherent toxicity using both bacterial and yeast enzymes, or enhance prodrug activation by mammalian enzymes. The general advantage of the former is the large therapeutic index that can be achieved, and of the latter, the non-immunogenicity (supporting longer periods of prodrug activation) and the fact that the prodrugs will continue to have some efficacy after transgene expression is extinguished. This review article describes 13 different prodrug activation schemes developed over the last 15 years, two of which - activation of ganciclovir by viral thymidine kinase and activation of 5-fluorocytosine to 5-fluorouracil - are currently being evaluated in clinical trials. Essentially all of these prodrug activation enzymes mediate toxicity through disruption of DNA replication, which occurs at differentially high rates in tumor cells compared with most normal cells. In cancer gene therapy, vectors target delivery of therapeutic genes to tumor cells, in contrast to the use of antibodies in antibody-directed prodrug therapy. Vector targeting is usually effected by direct injection into the tumor mass or surrounding tissues, but the efficiency of gene delivery is usually low. Thus it is important that the activated drug is able to act on non-transduced tumor cells. This bystander effect may require cell-to-cell contact or be mediated by facilitated diffusion or extracellular activation to target neighboring tumor cells. Effects at distant sites are believed to be mediated by the immune system, which can be mobilized to recognize tumor antigens by prodrug-activated gene therapy. Prodrug activation schemes can be combined with each other and with other treatments, such as radiation, in a synergistic manner. Use of prodrug wafers for intratumoral drug activation and selective permeabilization of the tumor vasculature to prodrugs and vectors should further increase the value of this new therapeutic modality.
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Affiliation(s)
- M Aghi
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, Boston 02114, USA
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15
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Abstract
The objective of this study was to estimate how much of an individual's appreciation of humour is influenced by genetic factors, the shared environment or the individual's unique environment. A population-based classical twin study of 127 pairs of female twins (71 monozygous (MZ) and 56 dizygous (DZ) pairs) aged 20-75 from the St Thomas' UK Adult Twin Registry elicited responses to five 'Far Side' Larson cartoons on a scale of 0-10. Within both MZ and DZ twin pairs, the tetrachoric correlations of responses to all five cartoons were significantly greater than zero. Furthermore, the correlations for MZ and DZ twins were of similar magnitude and in some cases the DZ correlation was greater than that of the MZ twins. This pattern of correlations suggests that shared environment rather then genetic effects contributes to cartoon appreciation. Multivariate model-fitting confirmed that these data were best explained by a model that allowed for the contribution of the shared environment and random environmental factors, but not genetic effects. However, there did not appear to be a general humour factor underlying responses to all five cartoons and no effect of age was seen. The shared environment, rather than genetic factors, explains the familial aggregation of humour appreciation as assessed by the specific 'off the wall' cognitive type of cartoons used in this study.
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Affiliation(s)
- L Cherkas
- Twin Research and Genetic Epidemiology Unit, St Thomas' Hospital, London, UK
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16
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Hochberg F. Lack of efficacy of 9-aminocamptothecin in adults with newly diagnosed glioblastoma multiforme and recurrent high-grade astrocytoma. Neuro Oncol 2000. [DOI: 10.1215/15228517-2-1-29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Hochberg F, Grossman SA, Mikkelsen T, Glantz M, Fisher JD, Piantadosi S. Lack of efficacy of 9-aminocamptothecin in adults with newly diagnosed glioblastoma multiforme and recurrent high-grade astrocytoma. NABTT CNS Consortium. Neuro Oncol 2000; 2:29-33. [PMID: 11302251 PMCID: PMC1920695 DOI: 10.1093/neuonc/2.1.29] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
9-Aminocamptothecin (9-AC) was administered as a 72-h i.v. infusion every 2 weeks to a total of 99 adults with high-grade astrocytomas. Fifty-one patients with newly diagnosed glioblastoma multiforme received 9-AC treatment prior to radiation therapy and 48 patients with high-grade astrocytomas were treated at the time of tumor recurrence. Upon entrance into these research protocols, all patients had measurable disease that was evaluated on a monthly basis with volumetric CT or MRI scans. A partial response was defined by > or =50% reduction in the contrast enhancing volume on stable or decreasing doses of glucocorticoids. The study specified that all apparent responders would have central review of their radiologic studies and histopathology. The initial patients treated with 9-AC were also receiving anticonvulsants and were noted to have minimal myelosuppression with this chemotherapy. Thus, 9-AC doses were escalated from the previously reported maximum tolerated dose (MTD) of 850 microg/m2/24 h. We then established new MTDs for patients receiving enzyme-inducing anticonvulsants. We defined these MTDs to be 1,776 microg/m2/24 h for newly diagnosed, previously untreated patients and 1,611 microg/m2/24 h for patients with recurrent disease. Twenty-two patients with newly diagnosed glioblastoma multiforme received 9-AC at doses > or =1,776 microg/m2/24 h. Of these, 18 had evaluable disease on central review, and 0 of 18 (0%) demonstrated a partial or complete response. Twenty-one patients with recurrent high-grade astrocytomas were treated at 1,611 microg/m2/24 h; 20 had evaluable disease and 0 of 20 (0%) had a partial or complete response. Thus, the overall response rate in the 38 evaluable patients treated at the MTD was 0 of 38 (0%). Furthermore, of the 51 evaluable patients who were treated at doses less than the MTD, only one partial response was observed, yielding an overall response rate of 2%. Evidence of drug failure was rapid with tumor progression in one-half of patients after 2 drug cycles. 9-AC lacks evidence of substantial activity in patients with newly diagnosed or recurrent high-grade astrocytomas.
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Affiliation(s)
- F Hochberg
- Massachusetts General Hospital, Boston 02114, USA
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18
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Abstract
The purpose of this study was to corroborate experimental findings that long-circulating, superparamagnetic iron oxide contrast agents accumulate at the margins of human brain tumors, thereby improving their delineation on magnetic resonance (MR) images. This limited clinical study examined a total of four patients with brain tumors (three with primary gliomas and one with metastatic melanoma; n = 8 lesions) who were given a pharmaceutical formulation of a superparamagnetic, ultra-small-particulate iron oxide (USPIO, intravenous dose of 1.1 mg Fe/kg). The agent has a characteristically long plasma half-life and is currently undergoing Phase III clinical trials for liver disease (AMI-227, Advanced Magnetics, Cambridge, MA). MR (conventional spin-echo and gradient-echo) images of the brain were obtained before and 12, 24, and/or 36 hours after administration of the agent, with follow-up several weeks later. Twelve to 36 hours after IV administration of the USPIO, both primary and metastatic brain tumors showed readily detectable increases in signal intensity on T1-weighted spin-echo images. Unlike the pattern of enhancement with a gadolinium (Gd) chelate, which occurred immediately and decreased within hours, that with the USPIO occurred gradually, with a peak at 24 hours, and decreased over several days. Whereas the enhancing tumor margin with the Gd chelate blurred with time due to diffusion of the agent, the margin with the USPIO remained sharp, presumably due to the much lower diffusion coefficient (large size) of the particles and partly because of local endocytosis by tumor cells. Compared with Gd chelates, long-circulating, superparamagnetic iron oxide contrast agents can provide prolonged delineation of the margins of human brain tumors on MR images, which has implications for the targeting of diagnostic biopsies and the planning of surgical resections.
