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6. Prognostic factors in leptomeningeal metastases Reply

Author

Le Rhun, Emilie, Devos, Patrick, Weller, Johannes, Seystahl, Katharina, Mo, Francesca, Compter, Anette, Berghoff, Anna S., Jongen, Joost L.M., Wolpert, Fabian, Rudà, Roberta, Brandsma, Dieta, van den Bent, Martin, Preusser, Matthias, Herrlinger, Ulrich, Weller, Michael, and Neurology

Subjects
SDG 3 - Good Health and Well-being
Published
2021

9. Erratum to: Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors

Author

Le Rhun, Emilie, primary, Devos, Patrick, additional, Weller, Johannes, additional, Seystahl, Katharina, additional, Mo, Francesca, additional, Compter, Anette, additional, Berghoff, Anna S, additional, Jongen, Joost L M, additional, Wolpert, Fabian, additional, Rudà, Roberta, additional, Brandsma, Dieta, additional, van den Bent, Martin, additional, Preusser, Matthias, additional, Herrlinger, Ulrich, additional, and Weller, Michael, additional

Published
2021
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10. Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors

Author

Le Rhun, Emilie, Devos, Patrick, Weller, Johannes, Seystahl, Katharina, Mo, Francesca, Compter, Annette, Berghoff, Anna S, Jongen, Joost L M, Wolpert, Fabian, Rudà, Roberta, Brandsma, Dieta; https://orcid.org/0000-0001-7998-9904, van den Bent, Martin, Preusser, Matthias, Herrlinger, Ulrich, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Le Rhun, Emilie, Devos, Patrick, Weller, Johannes, Seystahl, Katharina, Mo, Francesca, Compter, Annette, Berghoff, Anna S, Jongen, Joost L M, Wolpert, Fabian, Rudà, Roberta, Brandsma, Dieta; https://orcid.org/0000-0001-7998-9904, van den Bent, Martin, Preusser, Matthias, Herrlinger, Ulrich, and Weller, Michael; https://orcid.org/0000-0002-1748-174X

Abstract

BACKGROUND The EANO ESMO guidelines have proposed a classification of leptomeningeal metastases (LM) from solid cancers based on clinical, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) cytology presentation. MRI patterns are classified as linear, nodular, both, or neither. Type I LM is defined by positive CSF cytology (confirmed LM) whereas type II LM is defined by typical clinical and MRI signs (probable or possible LM). Here we explored the clinical utility of these LM subtypes. PATIENTS AND METHODS We retrospectively assembled data from 254 patients with newly diagnosed LM from solid tumors. Survival curves were derived using the Kaplan-Meier method and compared by Log-rank test. RESULTS Median age at LM diagnosis was 56 years. Typical clinical LM features were noted in 225 patients (89%); 13 patients (5%) were clinically asymptomatic. Tumor cells in the CSF were observed in 186 patients (73%) whereas the CSF was equivocal in 24 patients (9.5%) and negative in 44 patients (17.5%). Patients with confirmed LM had inferior outcome compared with patients with probable or possible LM (P = 0.006). Type I patients had inferior outcome than type II patients (P = 0.002). Nodular disease on MRI was a negative prognostic factor in type II LM (P = 0.014), but not in type I LM. Administration of either intrathecal pharmacotherapy (P = 0.020) or systemic pharmacotherapy (P = 0.0004) was associated with improved outcome in type I LM, but not in type II LM. CONCLUSION The EANO ESMO LM subtypes are highly prognostic and should be considered for stratification and overall design of clinical trials.

Published
2021

11. Richter’s Syndrome of the Central Nervous System

Author

Pronello, Edoardo, primary, Mo, Francesca, additional, Gottardi, Daniela, additional, Palmiero, Rosa, additional, Bertero, Luca, additional, Lanotte, Michele, additional, Ferrio, Maria Federica, additional, Rudà, Roberta, additional, and Soffietti, Riccardo, additional

Published
2021
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12. Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors

Author

Le Rhun, Emilie, primary, Devos, Patrick, additional, Weller, Johannes, additional, Seystahl, Katharina, additional, Mo, Francesca, additional, Compter, Annette, additional, Berghoff, Anna S, additional, Jongen, Joost L M, additional, Wolpert, Fabian, additional, Rudà, Roberta, additional, Brandsma, Dieta, additional, van den Bent, Martin, additional, Preusser, Matthias, additional, Herrlinger, Ulrich, additional, and Weller, Michael, additional

Published
2020
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15. NCOG-02. PROGNOSTIC VALIDATION OF THE EANO ESMO CLASSIFICATION OF LEPTOMENINGEAL METASTASIS

Author

Le Rhun, Emilie, primary, Devos, Patrick, additional, Weller, Johannes, additional, Seystahl, Katharina, additional, Mo, Francesca, additional, Compter, Annette, additional, Berghoff, Anna Sophie, additional, Jongen, Joost, additional, Wolpert, Fabian, additional, Rudà, Roberta, additional, Brandsma, Dieta, additional, Preusser, Matthias, additional, van den Bent, Martin, additional, Herrlinger, Ulrich, additional, and Weller, Michael, additional

Published
2020
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17. 41. PROGNOSTIC VALIDATION OF THE EANO ESMO CLASSIFICATION OF LEPTOMENINGEAL METASTASIS

Author

Le Rhun, Emilie, primary, Devos, Patrick, additional, Weller, Johannes, additional, Seystahl, Katharina, additional, Mo, Francesca, additional, Compter, Annette, additional, Sophie Berghoff, Anna, additional, Jongen, Joost, additional, Wolpert, Fabian, additional, Rudà, Roberta, additional, Brandsma, Dieta, additional, van den Bent, Martin, additional, Preusse, Matthias, additional, Herrlinger, Ulrich, additional, and Weller, Michael, additional

Published
2020
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22. Lacosamide in patients with gliomas and uncontrolled seizures: results from an observational study.

