Publications by authors named "Barbara J O'Brien"

Article Synopsis
  • Glioblastoma patients typically have a poor prognosis even after standard treatments, prompting research into new combinations of therapy.
  • The study evaluated the effectiveness of veliparib combined with temozolomide for glioblastoma patients with MGMT promoter hypermethylation, hoping to enhance treatment outcomes.
  • Results showed a slight improvement in median overall survival for the veliparib group compared to the placebo, but the difference wasn't significant enough to meet efficacy goals, though the combination treatment was generally well tolerated.
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Background: There are no validated tools for the clinical neurological assessment of patients with leptomeningeal metastases (LM). However, clinical examination during the course of the disease guides medical management and is part of response assessment in clinical trials. Because neuroimaging may not always be obtained owing to rapid clinical deterioration, clinical neurological assessment of LM is essential, and standardization Is important to minimize rater disagreement.

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Article Synopsis
  • - Burnout in the medical field is linked to emotional exhaustion, depersonalization, and a decreased sense of achievement, and younger professionals are particularly at risk; this study focused on SNO Young Investigators to better understand their experiences.
  • - An anonymous survey was conducted in 2019 among eligible SNO members, gathering data on their characteristics and using the Maslach Burnout Inventory to assess burnout levels, with analysis including various statistical methods.
  • - The results showed that YI members reported higher levels of emotional exhaustion and depersonalization than the general population, with 30% classified as overextended and 15% experiencing burnout; stress was largely attributed to organizational challenges, indicating a need for systemic interventions.
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Background: We observed rapid tumor progression following COVID-19 infection among patients with glioblastoma and sought to systematically characterize their disease course in a retrospective case-control study.

Methods: Using an institutional database, we retrospectively identified a series of COVID-19-positive glioblastoma cases and matched them by age and sex 1:2 to glioblastoma controls who had a negative COVID-19 test during their disease course. Demographic and clinical data were analyzed.

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Background: Leptomeningeal metastases (LM) in gastroesophageal (GE) malignancies are exceedingly rare. Historically, treatment for LM has included steroids, radiation, chemotherapy, and intrathecal (IT) chemotherapy. However, the outcomes in GE malignancies with LM remain poor.

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The prognosis of patients with glioblastoma (GBM) remains poor despite current treatments. Targeted therapy in GBM has been the subject of intense investigation but has not been successful in clinical trials. The reasons for the failure of targeted therapy in GBM are multifold and include a lack of patient selection in trials, the failure to identify driver mutations, and poor blood-brain barrier penetration of investigational drugs.

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Herein, we report a case of a collision tumor involving a multinodular and vacuolating neuronal tumor (MVNT) and a diffuse astrocytoma. A collision tumor between these two entities has not previously been reported. The patient is a 35-year-old woman who presented with new-onset hearing loss and ringing in her right ear.

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Purpose: In this study, we aimed to assess the clinical characteristics, reasons for referral, and outcomes of patients with brain metastases (BM) referred to the supportive care center.

Methods: Equal numbers of patients with melanoma, breast cancer, and lung cancer with (N = 90) and without (N = 90) BM were retrospectively identified from the supportive care database for study. Descriptive statistics were used to analyze demographic, disease, and clinical data.

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Purpose: Burnout is a psychological occupational syndrome defined by the Maslach Burnout Inventory (MBI) as emotional exhaustion, depersonalization, and a low sense of personal accomplishment. We sought to characterize the prevalence of burnout among early-career medical oncologists at The University of Texas MD Anderson Cancer Center (MDACC).

Methods: For this institutional review board-approved study, an electronic survey was developed for Assistant Professors in the MDACC Division of Cancer Medicine.

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Article Synopsis
  • A phase 1/1b study is being conducted to evaluate the safety and recommended dose of intrathecal (IT) nivolumab, given alongside intravenous (IV) nivolumab, for treating patients with melanoma and leptomeningeal disease (LMD).
  • The study, which involved 25 metastatic melanoma patients, found no dose-limiting toxicities, establishing the safe IT nivolumab dose at 50 mg administered with 240 mg of IV nivolumab every two weeks.
  • The median overall survival (OS) was 4.9 months, with 44% of patients alive at 26 weeks and 26% at 52 weeks, indicating potential effectiveness while
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Background: Leptomeningeal metastasis (LM) creates symptoms related to both the disease within the nervous system and treatment toxicities. Biologic processes, such as inflammation and behavioral processes, such as the meaning ascribed to illness (Meaning of Illness: MoI), can impact physical and psychosocial symptoms. The aim of this study was to understand the relationships among MoI, physical and psychosocial symptoms, and inflammation in patients with LM.