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Affiliation(s)
- W S Enochs
- Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston 02114, USA
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19
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Grossman SA, Hochberg F, Fisher J, Chen TL, Kim L, Gregory R, Grochow LB, Piantadosi S. Increased 9-aminocamptothecin dose requirements in patients on anticonvulsants. NABTT CNS Consortium. The New Approaches to Brain Tumor Therapy. Cancer Chemother Pharmacol 1998; 42:118-26. [PMID: 9654111 DOI: 10.1007/s002800050794] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND High grade astrocytomas remain uniformly fatal despite aggressive surgery and radiotherapy. As existing chemotherapeutic agents are of limited benefit, clinical trials are underway to screen new drugs, such as 9-aminocamptothecin (9-AC), for activity in high grade astrocytomas. PURPOSE This study was designed to estimate the efficacy of 9-AC in patients with newly diagnosed glioblastoma multiforme and recurrent high grade astrocytomas. The planned dose of 9-AC for this trial was 850 microg/m2 per 24 h as a 72-h continuous intravenous infusion every 2 weeks. This was the maximum tolerated dose (MTD) on this schedule in multiple phase I studies in patients with systemic malignancies. However, we found this dose subtherapeutic in our patient population. As a result, the purpose of the study was altered to determine the MTD. METHODS A group of 32 patients were studied using 850 microg/m2 per 24 h with a provision to escalate to 1000 microg/m2 per 24 h if the first three cycles of 9-AC were without significant hematologic toxicity. Once it was determined that myelosuppression did not occur in patients on anticonvulsants, dose escalations were initiated using the continual reassessment method. Dose escalations were conducted independently in newly diagnosed and recurrent patients and in those taking and not taking hepatic enzyme-inducing anticonvulsants. Pharmacologic studies were conducted during the first cycle of 9-AC. Toxicity was determined using the NCI common toxicity criteria and efficacy was assessed using serial volumetric brain scans. RESULTS 9-AC was administered to 59 patients, 31 with newly diagnosed glioblastoma multiforme and 28 with recurrent high grade astrocytomas. No grade III-IV myelosuppression was noted in the 29 patients (128 cycles) on phenytoin, carbamazepine, phenobarbital, and/ or valproic acid who received 850 microg/m2 per 24 h. In contrast, two of three patients (five cycles) who were not taking anticonvulsants developed grade IV myelosuppression. Steady-state total 9-AC plasma levels were lower in patients on anticonvulsants (median 25.3 nM) than in patients who were not taking anticonvulsants (median 76.5 nM). Dose escalations performed in 27 additional patients determined the MTD in patients taking anticonvulsants to be 1776 microg/m2 per 24 h for patients with newly diagnosed tumors and 1611 microg/m2 per 24 h for patients with recurrent disease. CONCLUSIONS We describe a new and unexpected drug interaction between 9-AC and anticonvulsants. This is similar to recent findings with paclitaxel, and suggests that higher than "usual" doses of some chemotherapeutic agents are required in patients on anticonvulsants. Prospectively defined dose escalations and pharmacologic studies are essential for the careful evaluation of new chemotherapeutic agents in patients with brain tumors.
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Affiliation(s)
- S A Grossman
- The Central Operations Office, The NABTT CNS Consortium, The Johns Hopkins Oncology Center, Baltimore, MD 21287, USA.
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20
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Nierenberg DW, Nordgren RE, Chang MB, Siegler RW, Blayney MB, Hochberg F, Toribara TY, Cernichiari E, Clarkson T. Delayed cerebellar disease and death after accidental exposure to dimethylmercury. N Engl J Med 1998; 338:1672-6. [PMID: 9614258 DOI: 10.1056/nejm199806043382305] [Citation(s) in RCA: 99] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- D W Nierenberg
- Department of Medicine, Dartmouth Medical School, Hanover, NH, USA
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21
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Glantz MJ, Cole BF, Recht L, Akerley W, Mills P, Saris S, Hochberg F, Calabresi P, Egorin MJ. High-dose intravenous methotrexate for patients with nonleukemic leptomeningeal cancer: is intrathecal chemotherapy necessary? J Clin Oncol 1998; 16:1561-7. [PMID: 9552066 DOI: 10.1200/jco.1998.16.4.1561] [Citation(s) in RCA: 196] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Standard treatments for neoplastic meningitis are only modestly effective and are associated with significant morbidity. Isolated reports suggest that concurrent systemic and intrathecal (i.t.) therapy may be more effective than i.t. therapy alone. We present our experience, which includes CSF and serum pharmacokinetic data, on the use of high-dose (HD) intravenous (i.v.) methotrexate (MTX) as the sole treatment for neoplastic meningitis. PATIENTS AND METHODS Sixteen patients with solid-tumor neoplastic meningitis received one to four courses (mean, 2.3 courses) of HD (8 g/m2 over 4 hours) i.v. MTX and leucovorin rescue. Serum and CSF MTX concentrations were measured daily. Toxicity, response, and survival were retrospectively compared with a reference group of 15 patients treated with standard i.t. MTX during the same time interval. RESULTS Peak methotrexate concentrations ranged from 3.7 to 55 micromol/L (mean, 17.1 micromol/L) in CSF and 178 to 1,700 micromol/L (mean, 779 micromol/L) in serum. Cytotoxic CSF and serum MTX concentrations were maintained much longer than with i.t. dosing. Toxicity was minimal. Cytologic clearing was seen in 81% of patients compared with 60% of patients treated intrathecally (P = .3). Median survival in the HD i.v. MTX group was 13.8 months versus 2.3 months in the i.t. MTX group (P = .003). CONCLUSION HD i.v. MTX is easily administered and well tolerated. This regimen achieves prolonged cytotoxic serum MTX concentrations and CSF concentrations at least comparable to those achieved with standard i.t. therapy. Cytologic clearing and survival may be superior in patients treated with HD i.v. MTX. Prospective studies and a reconsideration of the use of i.t. chemotherapy for patients with neoplastic meningitis are warranted.
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Affiliation(s)
- M J Glantz
- Department of Medicine, Brown University School of Medicine, Providence, RI, USA.
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22
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Abstract
BACKGROUND: Although magnetic resonance imaging (MRI) is effective in detecting the location of intracranial tumors, new imaging techniques have been studied that may enhance the specificity for the prediction of histologic grade of tumor and for the distinction between recurrence and tumor necrosis associated with cancer therapy. METHODS: The authors review their experience and that of others on the use of perfusion magnetic resonance imaging to evaluate responses of brain tumors to new therapies. RESULTS: Functional imaging techniques that can distinguish tumor from normal brain tissue using physiological parameters. These new approaches provide maps of tumor perfusion to monitor the effects of novel compounds that restrict tumor angiogenesis. CONCLUSIONS: Perfusion MRI not only may be as effective as radionuclide-based techniques in sensitivity and specificity in assessing brain tumor responses to new therapies, but also may offer higher resolution and convenient co-registration with conventional MRI, as well as time- and cost-effectiveness. Further study is needed to determine the role of perfusion MRI in assessing brain tumor responses to new therapies.
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Affiliation(s)
- MH Lev
- Department of Radiology, Massachusetts General Hospital, Boston 02114-9657, USA
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Hochberg F, Prados M, Russell C, Weissman D, Evans R, Cook P, Burton G, Eisenberg PD, Valenzuela R, Verkh L. Treatment of recurrent malignant glioma with BCNU-fluosol and oxygen inhalation. A phase I-II study. J Neurooncol 1997; 32:45-55. [PMID: 9049862 DOI: 10.1023/a:1005727204169] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To evaluate the toxicity and response rate following BCNU with oxygen inhalation and escalating dosages of fluosol administered to patients with radiographic progression of malignant glioma after definitive surgery and radiotherapy. METHOD This single arm, phase I-II multicenter trial, enrolled 99 patients with malignant gliomas recurrent after definitive surgery and radiotherapy. All patients received a fixed dose (200 mg/m2) of BCNU along with 100% oxygen and fluosol, a perfluorochemical. Fluosol doses were escalated between patients (150, 275, 400 and 600 ml/m2). Treatment was repeated every 6 weeks for a maximum of 6 cycles. Patients were assessed for toxicity at the time of infusion and sequentially thereafter. Response was evaluated clinically and radiologically at least every 6 weeks. RESULTS Treatment was well tolerated. Dose reductions were required at least once in 18 patients, treatment delays were necessary at least once in 33 patients. Grade 3-4 leukopenia occurred in 6 patients (12 events), grade 3-4 thrombocytopenia in 10 patients (25 events) and grade 3-4 liver enzymes elevations in 18 patients (31 events). Higher fluosol dosages did not produce increases in toxicity or responses. Response or stabilization was seen in 57% (38% were stabilizations) of the patients who entered the trial with progressive disease. The median time to progression was 45 weeks, and median survival was 66 weeks for patients who had response or stabilization. For patients with glioblastoma response/stabilization was seen in 45% with a mean duration of 24 weeks, for patients with anaplastic astrocytoma response/stabilization was seen in 68% with a mean duration of 50 weeks. CONCLUSION This treatment regimen is well tolerated. Our results suggest fluosol may enhance the effectiveness of BCNU for the treatment of recurrent malignant gliomas. Future studies will be performed using fluosol at the dose of 400 ml/m2.