Author

Rudà, Roberta, Pellerino, Alessia, Franchino, Federica, Bertolotti, Cinzia, Bruno, Francesco, Mo, Francesca, Migliore, Enrica, Ciccone, Gianni, and Soffietti, Riccardo

Abstract

To report the efficacy and tolerability of lacosamide as an add-on treatment in patients with gliomas and uncontrolled seizures despite conventional antiepileptic drugs (AEDs). We conducted an observational study on 71 patients to describe patterns of response to lacosamide and the association between clinico-pathological factors and seizure control. We observed at 3, 6 and 9 months a seizure reduction ≥ 50% in 74.6, 76 and 86.2% of patients and a seizure freedom in 42.2, 43 and 50%, respectively. The median number of seizures in the 3 months before treatment was 13, and decreased to 3 between baseline and 6 months, and to 0.5 between 6 and 9 months. The best seizure response was observed at 3 months (62%). Sixty per cent of patients displayed the maximum seizure control with doses of lacosamide of 100-250 mg/day, while 21% needed doses up to 400 mg/day. Seizure reduction ≥ 50% and seizure freedom were higher in patients who received lacosamide as first add-on compared to those who received a later adjunctive therapy. A reduction ≥ 50% of seizures was observed in a proportion of patients with progressive disease on MRI. Age > 45 years (OR 0.11, 95% CI 0.02-0.63, p = 0.013) was a significant predictor of seizure freedom at 9 months on multivariate analysis. The study suggests that lacosamide, when added to any baseline AEDs, is effective in obtaining a high seizure reduction and seizure freedom regardless of the tumor activity and response to antineoplastic therapies. [ABSTRACT FROM AUTHOR]

Published
2018
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23. Prognostic factors in leptomeningeal metastases.

Author

Rhun, Emilie Le, Devos, Patrick, Weller, Johannes, Seystahl, Katharina, Mo, Francesca, Compter, Anette, Berghoff, Anna S, Jongen, Joost L M, Wolpert, Fabian, Rudà, Roberta, Brandsma, Dieta, van den Bent, Martin, Preusser, Matthias, Herrlinger, Ulrich, and Weller, Michael

Published
2021
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26. Prognostic factors in leptomeningeal metastases.

Author

Le Rhun E, Devos P, Weller J, Seystahl K, Mo F, Compter A, Berghoff AS, Jongen JLM, Wolpert F, Rudà R, Brandsma D, van den Bent M, Preusser M, Herrlinger U, and Weller M

Subjects
Humans, Prognosis, Meningeal Carcinomatosis diagnosis, Meningeal Neoplasms
Published
2021
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27. Prognostic validation and clinical implications of the EANO ESMO classification of leptomeningeal metastasis from solid tumors.

Author

Le Rhun E, Devos P, Weller J, Seystahl K, Mo F, Compter A, Berghoff AS, Jongen JLM, Wolpert F, Rudà R, Brandsma D, van den Bent M, Preusser M, Herrlinger U, and Weller M

Subjects
Humans, Magnetic Resonance Imaging, Prognosis, Retrospective Studies, Practice Guidelines as Topic, Meningeal Carcinomatosis, Meningeal Neoplasms, Neoplasms
Abstract

Background: The EANO ESMO guidelines have proposed a classification of leptomeningeal metastases (LM) from solid cancers based on clinical, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) cytology presentation. MRI patterns are classified as linear, nodular, both, or neither. Type I LM is defined by positive CSF cytology (confirmed LM) whereas type II LM is defined by typical clinical and MRI signs (probable or possible LM). Here we explored the clinical utility of these LM subtypes., Patients and Methods: We retrospectively assembled data from 254 patients with newly diagnosed LM from solid tumors. Survival curves were derived using the Kaplan-Meier method and compared by Log-rank test., Results: Median age at LM diagnosis was 56 years. Typical clinical LM features were noted in 225 patients (89%); 13 patients (5%) were clinically asymptomatic. Tumor cells in the CSF were observed in 186 patients (73%) whereas the CSF was equivocal in 24 patients (9.5%) and negative in 44 patients (17.5%). Patients with confirmed LM had inferior outcome compared with patients with probable or possible LM (P = 0.006). Type I patients had inferior outcome than type II patients (P = 0.002). Nodular disease on MRI was a negative prognostic factor in type II LM (P = 0.014), but not in type I LM. Administration of either intrathecal pharmacotherapy (P = 0.020) or systemic pharmacotherapy (P = 0.0004) was associated with improved outcome in type I LM, but not in type II LM., Conclusion: The EANO ESMO LM subtypes are highly prognostic and should be considered for stratification and overall design of clinical trials., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2021
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