Eli Diamond

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Daniel Cassany

Pompeu Fabra University

David Seamon

Kansas State University

Stefan Frank

Radboud University Nijmegen

Ruth Filik

University of Nottingham

Michael Shanks

Stanford University

Catherine Walter

University of Oxford

Anezka Kuzmicova

Charles University, Prague

Viacheslav Kuleshov

Stockholm University

Willy A Renandya

Nanyang Technological University

Carlo Semenza

Università degli Studi di Padova

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QOL-29. Illness Understanding and Religiousness in Patients with Recurrent Glioblastoma

Neuro-Oncology

BACKGROUND Glioblastoma (GBM) is an aggressive neurologic malignancy with invariably poor prognos... more BACKGROUND Glioblastoma (GBM) is an aggressive neurologic malignancy with invariably poor prognosis. However, there is evidence that patients with GBM often have unrealistic perceptions of their prognosis. Strong religious beliefs have been shown to be associated with limited illness understanding (IU) in patients with advanced cancer, but IU and religiousness have not been investigated in patients with GBM. METHODS Patients enrolled in a prospective multi-center study of recurrent GBM (Coping with Glioblastoma; NCT02375841) completed surveys after a clinical encounter with their oncologist revealing GBM progression. Psychometrically validated measures assessed parameters of IU and religiousness. IU was compared between participants with at least a moderate or high degree of religiousness (vs. not) using Fishers-exact test. RESULTS Twenty-four adult patients (median age 57) completed surveys. Fifteen (63%) identified their illness as terminal. Six patients (25%) correctly identified...

CTNI-07. Phase I Study of Paxalisib and Radiotherapy for CNS Disease Harboring PI3K Pathway Mutations: Pilot Analysis of Circulating Tumor Dna for Patient Eligibility Confirmation and Post-Treatment Response

Neuro-Oncology

INTRODUCTION Radiotherapy (RT) is effective for brain metastases (BM) or leptomeningeal disease (... more INTRODUCTION Radiotherapy (RT) is effective for brain metastases (BM) or leptomeningeal disease (LMD), but disease control is poor for tumors harboring PI3K pathway alterations (PI3Kalt). We hypothesized that combining RT with paxalisib, a CNS-penetrant PI3K/mTOR inhibitor, offers therapeutic synergy. The role of plasma circulating tumor DNA (ctDNA) to confirm study eligibility and response monitoring is unclear. METHODS This is a multi-institutional, phase I trial of concurrent paxalisib and whole brain RT (30 Gy in 10 fractions, NCT04192981) for CNS disease. To establish eligibility, patients had documented PI3Kalt performed using institutional tumor targeted sequencing (MSK-IMPACT) of primary or metastatic tumors (eligibility sequencing). Plasma ctDNA was collected at baseline and 3-, 6- and 9-months post-treatment and sequenced using institutional plasma ctDNA targeted sequencing platform (MSK-ACCESS). Our objectives were to a) determine PI3Kalt concordance between eligibility s...

P1105: Neurologic Involvement in Adults with Rosai-Dorfman Disease: Clinical Presentation and Outcomes

HemaSphere

“For There Are Gods Here Too”

Aristotle on Human Nature

Neuroinflammatory Disease Responsive to MEK-Inhibitor

Neurology

Objective Illustrate that some neuroinflammatory diseases may respond best to antiproliferative t... more Objective Illustrate that some neuroinflammatory diseases may respond best to antiproliferative therapies rather than immunomodulatory therapies. Background Genomics are increasingly employed in the diagnostic armamentarium of refractory neuro-inflammatory diseases. Metagenomic next-generation sequencing is used to detect pathogens and germline genetic testing is used to detect inborn errors of the immune system. Genetic testing of tissue can identify somatic mutations for targeted treatment. MEK-inhibitors are an emerging treatment for RAS/MAPK pathway mutated diseases which include some neuro-inflammatory mimics like neuro-histiocytoses. Design/Methods NA. Results Previously healthy 12-year-old girl presented with 1 month of diplopia and headaches. Her brother has clinically diagnosed NF1 (café-au-lait macules, cutaneous neurofibromas). Exam notable for right third nerve palsy. MRI showed T2/FLAIR hyperintense lesions of the right temporal lobe, basal ganglia, and cervical through...

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