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Affiliation(s)
- F Hochberg
- Massachusetts General Hospital, Boston, USA
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Hochberg F, Miller G, Valenzuela R, McNelis S, Crump KS, Covington T, Valdivia G, Hochberg B, Trustman JW. Late motor deficits of Chilean manganese miners: a blinded control study. Neurology 1996; 47:788-95. [PMID: 8797481 DOI: 10.1212/wnl.47.3.788] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
High-level chronic manganese (Mn) exposure produces dystonic rigidity and proximal tremor. The late effects of asymptomatic exposure are uncertain. To evaluate hand movements of asymptomatic Chilean miners, we utilized a manual tremormeter (EAP) and a digitizing tablet (MOVEMAP). In Andacollo, Chile, we examined 59 individuals aged > 50 years (mean age, 64.4 years). Twenty-seven exposed miners had heavy Mn dust exposure in Mn mines for more than 5 years (mean duration, 20.25 years), ending at least 5 years previously. Thirty-two control miners had never worked in Mn mines or had short-term Mn employment. Tests of resting tremor (EAP Tremormeter, MOVEMAP Steady paradigm), action tremor (MOVEMAP Square paradigm), and repetitive hand movements (EAP Tapping Test and Orthokinesimeter) differentiated performance of exposed miners from that of controls. Chronic asymptomatic Mn exposure results in detectable late-life abnormalities of movement.
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Affiliation(s)
- F Hochberg
- Massachusetts General Hospital, Boston, USA
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Abstract
Some patients ultimately diagnosed with primary CNS lymphoma (PCNSL) have transient symptomatic contrast enhancing lesions. These "sentinel lesions" of PCNSL recede spontaneously or with corticosteroid treatment and present an important diagnostic dilemma because they show variable, but non-diagnostic histopathological features. Four previously healthy, immunocompetent patients aged 49 to 58 years had contrast enhancing intraparenchymal brain lesions. Before biopsy, three of the four were treated with corticosteroids. Initial biopsies showed demyelination with axonal sparing in two, non-specific inflammation in one, and normal brain in one. Infiltrating lymphocytes predominantly expressed T cell markers with rare B cells. All four patients recovered within two to four weeks after the initial biopsy and imaging studies showed resolution of the lesions. The CSF was normal in three of the four patients tested; oligoclonal bands were absent in both of the two tested. After seven to 11 months, each patient developed new symptomatic lesions in a different region of the brain, biopsy of which showed a B cell PCNSL. The mechanism of spontaneous involution of sentinel lesions is not understood, but may represent host immunity against the tumour. Sentinel lesions of PCNSL should be considered in patients with contrast enhancing focal parenchymal lesions that show non-specific or demyelinative histopathological changes. Close clinical and radiographic follow up is essential if PCNSL is to be diagnosed early in such patients.
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Affiliation(s)
- L Alderson
- Department of Neurology, Columbia Presbyterian Medical Center, New York, NY 10032, USA
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Fitzek M, Aronen H, Efird J, Hochberg F, Fischman A, Pardo F. 266 PET-FDG uptake as a prognostic indicator in gliomas. Eur J Cancer 1995. [DOI: 10.1016/0959-8049(95)95524-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Riccio A, Maini CL, Collombier L, Taillandier L, Dcbouverie M, Laurens MH, Thouvenot P, Weber M, Bertrand A, Cruickshank GS, Patterson J, Hadley D, De Witte O, Hildebrand J, Luxen A, Goldman S, Reifenberger J, Liu L, James CD, Wechsler W, Collins VP, Fabel-Schulte K, Jachimczak P, Heßdörfer B, Baur I, Schlingensiepen KH, Ernestus RI, Brysch W, Bogdahn U, Blesch A, Bosserhoff AK, Apfel R, Lottspeich F, Jachimczak P, Büttner R, Bogdahn U, Cece R, Bockhorst K, Barajon I, Tazzari S, Cavaletti G, Torri-Tarelli L, Tredici G, Hecht B, Turc-Carel C, Atllas R, Chatel M, Gaudray P, Eis M, Gioanni J, Hecht F, Balledux J, Rothbart D, Criscuolo GR, de Campos JM, Kusak ME, Rey JA, Bello MJ, Sarasa JL, Els T, Dubois F, Blond S, Parent M, Assaker R, Gosselin P, Christiaens JL, Feld R, Moringlane JR, Steudel WI, Schaudies JR, Hoehn-Berlage M, Janka M, Tonn JC, Fischer U, Meese E, Roosen K, Remmelink M, Salmon I, Cras P, Pasteels JL, Brotchi J, Gliese M, Kiss R, Bensadoun RJ, Frenay M, Formento JL, Milano G, Lagrange JL, Grellier P, Lee JY, Ernestus RI, Riese HH, Fründ R, Cervós-Navarro J, Reutter W, Lippitz B, Scheitinger C, Scholz M, Weis J, Gilsbach JM, Füzesi L, Koochekpour S, Merzak A, Geissler A, Pilkington GJ, Sanson M, Li YJ, Hoang-Xuan K, Delattre JY, Poisson M, Hamelin R, Van de Kelft E, Dams E, Martin JJ, Woertgen C, Willems P, Lehrke R, Voges J, Treuer H, Erdmann J, Müller RP, Sturm V, Wurm RE, Warrington AP, Laing RW, Holzschuh M, Sardell S, Hines F, Graham JD, Brada M, Ushio Y, Kuratsu JI, Kochi M, Kitz K, Aichholzer M, Rössler K, Goldman S, Alesch F, Ertl A, Sorensen PS, Helweg-Larsen S, Mourldsen H, Hansen HH, El Sharoum SY, Berfelo MW, Theunissen PHMH, Jager JJ, Levivier M, de Jong JMA, Fedorcsák I, Nyáry I, Osztie É, Horvath Á, Kontra G, Frenay M, Burgoni-chuzel J, Paquis P, Lagrange JL, Pirotte B, Helweg-Larsen S, Hansen SW, Sørensen PS, Salmon I, Kiss R, Krauseneck P, Müller B, Morche M, Tonn JC, Lagerwaard FJ, Brucher JM, Levendag PC, Eijkenboom WMH, Schmilz PIM, Lentzsch S, Weber F, Franke J, Dörken B, Lunardi P, Schettini G, Osman FJ, Luxen A, Qasho R, Mocellini C, Ruda R, Soffietti R, Garabello D, Sales S, De Lucchi R, Vasario E, Schiffer D, Muracciole X, Brotchi J, Régis J, Manera L, Peragut JC, Juin P, Sedan R, Nieder C, Niewald M, Walter K, Schnabel K, Nieder C, Hildebrand J, Niewald N, Nestle U, Schnabel K, Berberich W, Oschmann P, Theißen RD, Reuner KH, Kaps M, Dorndorf W, Martin KK, Hausmann O, Akinwunmi J, Rooprai HK, Kennedy A, Linke A, Ognjenovic N, Pilkington GJ, Svadovsky AI, Peresedov VV, Bulakov AA, Butyalko MY, Merlo