Publications by authors named "Martin J Van Den Bent"

Physicians face clinical dilemmas in the diagnosis of non-optic intraparenchymal lesions on MRI brain scans of patients with neurofibromatosis type 1. As the incidence and evolution of these lesions into adulthood remain unclear, we conducted a retrospective study on this topic. All adult neurofibromatosis type 1 patients who had at least one MRI brain scan in our center were selected for this study.

View Article and Find Full Text PDF
Article Synopsis
  • IDH-mutant gliomas are the most common malignant brain tumors in young adults, causing significant challenges for patients, including cognitive deficits and high mortality due to tumor progression.
  • Current treatments like surgery, radiation, and chemotherapy enhance survival but can have negative impacts on cognitive function and quality of life.
  • The recent FDA approval of vorasidenib, a drug targeting mutant IDH1/2 proteins, represents a promising new approach, with ongoing trials exploring its use alongside other therapies for better patient outcomes.
View Article and Find Full Text PDF

Subgroup analyses are essential to generate new hypotheses or to estimate treatment effects in clinically meaningful subgroups of patients. They play an important role in taking the next step towards personalized surgical treatment for brain tumor patients. However, subgroup analyses must be used with consideration and care because they have significant potential risks.

View Article and Find Full Text PDF

Adolescents and young adults (AYAs; ages 15-39 years) are a vulnerable population facing challenges in oncological care, including access to specialized care, transition of care, unique tumor biology, and poor representation in clinical trials. Brain tumors are the second most common tumor type in AYA, with malignant brain tumors being the most common cause of cancer-related death. The 2021 WHO Classification for central nervous system (CNS) Tumors highlights the importance of integrated molecular characterization with histologic diagnosis in several tumors relevant to the AYA population.

View Article and Find Full Text PDF

The standard of care for adult patients with gliomas, glioneuronal and neuronal tumors consists of combinations of surgery, radiotherapy, and chemotherapy. For many systemic cancers, targeted treatments are a major part of the standard treatment, however, the predictive significance of most of the targets for treatment in systemic cancer are less well established in central nervous system (CNS) tumors . In 2023 the EANO Guideline Committee presented evidence based recommendations for rational testing of molecular targets for targeted treatments.

View Article and Find Full Text PDF
Article Synopsis
  • Accurate grading of IDH-mutant gliomas is crucial for predicting patient outcomes and selecting treatment strategies, yet histological grading remains difficult, with limited molecular markers available.
  • Researchers performed RNA-sequencing on 138 IDH-mutant astrocytomas from the CATNON trial and analyzed multi-omics data to create a Continuous Grading Coefficient (CGC), which proved to be a better survival predictor than current grading systems.
  • The study identified four distinct transcriptional clusters linked to various gene expression patterns, revealing that higher-grade IDH-mutant astrocytomas exhibit DNA-methylation signatures correlated with increased cell cycling, tumor de-differentiation, and changes in the extracellular matrix.
View Article and Find Full Text PDF

Pineal parenchymal tumors are rare neoplasms for which evidence-based treatment recommendations are lacking. These tumors vary in biology, clinical characteristics, and prognosis, requiring treatment that ranges from surgical resection alone to intensive multimodal antineoplastic therapy. Recently, international collaborative studies have shed light on the genomic landscape of these tumors, leading to refinement in molecular-based disease classification in the 5th edition of the World Health Organization (WHO) classification of tumors of the central nervous system.

View Article and Find Full Text PDF

Purpose: IDH-mutant glioma is classified as oligodendroglioma or astrocytoma based on 1p19q-codeletion. Whether prognostic factors are similar between these tumor types is not well understood.

Experimental Design: Retrospective cohort study.

View Article and Find Full Text PDF
Article Synopsis
  • The 2016 and 2021 WHO classifications of CNS tumors have improved how we categorize IDH-mutant gliomas, leading to better treatment options and longer survival for patients.
  • Current treatment guidelines are still largely based on older data that mix different tumor types, often focusing on high-risk factors like age and residual tumor post-surgery.
  • New insights from recent studies suggest that postponing aggressive treatments like radiation and chemotherapy may be safe for many patients with lower-grade IDH-mutant gliomas, and that newer medications like vorasidenib could be beneficial before resorting to traditional therapies.
View Article and Find Full Text PDF

Purpose: To provide practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor (SSTR) ligands.

Methods: This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO).

Results: Positron emission tomography (PET) using somatostatin receptor (SSTR) ligands can detect meningioma tissue with high sensitivity and specificity and may provide clinically relevant information beyond that obtained from structural magnetic resonance imaging (MRI) or computed tomography (CT) imaging alone.

View Article and Find Full Text PDF

Low-grade gliomas present a formidable challenge in neuro-oncology because of the challenges imposed by the blood-brain barrier, predilection for the young adult population, and propensity for recurrence. In the past two decades, the systematic examination of genomic alterations in adults and children with primary brain tumors has uncovered profound new insights into the pathogenesis of these tumors, resulting in more accurate tumor classification and prognostication. It also identified several common recurrent genomic alterations that now define specific brain tumor subtypes and have provided a new opportunity for molecularly targeted therapeutic intervention.

