Neuro-Oncology&nbsp;&nbsp;&nbsp;

For patients with newly diagnosed brain metastases without a history of seizure activity, do you routinely start anti-seizure medication?

If so, how long do you continue medication and when do you discontinue? Does treatment with surgical resection versus radiation alone change your mana...

How do different inflammatory markers like CRP and ferritin contribute differently, if at all, to the monitoring of CART neurotoxicity?

What workup do you consider for a developmentally typical child with multiple large café au lait macules but no other signs of neurofibromatosis?

What is the expected timeframe for the development of radiation myelitis and therapies that have helped with neurologic symptoms?

How would you manage a patient less than 40 years old with an incidentally found LGG, IDH mutated, 1p19q intact, s/p STR?

Would you offer radiation and chemotherapy, vorasidenib, or observation?

Would you consider combining tovorafenib and trametinib as dual therapy?

3 Answers available

In pediatric patients with low-grade gliomas showing prolonged response or stable disease on tovorafenib, how would you adjust the duration of therapy?

Are there specific safety concerns or long-term risks that should be accounted for when considering drug holidays or overall treatment duration?

Based on the FIREFLY-1 data, would you consider using tovorafenib monotherapy front-line in pediatric patients who have low grade gliomas that are only amenable to subtotal resection or are unresectable?

What was the rationale behind using RANO-HGG criteria instead of RAPNO criteria for the primary endpoint in the FIREFLY-1 trial for pLGG?

How will you implement response assessments in patients starting tovorafenib given potential for pseudoprogression vs true progression?

How has the recent FDA approval of tovorafenib impacted your treatment decisions for pediatric patients with relapsed/refractory low-grade glioma?

Is it merely another option to try or will it become the standard choice for patients experiencing relapsed/refractory disease?

Would you offer adjuvant radiation therapy in a young adult with NF1 who has a craniopharyngioma s/p STR?

Tumor measures 4 cm after STR. Is NF1 a contraindication for adjuvant RT?

What approach do you use when treating adult diffuse gliomas with H3-G34 mutations, now classified into their own category under the 2021 glioma guidelines?

Do you treat this similarly to IDH-Wildtype GBM with the STUPP regimen? Is there any role of less-intensive paradigms, such as 59.4 Gy/33 fx?

How do you approach treatment of sub-total resected ZFTA fusion ependymoma after radiation therapy in a young adult?

Do you recommend adjuvant chemotherapy after radiation treatment?

How would you approach treatment in a patient with Fanconi anemia and glioblastoma?

When would you consider radiation therapy for an optic pathway glioma in a pediatric patient?

Do you recommend adjuvant radiotherapy for an adult patient with localized myxopapillary ependymoma, WHO Grade 2, status-post gross total resection?

How do you manage incidentally identified pituitary lesions on brain imaging?

What workup do you typically recommend?

How do you manage symptomatic radiation necrosis not responsive to steroids?

How do you choose between Avastin, hyperbaric O2 and other therapies?

How do you manage a pediatric patient less than 3 years old with first relapse of medulloblastoma?

Why do we use dexamethasone for CNS edema and prednisone for pneumonitis?

Is this an artifact of what agent prior clinical trials used or something to do with the mechanism of action (i.e., less mineralocorticoid effect of d...

What are some alternatives to dexamethasone for brain edema in patients who are allergic, have an intolerance, or refuse the medication?

5 Answers available

How would you treat an essential-like tremor secondary to tumor (e.g. glioma)?

Is your approach different than that to a primary essential tremor?

What would your next line treatment be for a patient previously treated with repeat resection, craniospinal irradiation, and initial cisplatin/vincristine/CCNU with medulloblastoma?

What would be your next treatment for a young adult patient with medulloblastoma refractory to repeat resection, craniospinal irradiation, and initial...

How do you manage AEDs in patients with malignant brain tumors?

Do you ever add prophylactic Keppra (levetiracetam) for glioblastoma patients without a seizure history based on data such as this study (nature.com) ...

5 Answers available

Should all pediatric CNS cases be referred to a proton center?

If not, how should you select those cases that should be referred?

How do you treat a primary pineal neoplasm of intermediate differentiation?

Would extent of surgical resection matter? Do these patients need CSI (like Pineoblastoma), just local radiation, or something in-between (say whole ...

How do you approach treatment of a glioblastoma in pregnancy?

3 Answers available

Is placing a VP shunt a major risk to spread medulloblastoma or other malignant brain tumors into the gut?

Should special precautions be taken patients with Ehlers-Danlos syndrome receiving radiation therapy?

Would you have reservations in treating patients with breast, GI, or pelvic malignancies with radiation alone or concurrent chemoradiation?

How would you manage an unresectable central meningioma in a young patient with evidence of mild compression on the optic nerve and 4th ventricle involvement?

Should adjuvant maintenance chemotherapy be provided to children with anaplastic ependymoma following radiation therapy?

Utility of maintenance chemotherapy per ACNS0831 in patients with anaplastic ependymoma

What treatment approach do you take in a pediatric patient less than 3 years old with malignant papillary epithelioid tumor within the pineal region?

When do you offer hyperbaric oxygen therapy to a pediatric brain tumor patient with radiation injury/necrosis?

How do you approach treatment in an infant with metastatic atypical teratoid/rhabdoid tumor (ATRT) of the brain?

When would you consider obtaining tumor tissue in NF-1 associated pediatric low grade glioma?

What is the role for adjuvant monoclonal antibody therapy with radiation for diffuse intrinsic pontine glioma?

Discuss the role of mAb in DIPG.

What treatment would you offer a young pregnant woman with a symptomatic midline low grade glioma?

Discussion of treatment options for midline low-grade glioma causing life-altering symptoms in a pregnant patient to avoid teratogenicity.

What neoadjuvant, adjuvant chemotherapy regimen or targeted therapy can be used in paediatric patients with pelvic peripheral medulloepithelioma?

Do you use hippocampal avoidance techniques when delivering PCI for high-risk leukemia?

What is your preferred adjuvant chemotherapy for a pediatric patient less than 1 year old who had a gross total resection of a localized intracranial ependymoma, and will not be receiving radiation therapy due to his/her young age?

What treatment do you offer to a pediatric patient with an optic pathway glioma with a BRAFV600E mutation who progressed despite receiving conventional chemotherapy, BRAF/MEK inhibitors, and radiation therapy?

Should post-op RT be delayed for children < 3yo after a GTR resection for a posterior fossa or supratentorial ependymoma?

What is your approach when it comes to reirradiation for DIPG patients who have already received 54Gy upfront?

Is there a role for hyperbaric oxygen treatment concurrent with radiotherapy in the treatment of pediatric glioblastoma?

What is the value and potential morbidity of second look surgery in patients with sub-totally resected ependymoma?