A, Zhirnova IG, Labunsky DA, Gnazdizky VV, Gannushkina IV, Taphoorn MJB, Potman R, Barkhof F, Weerts JG, Karim ABMF, Heimans JJ, Jerrnann E, van de Pol M, van Aalst VC, Wilmink JT, Twijnstra A, van der Sande JJ, Boogerd W, Kröger R, Jäger A, Wismeth C, Dekant A, Uirich J, Brysch W, Schlingensiepen KH, Jachimczak P, Bogdahn U, Pirolte B, Cool V, Gérard C, Levivier M, Dargent JL, Goldman S, Chiquet-Ehrismann R, Brotchi J, Hildebrand J, Velu T, Herrlinger U, Schabet M, Ohneseit P, Buchholz R, Zhu J, Reszka R, Weber F, Müller J, Walther W, Zhang LI, Brock M, Roosen N, Rock JP, Zeng H, Feng J, Fenstermacher JD, Rosenblum ML, Siegal T, Mäcke H, Gabizon A, Beljanski M, Crochet S, Bergenheim AT, Zackrisson B, Elfverson J, Bergström P, Henriksson R, Butti G, Baetta R, Gratzl O, Magrassi L, De Renzis MR, Soma MR, Davegna C, Pezzotta S, Paoletti R, Fumagalli R, Infuso L, Sankar AA, Darling JL, Herholz K, Thomas DGT, Defer GL, Brugières P, Gray F, Chomienne C, Poirier J, Degos L, Degos JD, Colombo BM, DiDonato S, Ghaemi M, Finocchiaro G, Hebeda KM, Sterenborg HJCM, Saarnak AE, Wolbers JG, van Gemert MJC, Kaaijk P, Troost D, Leenstra S, Das PK, Würker M, Bosch DA, Kostron H, Hochleitner BW, Obwegeser A, Ortler M, Seiwald M, Vooys W, Krouwer HGJ, de Gast GC, Marx JJM, Pietrzyk U, Osman FJ, Lunardi P, Puzzilli F, Menovsky T, Beek JF, Wolbers JG, van Gemert MJC, Naujocks G, Wiestler OD, Schirrmacher V, Heiss WD, Schramm J, Schmitz A, Eis-Hübinger AM, Piepmeier PH, Pedersen P, Greer C, Quigley MR, Shih T, Elrifal A, Rothfus W, Kotitschke K, Maroon JC, Rohertson L, Rampling R, Whoteley TL, Piumb JA, Kerr DJ, Falina PA, Crossan IM, Roosen N, Rock JP, Brandl M, Feng J, Zeng H, Ho KL, Fenstermacher JD, Rosenblum ML, Ruchoux MM, Vincent S, Jonca F, Plouet J, Lecomte M, Tonn JC, Samid D, Thibault A, Ram Z, Oldfield EH, Myers CE, Reed E, Schabet M, Herrlinger U, Buchholz R, Shoshan Y, Haase A, Siegal T, Siegal T, Shezen E, Siegal T, Stockhammer G, Rosenblum M, Samid D, Lieberman F, Terzis AJA, Bjerkvig R, Bogdahn U, Laerum OD, Arnold H, Thibault A, Samid D, Figg WD, Myers CE, Reed E, Thomas R, Flux G, Chittenden S, Kotitschke K, Doshi P, Brazil L, Thomas DGT, Bignor D, Zalutsky M, Brada M, Tjuvajev J, Kaplitt M, Desai R, Bradley MS, Muigg S, Bettie BS, Gansbacher B, Blasberg R, Haugland HK, Saraste J, Rooseni K, Laerum OD, Vincent AJPE, Avezaat CJJ, Bout A, Felber S, Noteboom JL, Vecht CH, Valerio D, Hoogerbrugge PM, Weber F, Reszka R, Zhu J, Walther W, List J, Schulz W, Aichner F, Wolbers JG, Sterenborg IIJCM, Kamphorst W, van Gemert MJC, van Alplien HAM, Salander P, Bergenheim T, Henriksson R, Grant R, Brazil L, Haase A, Thomas R, Guerrero D, Laing R, Ashley S, Brada M, Schmidt B, Bauer B, Grau G, Bohnstedt T, Frydrych A, Bogdahn U, Franz K, Lorenz R, Brandes A, Amanzo PD, Zampieri P, Rigon A, Scelzi E, Rotilio A, Berti F, Paccagnella A, Krone A, Fiorentino MV, Müller B, Krauseneck P, van Deventer PL, Dellemijn PLI, van den Bent MJ, Vecht CJ, Kansen PJ, Tredici G, Petruccioli NG, Becker G, Cavaletti G, Cavalletti E, Kiburg B, Müller LJ, Moorer-van Delft CM, Heimans JJ, Boer HH, Pace A, Bove L, Pietrangeli A, Woydt M, Innocenti P, Aloe A, Nardi M, Jandolo B, Kellie SJ, De Graaf SSN, Bloemhof H, Roebuck D, Dalla PL, Uges DDR, Roggendorf W, Johnston I, Besser M, Chaseling RA, Koeppen S, Gründemann S, Lossos A, Siegal T, Nitschke M, Vieregge P, Reusche E, Hofmann E, Rob P, Kömpf D, Postma TJ, Vermorken JB, Heimans JJ, Rampling RP, Dunlop DJ, Steward MS, Campbell SM, Roy S, Bogdahn U, Hilkens PHE, Verweij J, van Putten WLJ, Vecht CJ, van den Bent MJ, Hilkens PHE, Moll JWB, van der Burg MEL, Planting AST, van Putten WLJ, Roosen K, Vecht CJ, van den Bent MJ, Wondrusch E, Zifko U, Drlicek M, Liszka U, Grisold W, Zifko U, Fazeny B, Dittrich C, Lanfermann H, Wondrusch E, Grisold W, Verschuuren JJ, Meneses PI, Rosenfeld MR, Kaplitt MG, Posner JB, Dalmau J, Sillevis Smitt PAE, Manley G, Heindel W, Posner JB, Cavaletti G, Bogliun G, Margorati L, Bianchi G, Drlicek M, Liska U, Casati B, Kolig C, Grisold H, Kugel H, Graus F, Reñe R, Uchuya M, Valldeoriola F, Delattre JY, Benedetti de Cosentiro C, Ortale D, Martinez R, Lambre J, Cagnolati S, Erneslus RI, Vinai C, Salmaggi A, Nemni R, Silvani A, Forno MG, Luksch R, Confalonieri P, Boiardi A, Nitschke M, Scholz J, Röhn G, Vieregge P, Kömpf D, Hochberg FH, Pfeiffer G, Netzer J, Hansen C, Eggers C, Hagel C, Kunze K, Verschuuren JJ, Lackner K, Rosenblum MK, Lieberman FS, Posner JB, Dalmau J, Metz RJ, Kennedy DN, Pardo FS, Kutke S, Sorensen AG, Hochberg FH, Fishman AJ, Filipek PA, Rosen BR, Caviness VS, Mechtler LL, Withiam-Lench S, Shin K, Klnkel WR, Patel M, Truax B, Kinkel P, Shin K, Mechtler L, Ricci M, Pantano P, Maleci A, Pierallini S, Di Stefano D, Bozzao L, Cantore GP, Röhn G, Els T, Schröder R, Hoehn-Berlage M, Ernestus RI, Ruda R, Mocellini C, Soffietti R, Campana M, Ropolo R, Riva A, de Filippi PG, Schiffer D, Salgado D, Rodrigues M, Salgado L, Fonseca AT, Vieira MR, Bravo Marques JM, Satoh H, Uozumi T, Kiya K, Kurisu K, Arita K, Sumida M, Ikawa F, Tzuk-Shina T, Gomori JM, Rubinstein R, Lossos A, Siegal T, Vaalburg W, Paans AMJ, Willemsen ATM, van Waarde A, Pruim J, Visser GM, Go KG, Valentini S, Ting YLT, De Rose R, Chidichimo G, Corricro G, van Lcycn-Pilgram K, Erncslus RI, Klug N, van Leyen-Pilgram K, Ernestus RI, Schröder R, Klug N, Woydt M, Krone A, Tonn JC, Becker G, Neumann U, 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F, Cull A, Sellar R, Brada M, Thomas C, Elyan S, Hines F, Ashley S, Stenning S, Bernstein JJ, Goldberg WJ, Roelcke U, Von Ammon K, Hausmann O, Radu EW, Kaech D, Leenders KL, Fitzek MM, Aronen JE, Hochberg F, Gruber M, Schmidt E, Rosen B, Flschman A, Pardo P, Afra UMU, Sipos L, Slouik F, Boiardi A, Salmaggi A, Pozzi A, Farinotti L, Fariselli L, Silvani A, Brandes A, Scelzi E, Rigon A, Zampieri P, Pignataro M, Amanzo PD, Amista P, Rotilio A, Fiorentino MV, Thomas R, Brazil L, O'Connor AM, Ashley S, Brada M, Salvati M, Cervoni L, Puzzilli F, Cervoni L, Salvati M, Raguso M, Cruickshank GS, Duckworth R, Rumpling R, Rottuci M, Fariselli L, Boiardi A, Broggi G, Plrint NG, Sabattini E, Manetto V, Gambacorta H, Poggi S, Pileri S, Ferracini