View Article and Find Full Text PDF

A diagnosis of brain metastasis (BM) significantly affects quality of life in patients with metastatic renal cell cancer (mRCC). Although systemic treatments have shown efficacy in mRCC, active surveillance (AS) is still commonly used in clinical practice. In this single-center cohort study, we assessed the impact of different initial treatment strategies for metastatic RCC (mRCC) on the development of BM.

View Article and Find Full Text PDF

Introduction: A greater extent of resection of the contrast-enhancing (CE) tumour part has been associated with improved outcomes in glioblastoma. Recent results suggest that resection of the non-contrast-enhancing (NCE) part might yield even better survival outcomes (supramaximal resection, SMR). Therefore, this study evaluates the efficacy and safety of SMR with and without mapping techniques in high-grade glioma (HGG) patients in terms of survival, functional, neurological, cognitive and quality of life outcomes.

View Article and Find Full Text PDF

Background: The utility of liquid biopsies is well documented in several extracranial and intracranial (brain/leptomeningeal metastases, gliomas) tumors.

Methods: The RANO (Response Assessment in Neuro-Oncology) group has set up a multidisciplinary Task Force to critically review the role of blood and cerebrospinal fluid (CSF)-liquid biopsy in CNS lymphomas, with a main focus on primary central nervous system lymphomas (PCNSL).

Results: Several clinical applications are suggested: diagnosis of PCNSL in critical settings (elderly or frail patients, deep locations, and steroid responsiveness), definition of minimal residual disease, early indication of tumor response or relapse following treatments, and prediction of outcome.

View Article and Find Full Text PDF

Background: The health-related quality of life (HRQoL) and cognition are important indicators for the quality of survival in patients with high-grade glioma (HGG). However, data on long-term survivors and their caregivers are scarce. We aim to investigate the interaction between cognition and HRQoL in long-term survivors, their caregivers' evaluations, and the effect on caregiver strain and burden.

View Article and Find Full Text PDF

Accurate grading of IDH-mutant gliomas defines patient prognosis and guides the treatment path. Histological grading is however difficult and, apart from CDKN2A/B homozygous deletions in IDH-mutant astrocytomas, there are no other objective molecular markers used for grading. Experimental Design: RNA-sequencing was conducted on primary IDH-mutant astrocytomas (n=138) included in the prospective CATNON trial, which was performed to assess the prognostic effect of adjuvant and concurrent temozolomide.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to evaluate the effectiveness of PSMA-targeting radioligand therapy (RLT) for treating malignant brain tumors and investigated if administering the treatment via super-selective intra-arterial (ssIA) methods could improve drug uptake in tumors.
  • Ten patients with brain tumors underwent both intravenous and intra-arterial administration of [Ga]Ga-PSMA-11, with safety monitored and tumor uptake quantified through PET-MRI imaging across different time points.
  • Results showed that ssIA administration significantly increased radioligand uptake in tumors (15-fold higher median) compared to intravenous administration, without adverse effects, indicating it may be a promising approach for enhancing treatment options for brain tumor patients.*
View Article and Find Full Text PDF
Article Synopsis
  • MRI scans take a long time to get, especially in places with fewer resources, so researchers want to make it faster using a special computer program called a deep convolutional neural network (dCNN).
  • They studied information from a lot of patients with a type of brain cancer called glioblastoma to help train the dCNN to create better MRI images quickly by using less data.
  • Their tests showed that the dCNN-created images were very similar to the original ones, and it worked well when looking at important cancer details in the scans.
View Article and Find Full Text PDF

Background And Objectives: Hydrocephalus is a common radiologic sign in patients with leptomeningeal metastasis (LM) from solid tumors which can be assessed using the Evans index (EI). Here, we explored the prognostic value of ventricular size in LM.

Methods: We identified patients with LM from solid tumors by chart review at 3 academic hospitals to explore the prognostic associations of the EI at diagnosis, first follow-up, and progression.

View Article and Find Full Text PDF

Response Assessment in Neuro-Oncology (RANO) response criteria have been established and were updated in 2023 for MRI-based response evaluation of diffuse gliomas in clinical trials. In addition, PET-based imaging with amino acid tracers is increasingly considered for disease monitoring in both clinical practice and clinical trials. So far, a standardised framework defining timepoints for baseline and follow-up investigations and response evaluation criteria for PET imaging of diffuse gliomas has not been established.

View Article and Find Full Text PDF
Article Synopsis
  • The study analyzed the epigenetic changes in gliomas from 132 patients over time, comparing initial and recurrent tumors in both IDH-wildtype (IDHwt) and IDH-mutant (IDHmut) types.
  • IDHwt gliomas remained stable in their epigenetic profile, while IDHmut gliomas showed a notable decrease in DNA methylation, making their profiles more similar to IDHwt tumors.
  • The research identified HOXD13 as crucial for the evolution of IDHmut tumors and found that treatment led to changes in the tumor microenvironment, like increased blood vessel formation and T-cell presence, mimicking the characteristics of IDHwt gliomas.
View Article and Find Full Text PDF

Background: Studies on the efficacy of rituximab in primary CNS lymphoma (PCNSL) reported conflicting results. Our international randomized phase 3 study showed that the addition of rituximab to high-dose methotrexate, BCNU, teniposide, and prednisolone (MBVP) in PCNSL was not efficacious in the short term. Here we present long-term results after a median follow-up of 82.

View Article and Find Full Text PDF