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Background: Treatment options for unresectable new and recurrent glioblastoma remain limited. Laser ablation has demonstrated safety as a surgical approach to treating primary brain tumors. The LAANTERN prospective multicenter registry (NCT02392078) data were analyzed to determine clinical outcomes for patients with new and recurrent wild-type glioblastoma.

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Article Synopsis
  • * A study spanning 2010-2015 analyzed 52 HGG patients who received palliative care (PC), finding that many were referred late in their illness, and that HGG patients generally received less aggressive care at EoL compared to those with non-CNS cancers.
  • * Results indicated that early indicators of disease progression and symptoms like motor weakness can affect the level of care received, highlighting the need for more timely and effective palliative care consultations to improve outcomes for HGG patients.
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Background/aim: Leptomeningeal disease (LMD) is a debilitating complication of advanced malignancies. Immune-checkpoint inhibitors (ICIs) may alter disease course. We analyzed the role and toxicity of ICIs in LMD.

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Cerebral ischemia is a known complication of meningitis. Most meningitis-induced infarcts have been reported in the neonatal and pediatric population. To the best of our knowledge, there have been no previous reports describing bilateral cortical infarcts in an adult secondary to a K1 strain of meningitis, and herein we report a case in a 25-year-old female.

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Dynamic interplay between cancer cells and the surrounding microenvironment is a feature of the metastatic process. Successful metastatic brain colonization requires complex mechanisms that ultimately allow tumor cells to adapt to the unique microenvironment of the central nervous system, evade immune destruction, survive, and grow. Accumulating evidence suggests that components of the brain tumor microenvironment (TME) play a vital role in the metastatic cascade.

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Purpose: Cytomegalovirus (CMV) antigens occur in glioblastoma but not in normal brains, making them desirable immunologic targets.

Patients And Methods: Highly functional autologous polyclonal CMV pp65-specific T cells from patients with glioblastoma were numerically expanded under good manufacturing practice compliant conditions and administered after 3 weeks of lymphodepleting dose-dense temozolomide (100 mg/m) treatment. The phase I component used a 3+3 design, ascending through four dose levels (5 × 10-1 × 10 cells).

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Background: Low-grade gliomas (LGGs) are slow-growing, infiltrative tumors frequently associated with seizures. Predicting which patients will develop early tumor recurrence based on clinical indicators following initial surgical intervention remains a challenge. Seizure recurrence following surgery may be an early indicator of tumor recurrence, especially in patients presenting with increase in seizure frequency.

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Background: It is estimated only 8-11% of patients with glioblastoma (GBM) enrol in clinical trials, limiting treatment development. We analysed the clinical and demographic features of patients with GBM enroled in clinical trials at the University of Texas MD Anderson Cancer Center (MDACC).

Methods: We reviewed the records of adult patients treated for primary GBM between 2007 and 2012 at the MDACC.

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Purpose: Although the survival of most melanoma patients diagnosed with leptomeningeal disease (LMD) is short, some patients can have better outcomes and prolonged survival. A large retrospective cohort of patients was analyzed to identify features associated with survival with LMD from melanoma.

Methods: Clinical characteristics, treatments and survival were collected for melanoma patients diagnosed with LMD from 1999 to 2015.

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Glioblastoma is the most common primary malignant brain tumor in adults and is associated with poor survival. The Ivy Foundation Early Phase Clinical Trials Consortium conducted a randomized, multi-institution clinical trial to evaluate immune responses and survival following neoadjuvant and/or adjuvant therapy with pembrolizumab in 35 patients with recurrent, surgically resectable glioblastoma. Patients who were randomized to receive neoadjuvant pembrolizumab, with continued adjuvant therapy following surgery, had significantly extended overall survival compared to patients that were randomized to receive adjuvant, post-surgical programmed cell death protein 1 (PD-1) blockade alone.

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Background: Repurposed memantine, mefloquine, and metformin have putative anticancer activity. The objective of this phase 1 study was to determine the maximum tolerated doses (MTDs) of combinations of these agents with temozolomide (TMZ).

Methods: Adults with newly diagnosed glioblastoma who completed chemoradiation were eligible.

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We sought to compare the tumor profiles of brain metastases from common cancers with those of primary tumors and extracranial metastases in order to identify potential targets and prioritize rational treatment strategies. Tumor samples were collected from both the primary and metastatic sites of nonsmall cell lung cancer, breast cancer and melanoma from patients in locations worldwide, and these were submitted to Caris Life Sciences for tumor multiplatform analysis, including gene sequencing (Sanger and next-generation sequencing with a targeted 47-gene panel), protein expression (assayed by immunohistochemistry) and gene amplification (assayed by in situ hybridization). The data analysis considered differential protein expression, gene amplification and mutations among brain metastases, extracranial metastases and primary tumors.

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