R, Grant R, Plev DV, Hopf NJ, Knosp E, Bohl J, Perncczky A, Kiss R, Salmon I, Catnby I, Dewitte O, Brotchi J, Pasteels JL, Camby I, Salmon I, Darro F, Danguy A, Brotchi J, Pasteels JL, Kiss R, Kiu MC, Lai GM, Yang TS, Ng KT, Chen JS, Chang CN, Leung WM, Ho YS, Rychter MD, Klimek A, Liberski PP, Karpinaka A, Krauseneck P, Schöffel V, Müller B, Kreth FW, Faist M, Warnke PC, Ostertag CB, Nielen KMBV, Visscr MC, Lebrun C, Lonjon M, Desjardin T, Michiels JF, Chanalet SLJL, Roche JL, Chatel M, Mastronardi L, Puzzilli F, Osman FJ, Lunardi P, Matsutani M, Ushio Y, Takakura K, Menten J, Hamers H, Ribot J, Dom R, Tcepen H, Müller B, Weidner N, Krauseneck P, Naujocks G, van Roost D, Wiestler OD, Kuncz A, Nieder C, Setzel-Sesterhein M, Niewald M, Schnabel I, O'Neill KS, Kitchen ND, Wilkins PR, Marsh HT, Pierce E, Doshi R, Deane R, Previtali S, Quattrini A, Nemni R, Ducati A, Wrabetz L, Canal N, Punt CJA, Stamatakis L, Giroux B, Rutten E, Quigley MR, Beth Sargent PAC, Flores N, Simon S, Maroon JC, Quigley MR, Beth Sargent PAC, Flores N, Maroon JC, Rocca AA, Gervasoni C, Castagna A, Picozzi P, Giugni E, Rocca AA, Tonnarelli GP, Ducati A, Mangili F, Truci G, Canal N, Giovanelli M, Roelcke U, Von Ammon K, Radu EW, Leenders KL, Sachsenheimer W, Bimmler T, Seiwald M, Eiter HRW, Ortler M, Obwegesser A, Kostron H, Steilen H, Henn W, Moringlane JR, Kolles H, Feiden W, Zang KD, Sleudel WI, Steinbrecher A, Schabet M, Heb C, Bamberg M, Dichgans J, Stragliotto G, Delattre JY, Poisson M, Zampieri P, Brandes A, Rigon A, Tosatto L, D'Amanzo P, Menicucci N, Rotilio A, Mingrino S, Steudel WI, Feld R, Henn W, Zang KD, Maire JP, Caudry M, Guerin J, Celerier D, Salem N, Demeaux H, Fahregat JF, Kusak ME, Bucno A, Albisua J, Jerez P, Sarasa JL, Garefa R, de Campos JM, Kusak ME, de Campos JM, Bueno A, García-Delgado R, Sarasa JL, García-Sola R, Lantsov AA, Shustova TI, Lcnartz D, Wellenreuther R, von Deirnling A, Köning W, Menzel J, Scarpa S, Manna A, Reale MG, Oppido PA, Carapella CM, Frati L, Valery CA, Ichen M, Foncin JP, Soubrane C, Khayat D, Philippon J, Vaz R, Cruz C, Weis S, Protopapa D, März R, Winkler PA, Reulen HJ, Bise K, Beuls E, Berg J, Deinsberger W, Böker DK, Samii M, Caudry M, Darrouzet V, Guérin J, Trouette R, Causse N, Bébéar JP, Parker F, Vallee JN, Carlier R, Zerah M, Lacroix-Jousselin C, Piepmeier JM, Kveton J, Czibulka A, Tigliev GS, Chernov MP, Maslova LN, Valdueza JM, Jänisch W, Bock A, Harms L, Bessell EM, Graus F, Punt J, Firth J, Hope T, Koriech O, Al Deeb S, Al Moutaery K, Yaqub B, Silvani A, Salmaggi A, Pozzi A, Franzini A, Boiardi A, Goldbrunner R, Warmuth-Metz M, Paulus W, Tonn JC, Roosen K, Strik II, Müller B, Markert C, Pflughaupt KW, Krauseneck P, O'Neill BP, Dinapoli RP, Voges J, Sturm V, Deuß U, Traud C, Treuer H, Lehrke R, Kim DG, Müller RP, Alexandrov YS, Moutaery K, Aabed M, Koreich O, Ross GM, Rajan B, Traish D, Ashley S, Ford D, Brada M, Schmeets ILO, Jager JJ, Pannebakker MAG, de Jong JMA, van Lindert E, Knosp E, Kitz K, Blond S, Dubois F, Assaker R, Baranzelli MC, Sleiman M, Pruvo JP, Coche-Dequeant B, Matsutani M, Takakura K, Sano K, PetriČ-Grabnar G, Jereb B, Župančič N, Koršič M, Rainov NG, Burkert W, Ushio Y, Kochi M, Itoyama Y, de Campos JM, Kusak ME, Sarasa JL, García R, Bueno A, Ferrando L, Hoang-Xuan K, Sanson M, Merel P, Delattre JY, Poisson M, Delattre O, Thomas G, Hoang-Xuan K, Delattre JY, Poisson M, Thomas G, Haritz D, Obersen B, Grochulla F, Gabel D, Haselsberger K, Radner H, Pendl G, Brada M, Laing RW, Warrington AP, Nowak PJCM, Kolkman-Deurloo IKK, Visser AG, Berge HD, Niël CGJH, Levendag PC, Bergström P, Hariz M, Löfroth PO, Bergenheim T, Henriksson R, Blond S, Assaker R, Cortet-rudelli C, Dewailly D, Coche-dequeant B, Castelain B, Dinapoli R, Shaw E, Coffey R, Earle J, Foote R, Schomberg P, Gorman D, Girard N, Courel MN, Delpech B, Haselsberger K, Friehs GM, Schröttner O, Pendl G, Pötter R, hawliczek R, Sperveslage P, Prott FJ, Wachter S, Dieckmann K, Würker M, Herholz K, Pietrzyk U, Voges J, Treuer H, Sturm V, Bauer B, Heiss WD, Jund R, Zimmermann F, Feldmann HJ, Gross MW, Kneschaurek P, Molls M, Lederman G, Lowry J, Wertheim S, Voulsinas L, Fine M, Lederman G, Lowry J, Wertheim S, Fine M, Voutsinas I, Qian G, Rashid H, Lederman G, Lowry J, Wertheim S, Fine M, Voulsinas L, Qian G, Rashid H, Moutaery K, Aabed M, Koreich O, Scerrati M, Montemaggi P, Iacoangeli M, Pompucci A, Roselli R, Trignani R, Rossi GF, Shin K, Mechtler L, West C, Grand W, Shin K, Sibata C, West C, Mechtler L, Grand W, Thomas R, Guerrero D, James N, Ashley S, Gregor A, Brada M, Voges J, Sturm V, Bramer R, Pahlke H, Lehrke R, Treuer H, Banik N, Kim DG, Hövels M, Bernsen HJJA, Rijken PFJW, Van der Sanden BPJ, Hagemeier NEM, Van der Kogel AJ, Koehler PJ, Verbiest H, Jager J, Vecht CJ, Ross GM, McIlwrath A, Brown R, Mottolesb C, Pierre'Kahn A, Croux M, Roche JL, Marchai J, Delhemes P, Tremoulet M, Stilhart B, Chazai J, Caillaud P, Ravon R, Passacha J, Bouffet E, Dirven CMF, Mooy JJA, Molenaar WM, Lewandowicz GM, Grant N, Harkness W, Hayward R, Thomas DGT, Darling JL, Delepine N, Subovici II, Cornille B, Markowska S, Alkallaf JCD, KühI J, Niethammer D, Spaar HJ, Gnekow A, Havers W, Berthold F, Graf N, Lampert F, Maass E, Mertens R, Schöck V, Aguzzi A, Boukhny A, Smirtukov S, Prityko A, Hoiodov B, Geludkova O, Nikanorov A, Levin P, Rothbart D, Balledux J, Criscuolo GR, D'haen B, Van Calenbergh F, Casaer P, Dom R, Menten J, Goffin J, Plets C, Hertel A, Hernaiz P, Seipp C, Siegler K, Baum RP, Maul FD, Schwabe D, Jacobi G, Kornhuber B, Hör G, Menten J, Casaer P, Pilkington GJ, Merzak A, Rooprai HK, Bullock P, van Domburg PHMF, Wesseling P, Thijssen HOM, Wolff JEA, Boos J, Krähling KH, Gressner-Brocks V, Jürgens H, Schlegel J, Scherthan H, Arens N, Stumm G, Kiessling M, Merzak A, Koochekpour S, Pilkington GJ, Reifenberger G. Abstracts. J Neurooncol 1994. [DOI: 10.1007/bf01070874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bashir R, McManus B, Cunningham C, Weisenburger D, Hochberg F. Detection of Eber-1 RNA in primary brain lymphomas in immunocompetent and immunocompromised patients. J Neurooncol 1994; 20:47-53. [PMID: 7807183 DOI: 10.1007/bf01057960] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Tissue