Tag: Treatment response

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Dynamic Tumor in Situ Fluid Circulating Tumor DNA Postsurgery Effectively Predicts Recurrence and Clinical Benefits for Glioblastomas

Neurosurgery 97:671–680, 2025

Dynamic monitoring of tumor in situ fluid circulating tumor DNA (TISF-ctDNA) after glioblastoma surgery predicts recurrence earlier than imaging, effectively identifies molecular residual disease, and serves as a robust prognostic biomarker. TISF-ctDNA status guides treatment response assessment and may enable more personalized, timely interventions for GBM patients.

• TISF-ctDNA (tumor in situ fluid circulating tumor DNA) is a promising biomarker for monitoring molecular residual disease (MRD) and recurrence in glioblastoma (GBM) patients after surgery.

• In a prospective study of 37 GBM patients, TISF-ctDNA positivity after surgery was detected in 62.2% of cases and predicted a higher risk of recurrence and shorter progression-free survival (PFS).

• TISF-ctDNA positivity preceded imaging-detected recurrence by a median of 71 days, allowing for earlier intervention.

• Conversion from TISF-ctDNA positive to negative during adjuvant therapy was associated with improved overall survival.

• TISF-ctDNA showed high sensitivity (86.2%) and specificity (100%) in detecting postsurgical MRD recurrence.

• Common tumor gene mutations (EGFR, TP53, PTEN, NF1) did not significantly impact prognosis in this cohort.

• TISF-ctDNA monitoring is less effective for detecting distant tumor recurrences.

• The study supports TISF-ctDNA as an early, noninvasive tool for personalized GBM management, though larger studies are needed for validation.

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The Impact of Early Corticosteroid Pretreatment Before Initiation of Chemotherapy in Patients With Primary Central Nervous System Lymphoma

Neurosurgery, Volume 85, Issue 2, August 2019, Pages 264–272

The optimal timing of corticosteroid (CS) treatment in patients with primary central nervous system (CNS) lymphoma (PCNSL) remains controversial. While poor clinical presentation may justify early treatment with CS, this may ultimately result in reduced concentrations of chemotherapeutic agents via perturbations in the permeability of the blood-brain barrier.

OBJECTIVE: To investigate whether early CS exposure is associated with beneficial outcomes and/or reduced occurrence of adverse events as opposed to delayed/concomitant administration.

METHODS: Herein we performed a retrospective observational analysis using patients that were prospectively entered into a database. All patients whom were admitted to the University Hospital between 2009 and 2015 with newly diagnosed PCNSL were included within our study.

RESULTS: Our cohort included 50 consecutive patients diagnosed with PCNSL; of these, in 30 patients CS administration was initiated prior to chemotherapy (early), whilst in the remaining 20 patientsCS administrationwas initiated concomitantly with their chemotherapeutic regimen (concomitant).Within the early vs concomitant CS administration groups, no significant differences were observed with regard to progression-free survival (PFS) (P=.81), overall survival (OS) (P=.75), or remission (P=.68; odds ratio 0.76 and confidence interval [95%] 0.22-2.71). Critically, the timing of CS initiation was not associated with either PFS (P = .81) or PFS (P = .75).

CONCLUSION: Early CS administration was not associated with a deterioration in response to chemotherapy, PFS, or OS. As such, administration of CS prior to initiation of chemotherapy is both reasonable and safe for patients with newly diagnosed PCNSL

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