Publications by authors named "Naoki Shinojima"

Background: Combination therapy with BRAF and MEK inhibitor holds promise for treating gliomas harboring the V600E mutation; however, the development of acquired resistance remains a challenge.

Case Description: We describe a case of repeated recurrent mutant pleomorphic xanthoastrocytoma (central nervous system World Health Organization grade 3) treated with combination therapy with BRAF and MEK inhibitor. The patient received dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor); however, she developed resistance to the combination therapy.

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Background: A previous Phase II clinical trial, conducted from 1995 to 2003, evaluated CNS germ cell tumors (GCTs) using a three-group treatment stratification based on histopathology. The primary objective of the study was to assess the long-term efficacy of standardized treatment regimens, while the secondary objective focused on identifying associated long-term complications.

Methods: Total 228 patients were classified into three groups for treatment: germinoma (n=161), intermediate prognosis (n=38), and poor prognosis (n=28), excluding one mature teratoma case.

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Pineal parenchymal tumors (PPTs) are rare, accounting for less than 0.3% of all primary central nervous system (CNS) tumors. Pineal parenchymal tumors of intermediate differentiation (PPTID) (WHO grade 2 or 3) show an intermediate prognosis between pineocytoma and pineoblastoma.

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  • * This study analyzed 23 patients who underwent stereotactic radiotherapy (SRT) after surgery for craniopharyngiomas from 2006 to 2021, showing excellent long-term survival rates of 100% at 10 years and 85.7% at 20 years.
  • * SRT proved to be safe and effective, with high local control rates and no significant adverse effects on vision or pituitary function, suggesting that planning for SRT during surgery can lead to better patient
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  • Leptomeningeal enhancement (LME) in glioblastoma patients can indicate the spread of tumor cells, but its presence doesn't always mean the disease is untreatable, particularly given some cases where LME disappears post-surgery.
  • In a study of glioblastoma patients with preoperative LME, 8% showed LME at the brainstem, with larger tumor size linked to its presence and a trend toward significance for deep tumor location.
  • Post-surgery, four out of six patients had significant LME disappearance, suggesting that LME might stem from different factors like impaired blood flow rather than leptomeningeal dissemination, potentially leading to better prognosis than expected.
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Chordoma is a rare tumor that arises from chordal tissue during fetal life. Recently, the concept of poorly differentiated chordoma, a subtype of chordoma characterized by loss of / with a poorer prognosis than conventional chordomas, was established. It predominantly occurs in children and is rare in adults.

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Background: Tirabrutinib, a second-generation inhibitor of Bruton's tyrosine kinase, was approved in March 2020 for the treatment of relapsed or refractory primary central nervous system lymphoma (r/r PCNSL) based on phase I/II studies in Japan. We previously reported the overall response rate and safety profile. We describe Karnofsky Performance Status (KPS) and the quality of life (QoL) in patients with r/r PCNSL receiving tirabrutinib based on more than 1-year follow-up data.

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  • The study aimed to assess the image quality of a faster method for time-of-flight magnetic resonance angiography (TOF-MRA) that combines compressed sensitivity encoding (CS) and spiral imaging.
  • Twenty volunteers participated in the analysis, compared four TOF-MRA sequences, and two radiologists evaluated the images based on quality metrics.
  • Results showed CS and spiral techniques had lower signal-to-noise ratios for certain branches, but CS-spiral provided better quality overall compared to using either method alone.
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  • Chordoma is a rare malignant bone tumor linked to notochordal tissue, often resistant to standard treatments like surgery and radiation, leading to tumor recurrence.
  • A case study of a 72-year-old man revealed his chordoma had a high tumor mutational burden (TMB) and mutations associated with Lynch syndrome, highlighting a genetic connection.
  • The findings suggest that genetic analysis can inform treatment strategies for chordoma, particularly with immune checkpoint inhibitors showing effectiveness in this unusual high TMB case.
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  • Pineal parenchymal tumors of intermediate differentiation (PPTIDs) are rare brain tumors, making up less than 1% of CNS tumors, which creates challenges for diagnosis and treatment.* -
  • A study across 11 institutions identified 28 patients with PPTID, with findings showing a median age of 49, a predominance of females, and a gross total resection success rate of 46%.* -
  • The study concluded that female sex and gross total resection are important factors for better patient outcomes, with a high occurrence of leptomeningeal recurrences and KBTBD4 mutations present in most patients.*
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Lymphocytic hypophysitis (LYH) is a rare chronic inflammatory disease characterized by lymphocytic infiltration of the anterior or posterior pituitary gland and hypothalamus. LYH is subdivided into lymphocytic adenohypophysitis (LAH), lymphocytic infundibulo-neurohypophysitis (LINH), and lymphocytic panhypophysitis (LPH) depending on the primary site. Most cases occur in adults, with few cases reported in children, and it is especially important to distinguish LYH from suprasellar malignancies, such as germ cell tumors and other neoplastic diseases.