from primary central nervous system lymphoma (PCNSL) which developed in five patients with acquired immuno deficiency syndrome (AIDS), nine patients without immunodeficiency, and two Epstein-Barr virus (EBV)-positive control cell lines (B95-8 and Raji) were examined for the presence of EBER-1 RNA. The tissues were hybridized with digoxigenin-labeled sense or anti-sense EBER-1 riboprobes. In all five AIDS-related PCNSLs, strong hybridization signals were found with the EBER-1 anti-sense probe. Signals could be eliminated by preincubation of the tissues with RNase-A. Hybridization with the EBER-1 sense probe showed no signal. All PCNSLs from immunocompetent patients (five paraffin-embedded, four frozen) showed no hybridization signals with EBER-1 sense or antisense probe but good hybridization signals with probes to immunoglobulin kappa or lambda light chain indicating RNA preservation. The paraffin-embedded B95-8-positive control cell-line showed positive hybridization in most cells with the anti-sense EBER-1 probe, and up to one percent of the cells had a weak signal with the sense probe. Most Raji cells showed a uniform signal with the anti-sense EBER-1 probe only. We conclude that, PCNSLs that arise in AIDS patients are associated with latent EBV infections, whereas PCNSLs from immunocompetent patients are not indicating a probable role for EBV in pathogenesis of these tumors.
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Affiliation(s)
- R Bashir
- University of Nebraska Medical Center, Department of Internal Medicine, Omaha
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Abstract
We examined the expression of the Epstein-Barr virus (EBV)-induced proteins (LMP [latent membrane protein], EBNA-2, and CD23) and a lytic protein, viral capsid antigen (VCA), in five acquired immune deficiency syndrome (AIDS)-related primary CNS lymphomas (PCNSLs). We compared that expression with the expression of the same proteins in PCNSL from six immunocompetent patients and severe combined immune deficiency (SCID) mouse brains injected with EBV-infected lymphoblastoid cell lines (LCLs). Brain biopsy tissue from an AIDS patient with progressive multifocal leukoencephalopathy (PML) and a normal brain was also studied. Three of the AIDS PCNSLs expressed both human immunoglobulin kappa and lambda light chains and two expressed lambda light chain only. All non-AIDS-related PCNSLs expressed a single light-chain isotype. All five AIDS-related PCNSLs expressed LMP-1 (> 40%), EBNA-2 (> 60%), and VCA (1 to 5%) of tumor cells. These proteins were similarly expressed in the SCID/human chimeras. None of the PCNSLs from immunocompetent subjects, the normal brain, or the brain of the patient with PML expressed these proteins. PCNSL in AIDS patients bears greater similarity to EBV-infected LCLs than to PCNSL from immunocompetent patients.
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Affiliation(s)
- R Bashir
- Department of Internal Medicine, University of Nebraska, Medical Center, Omaha 68198-2045
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Abstract
We report a longitudinal follow-up study on six patients with chronic manganese-induced parkinsonism following cessation of manganese exposure. Compared with the 1987 study, their parkinsonian symptoms showed a slow progression, particularly in gait disturbances such as freezing during turning and walking backward with retropulsion. The mean disability scores on the King's College Hospital Rating Scale were 15.0 +/- 4.2 in 1987 and 28.3 +/- 6.7 in 1991 (p = 0.003, paired t test). Review of the video records also confirmed a worsening of parkinsonism, especially in difficulty turning. Three of six patients receiving levodopa treatment had an initial improvement. The response decreased after 2 to 3 years. During the therapy, they did not develop on-off fluctuation or dyskinesia. We conclude that patients with manganese-induced parkinsonism may develop increasing neurologic dysfunction long after cessation of exposure and that their responses to levodopa are different from those of patients with Parkinson's disease.
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Affiliation(s)
- C C Huang
- Department of Neurology, Chang Gung Medical College and Memorial Hospital, Taipei, Taiwan
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Brouillet EP, Shinobu L, McGarvey U, Hochberg F, Beal MF. Manganese injection into the rat striatum produces excitotoxic lesions by impairing energy metabolism. Exp Neurol 1993; 120:89-94. [PMID: 8477830 DOI: 10.1006/exnr.1993.1042] [Citation(s) in RCA: 219] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
There is compelling evidence that excessive exposure to manganese (Mn) produces neurotoxicity, especially in the basal ganglia, resulting in a dystonic Parkinsonian disorder. Several experimental or clinical observations suggest that Mn neurotoxicity could involve impairment of energy metabolism. We examined the neurotoxic effects of Mn following local intrastriatal injection. Three hours after the injection of 2 mumol of MnCl2 into rat striatum, ATP levels were reduced to 51% of the control side and lactate level were increased by 97%, indicating an impairment of oxidative metabolism. Neurochemical analysis of the striata 1 week after Mn injection showed changes consistent with a N-methyl-D-aspartate (NMDA) excitotoxic lesion. Dopamine, gamma-aminobutyric acid, and substance P concentrations showed dose-dependent significant decreases, but concentrations of somatostatin-like immunoreactivity and neuropeptide Y-like immunoreactivity were unchanged. The lesions were blocked by prior removal of the cortico-striatal glutamatergic input or by treatment with the noncompetitive NMDA antagonist MK-801. These findings indicate that Mn neurotoxicity involves a NMDA receptor-mediated process similar to that we have previously found with two characterized mitochondrial toxins, aminooxyacetic acid, and 1-methyl-4-phenylpyridinium. Our results show that Mn may produce neuronal degeneration by an indirect excitotoxic process secondary to its ability to impair oxidative energy metabolism.