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Purpose: This study aimed to investigate the most useful clinical and magnetic resonance imaging (MRI) parameters for differentiating isocitrate dehydrogenase (IDH)-mutant and -wildtype glioblastomas in the 2016 World Health Organization Classification of Tumors of the Central Nervous System.

Methods: This multicenter study included 327 patients with IDH-mutant or IDH-wildtype glioblastoma in the 2016 World Health Organization classification who preoperatively underwent MRI. Isocitrate dehydrogenase mutation status was determined by immunohistochemistry, high-resolution melting analysis, and/or IDH1/2 sequencing.

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Although pituitary neuroendocrine tumors (PitNETs) are usually benign, some are highly invasive and recurrent. Recurrent PitNETs are often treatment-resistant and there is currently no effective evidence-based treatment. Tumor-associated macrophages (TAMs) promote tumor growth in many cancers, but the effect of TAMs on PitNETs remains unclear.

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Background: The goal was to determine whether the addition of temozolomide (TMZ) to the standard treatment of high-dose methotrexate (HD-MTX) and whole-brain radiotherapy (WBRT) for primary central nervous system lymphoma (PCNSL) improves survival.

Methods: An open-label, randomized, phase III trial was conducted in Japan, enrolling immunocompetent patients aged 20-70 years with histologically confirmed, newly diagnosed PCNSL. After administration of HD-MTX, patients were randomly assigned to receive WBRT (30 Gy) ± 10 Gy boost (arm A) or WBRT ± boost with concomitant and maintenance TMZ for 2 years (arm B).

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Gliosarcoma is a rare malignant neoplasm. It accounts for approximately 2% of all glioblastomas. To date, there is no established treatment method for gliosarcoma, and a variety of therapies, such as surgical resection, radiotherapy, and chemotherapy, are typically employed.

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Background: Approximately 70% of lower-grade gliomas harbor isocitrate dehydrogenase 1 (IDH1) mutations, resulting in the accumulation of oncometabolite D-2-hydroxyglutarate (D-2-HG); this leads to epigenetic dysregulation, oncogenesis, and subsequent clonal expansion. DS-1001 is an oral brain-penetrant mutant IDH1 selective inhibitor. This first-in-human study investigated the safety, pharmacokinetics, pharmacodynamics, and efficacy of DS-1001.

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BCORL1 encodes a transcriptional corepressor homolog to BCOR. BCORL1 rearrangements have been previously described as rare events, and among them, CREBBP-BCORL1 has been reported only in 2 cases of ossifying fibromyxoid tumors. Herein, we present the first case of diffusely infiltrating glioma with CREBBP-BCORL1 involving a 17-year-old female patient.

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The characteristic features of plasticity and heterogeneity in glioblastoma (GB) cells cause therapeutic difficulties. GB cells are exposed to various stimuli from the tumor microenvironment and acquire the potential to resist chemoradiotherapy. To investigate how GB cells acquire stem cell-like phenotypes, we focused on ribosomal proteins, because ribosome incorporation has been reported to induce stem cell-like phenotypes in somatic cells.

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Objectives: This study aimed to evaluate the efficacy of a combined wavelet and deep-learning reconstruction (DLR) method for under-sampled pituitary MRI.

Methods: This retrospective study included 28 consecutive patients who underwent under-sampled pituitary T2-weighted images (T2WI). Images were reconstructed using either the conventional wavelet denoising method (wavelet method) or the wavelet and DLR methods combined (hybrid DLR method) at five denoising levels.

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Background: Pituitary abscess (PA) can be fatal if diagnosed late. Rim enhancement is a typical radiological finding of PA on postgadolinium T1-weighted magnetic resonance imaging (MRI). Diffusion-weighted imaging is helpful in distinguishing PA from other sellar cystic lesions.

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Although glioblastoma (GBM) stem-like cells (GSCs), which retain chemo-radio resistance and recurrence, are key prognostic factors in GBM patients, the molecular mechanisms of GSC development are largely unknown. Recently, several studies revealed that extrinsic ribosome incorporation into somatic cells resulted in stem cell properties and served as a key trigger and factor for the cell reprogramming process. In this study, we aimed to investigate the mechanisms underlying GSCs development by focusing on extrinsic ribosome incorporation into GBM cells.

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Article Synopsis
  • * Treatment mainly involves chemotherapy and radiotherapy, with surgery being limited to certain cases; however, standardizing treatment is difficult due to the rarity of these tumors across institutions.
  • * In response to a higher incidence of GCTs in East Asia, the Japan Society for Neuro-Oncology developed comprehensive guidelines to aid healthcare professionals in clinical management, addressing diagnostics, treatment strategies, and long-term care for patients.
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Glioblastoma is a glioma characterized by highly malignant features. Numerous studies conducted on the relationship between glioblastoma and the microenvironment have indicated the significance of tumor-associated macrophages/microglia (TAMs) in glioblastoma progression. Since interleukin (IL)-1β secreted by TAMs has been suggested to promote glioblastoma growth, we attempted to elucidate the detailed mechanisms of IL-1β in glioblastoma growth in this study.

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