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Affiliation(s)
- E P Brouillet
- Neurochemistry Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston 02114
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Abstract
We examined a possible role for the adhesion molecules LFA-1 and ICAM-1 in localizing central nervous system non-Hodgkin's lymphomas (CNS-NHLs) to the brain. Fresh frozen sections from 12 monoclonal CNS NHLs (11 primary, one secondary) were stained with monoclonal antibodies to LFA-1 alpha chain (CD11a), beta chain (CD18) and, ICAM-1 (CD54). Additional staining made use of rat monoclonal antibodies to the human and mouse high endothelial venule antigens HECA 452 and MECA 79 and mouse ICAM-1. The expression of these same molecules was also studied in mice with severe combined immunodeficiency (SCID) mice, bearing intracranial human lymphoblastoid cells. Eleven of the CNS-NHL tumors expressed LFA-1 alpha (one strongly, one intermediate, nine weakly). Nine of the tumors weakly expressed LFA-1 beta.. Nine of twelve tumors weakly expressed ICAM-1. In six of seven tumors definite blood vessels stained for ICAM-1. Non-tumor brain from two patients and non-tumor cerebral blood vessels showed no staining with CD11a, CD18 or CD54 antibodies. Strong expression of LFA-alpha and LFA-beta as well as ICAM-1 was noted in human lymphoblastoid cells (LCLs)/SCID mouse CNS lymphomas. Tumor blood vessels in these mice stained for mouse ICAM-1. Normal SCID mouse brains showed no staining with CD11a, CD18, CD54 or mouse ICAM-1 antibodies. Human, human/mouse CNS lymphomas, normal human, and mouse brains showed no staining with either HECA 452 or MECA 79.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Bashir
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha
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Abstract
A case-control study of brain tumor was conducted in collaborating hospitals in Boston, Providence, and Baltimore. Cases were 160 consecutive patients being treated for glioblastoma, grade 3 or 4 astrocytoma, or anaplastic astrocytoma. Controls were 128 healthy persons identified among the case's friends. A complex self-administered questionnaire was used to assess exposure to factors of interest. There was some evidence that glioblastoma is associated with a decreased susceptibility to allergies, a finding that may call attention to the involvement of immunologic disturbances in brain tumors. Our data are not supportive of previous reports of an association between brain tumors and exposure to pets or farm environment, family history of CNS malignancies or other neurologic conditions, or irradiation to the head. We did not find any evidence for an association with life-style characteristics such as cigarette smoking, alcohol consumption, use of drugs of any kind, or dietary intake of cured or smoked meat or fish.
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Affiliation(s)
- F Hochberg
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
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Bashir R, Hochberg F, Singer RH. Detection of Epstein-Barr virus by in situ hybridization. Progress toward development of a nonisotopic diagnostic test. Am J Pathol 1989; 135:1035-44. [PMID: 2556925 PMCID: PMC1880496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This work presents some initial quantitation of an in situ hybridization method for detection of Epstein-Barr (EB) virus nucleic acids. The purpose is to develop evaluative criteria for diagnosis of viral presence in clinical tissue specimens. In this work simultaneous denaturation of probe and target DNA and an alkaline phosphatase conjugate to detect biotinated probe were used as described by Unger et al. For evaluation of the hybridization, a variety of cell lines, both productively and latently infected, that were hybridized in situ using nick translated 32P-labeled viral probe sequences and counted by scintillation after the method of Lawrence and Singer were used. Producer cells (B95-8) showed intense foci of staining in approximately 5% of cells, with most of the other cells showing varying staining intensity. Raji cells showed varying amounts of signal from cell to cell. Namalwa cells exhibited one spot in most cells that was decreased after cells were treated with Actinomycin D (dactinomycin, Merck Sharp & Dohme, West Point, PA). Signal was identified in only a third of these same cells after sectioning. EB virus-negative Ramos cells showed no signal. The nuclear punctate nature of the signal generated is diagnostic of infected cells, and may be a useful test for cultured cells or pathologic specimens.
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Affiliation(s)
- R Bashir
- Division of Neurology, University of Nebraska, Medical Center, Omaha 68105
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Abstract
The cell surface antigenic phenotype of 18 cases of central nervous system (CNS) large-cell lymphoma (14 primary, four secondary) was examined by an immunoperoxidase technique using antibodies that identify B cell restricted and associated antigens. All cases were shown to be of B cell origin by virtue of the expression of monotypic immunoglobulin (Ig) (16 IgM, two IgG) and the pan B cell antigen B1 (CD20). A panel of monoclonal antibodies directed against B cell restricted and associated activation antigens including B5, Blast-1, Blast-2 (CD23), BB1, interleukin 2 receptor (IL2R, CD25), T9 (transferrin receptor) and TNK-TAR (4F2) was used on 12 of the cases. The majority expressed T9 and TNK-TAR. Blast-1 was expressed by less than half the cases and Blast-2 and B5 by one of 12 cases each. This is in contrast to 10 non-CNS diffuse large cell lymphomas where B5 and Blast-1 were present on all cases. This study confirms previous observations that primary CNS large cell lymphomas are of B cell derivation. Moreover, the differences in expression of B cell activation antigens on CNS large cell lymphomas as compared to non-CNS lymphomas raise the possibility that a subset of neoplastic B cells may have unique tropism for the CNS.
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Affiliation(s)
- R Bashir
- Division of Neurology, University of Nebraska Medical Center
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Abstract
The effects of botulinum toxin injections have been studied on 19 patients with hand dystonia. The dystonic muscles were identified by clinical examination and EMG findings of localised bursts of muscle activation with fine wire electrodes during the tasks that precipitated the dystonia. Injections into the most active muscles were given to each patient every 2 weeks in increasing doses (up to 20 U the first week, up to 40 U the second week, and up to 80 U the third week) until performance improvement was achieved. Subjective improvement of cramping, pain and/or tension was associated with temporary weakness in injected muscles. Benefit was seen in 16 patients, lasted between 1 and 6 months, and was reproducible.
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Affiliation(s)
- L G Cohen
- Human Motor Control Section, NINCDS, Bethesda, MD 20892
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Abstract
Recognition of the local nature of glioblastoma has generated an increasing interest in treatment using radioactive implants (interstitial brachytherapy). A key issue in such implantation is the configuration of the radiation field in relation to the resected tumor. In particular, should radiation be provided to the area from which the tumor has been resected? To clarify this issue, we evaluated patterns of tumor regrowth into this resected area in 62 patients. Three patterns of computed tomographic scan-documented tumor regrowth were recognized: preferential (regrowth to refill the resected area only), circumferential (regrowth into the resected area and previously uninvolved contiguous brain) and away (local regrowth into noncontiguous brain, sparing the surgical bed). Regrowth of the tumor 6.3 to 6.8 months after resection was seen in 59 of 62 patients (95.2%). Preferential regrowth was seen in 32 of 62 patients (51.6%), and circumferential regrowth was seen in 27 of 62 patients (43.5%). Regrowth away was seen in 3 of 62 patients (4.8%). Radiation fields planned for interstitial brachytherapy must adequately include the resected area because of the high incidence of tumor regrowth into that area.
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Affiliation(s)
- R Bashir
- Department of Neurology, Massachusetts General Hospital, Boston
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Palmer E, Henrikson B, McKusick K, Strauss HW, Hochberg F. Pain as an indicator of bone metastasis. Acta Radiol 1988; 29:445-9. [PMID: 3408606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Patients with breast or prostate cancer routinely referred for bone scintigraphy were evaluated for the presence of skeletal pain, as determined by a self administered questionnaire. Pain was a common finding, whether or not metastatic disease was present, and occurred in over half of patients. Although most patients with bone metastases did report bone pain, a significant fraction (21% of breast and 22% of prostate patients) were asymptomatic. A distinct minority of individual anatomic regions of metastasis were painful: pain was reported in 23% of sites of breast metastases and 15% of metastatic prostate cancer sites. Of all sites at which pain was present, metastases were demonstrated in only about one half. These results indicate that pain is not a reliable indicator of the presence of location of metastatic bone disease.
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Affiliation(s)
- E Palmer
- Department of Radiology, Massachusetts General Hospital, Boston
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Affiliation(s)
- R Bashir
- Massachusetts General Hospital, Boston 02114
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Abstract
The natural history of primary intracranial germ-cell tumors (GCT's) is defined from 389 previously published cases, of which 65% were germinomas, 18% teratomas, 5% embryonal carcinomas, 7% endodermal sinus tumors, and 5% choriocarcinomas. Intracranial GCT's display specificity in site of origin. Ninety-five percent arise along the midline from the suprasellar cistern (37%) to the pineal gland (48%), and an additional 6% involve both sites. The majority of germinomas (57%) arise in the suprasellar cistern, while most nongerminomatous GCT's (68%) preferentially involve the pineal gland (p less than 0.0001). The age distribution of afflicted patients is unimodal, centering with an abrupt surge in frequency in the early pubertal years; 68% of patients are diagnosed between 10 and 21 years of age. Nongerminomatous GCT's demonstrate an earlier age of onset than do germinomas (p less than 0.0001). Prolonged symptomatic intervals prior to diagnosis are common in germinomas (p = 0.0007), in suprasellar GCT's (p = 0.001), and among females (p = 0.02). Parasellar germinomas commonly present with diabetes insipidus, visual field defects, and hypothalamic-pituitary failure. Nongerminomatous GCT's present as posterior third ventricular masses with hydrocephalus and midbrain compression. Germ-cell tumors may infiltrate the hypothalamus (11%), or disseminate to involve the third ventricle (22%) and spinal cord (10%). Among a subpopulation of 263 conventionally treated patients, two factors were of prognostic significance: 1) histological diagnosis; germinomas were associated with significantly longer survival than nongerminomatous GCT's (p less than 0.0001); and 2) staging of the extent of disease; this emphasizes the ominous character of involvement of the hypothalamus (p = 0.0002), third ventricle (p = 0.02), or spinal cord (p = 0.01). Specific recommendations regarding the necessity of histological diagnosis and staging of the extent of disease are made in light of modern chemotherapeutic advances. The pathogenesis of GCT's may be revealed by their specificity of origin within the positive (suprasellar cistern-suprachiasmatic nucleus) and negative (pineal) regulatory centers for gonadotropin secretion within the diencephalon. The abrupt rise in age distribution at 10 to 12 years suggests that the neuroendocrine events of puberty are an "activating" influence in the malignant expression of these embryonal tumors.
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Abstract
This is a case-control study of 160 persons with glioblastoma and 128 of their "best friends" as controls. Subjects came mainly from greater Boston, and data were gathered by questionnaire and telephone interview. Among those who had had a "severe" head injury at age 15 or later, the age-adjusted rate ratio (RR) of glioblastoma was 10.6, p = 0.004. There were six cases and no controls who had seizures for 15 or more years. The related RR is inestimable, but has a p value of 0.03. We could not evaluate whether the latter association implies a direct relationship between the causes of seizures and the causes of glioblastoma, or if it reflects the effect of another factor, such as medications to control the seizures.
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Ross RL, Kapp JP, Hochberg F, Krull IS, Ding XD, Selavka C. Solvent systems for intracarotid 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) infusion. Neurosurgery 1983; 12:512-4. [PMID: 6866232 DOI: 10.1227/00006123-198305000-00006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The agent, 1,3-bis(3-chloroethyl)-1-nitrosourea (BCNU), when given by arterial infusion for brain tumor chemotherapy is usually dissolved in an alcohol/saline solution. The authors compared the osmolality of and drug recovery from solvent systems of alcohol/saline, dimethyl sulfoxide (DMSO)/water, and dextrose/water. Recovery of drug was adequate from all solvent systems, although variability of drug recovery from the alcohol/saline and DMSO/water systems was greater than from the dextrose/water system. The alcohol/saline system was significantly hyperosmolar. The alcohol/saline and DMSO/water solvent systems offer no advantage over the dextrose/water system and may be associated with significant disadvantages.
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Abstract
Liquid chromatography-electrochemical detection (LCEC) methods and instrumentation have been successfully applied for the trace determination of at least three separate platinum (Pt) anti-cancer (neoplastic) agents. All of these compounds have proven clinically effective in the treatment of human neoplasms. The three Pt derivatives studied were: cis-dichloro diammine platinum (cis-Pt); cis-diammine-1, 1-cyclobutane dicarboxylate platinum (CBDCA); and cis-dichloro-trans-dihydroxy diisopropylamine platinum (CHIP). The parent compound, cis-Pt (CDDP), can be determined via both oxidative and reductive LCEC, with differences in the minimum limits of detection. Calibration plots and minimum detection limits have been determined for all three derivatives. Both CBDCA and CHIP can be determined via direct LCEC, but the minimum detection limits for CBDCA are not practical for stability or clinical studies. A new method of derivatization for CBDCA and related Pt compounds has been developed, wherein this can be quantitatively converted to cis-Pt, and the final derivative is then determined as for the parent cis-Pt. CDDP can be determined via reductive LCEC at the 100-ppb level in plasma. The final methods of LCEC analysis have now been applied to a variety of stability studies with all three Pt drugs, in water, plasma, and saline infusion solutions. It is suggested that these LCEC methods are directly applicable and amenable to "real world" clinical settings and cancer-patient samples.
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Whitmore EL, Hochberg F, Wolfson L, Royalty J, Taft PD. Quantitative cytocentrifugation in the evaluation of cerebrospinal fluid. Acta Cytol 1982; 26:847-50. [PMID: 6186112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Five hundred sixteen samples of cerebrospinal fluid (CSF) were subjected to cytocentrifugation to determine whether this technique is reliable in quantifying the cells present while simultaneously allowing precise cytologic identification of the types of malignant and atypical cells present. Cell counts obtained by the cytocentrifuge method were comparable to those obtained by the standard hemocytometer method. Because of the larger volume of fluid used in cytocentrifugation, cells (0.2/cu mm) were found in 264 specimens that would have been considered devoid of cells by hemocytometry. Six of these samples contained malignant cells. The Wright's-stained cytocentrifuged specimens also allowed precise identification of hematopoietic cell types. CSF cytocentrifugation offers the advantages of (1) a simple and rapid method of quantifying the number of cells present, (2) use of larger volumes than the hemocytometer method, thereby minimizing the possibility that the specimen will be classified as acellular, and (3) improved morphology of hematopoietic cell types by use of the Wright's stain. We conclude that the cytocentrifugation method is useful in the routine quantification and diagnosis of CSF specimens.
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Abstract
1,3-Bis(2-chloroethyl)-1-nitrosourea, BCNU, a widely used anticancer agent for a variety of neoplasms, can be rapidly, conveniently, and inexpensively determined at trace levels of clinical importance, from a variety of biological media, using HPLC-UV approaches. Limits of detection for BCNU from patient and control samples have been compared for HPLC-UV, HPLC-EC, and the Griess Test. The distribution and disappearance of BCNU from blood samples can be quickly and easily determined using the methods described. Individual blood samples are completely analyzed in less than 30 mins, from the time of sampling to qualitative and quantitative results.
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Abstract
A rare intra-articular tumor of the knee is described. The tumor was delineated preoperatively by arthrography. The value of arthrography is discussed in nonmeniscal damage.
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49
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Glass KS, Hochberg F. Nonunion of carpal navicular bone: comparison of two methods of treatment. Bull N Y Acad Med 1978; 54:865-8. [PMID: 280395 PMCID: PMC1807522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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50
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Lancourt JE, Hochberg F. Delayed fracture healing in primary hyperparathyroidism. Clin Orthop Relat Res 1977:214-8. [PMID: 598080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The incidence of fractures in primary hyperparathyroidism is highly variable. The possibility that there might be an increased susceptibility to fracture is discussed. Healing in most is without delay. Three cases of delayed or nonunion following fracture are presented. In all three, healing accelerated dramatically after excision of a parathyroid adenoma. A pathological fracture secondary to the hyperparathyroidism of parathyroid carcinoma healed after excision of the tumor allowed regression of the osseous lesions. The endocrinologic mechanisms which cause nonunion in a small percentage of cases have not been clearly elucidated.
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