The incidence rate of both benign and malignant primary central nervous system (CNS) tumors is 18.16 per 100,000 person-years in the general population. The incidence of primary CNS tumors is highest among those 75 to 84 years old (63.75 per 100,000 person-years). In addition, as the elderly segment of the general population grows faster than any other age group, the number of primary brain tumors in older adults is expected to increase. Certain tumor histologies are especially common in older adults;for example, the incidence of glioblastomas, anaplastic astrocytomas, and primary CNS lymphoma (PCNSL) peaks in the seventh decade, and the incidence of meningiomas rises steadily with age. Several factors make the treatment of CNS tumors in the elderly unique. Poor overall health status, the presence of multiple comorbidities, and polypharmacy may pose a significant challenge in managing older patients with brain tumors. In addition, advanced age is a well-known prognostic factor associated with worse survival when adjusted for histologic diagnosis and tumor grade. Finally, elderly patients are underrepresented in clinical trials because of study-imposed restrictions, coexisting conditions, concern about the toxic effects of treatment, or the reluctance of physicians to enroll elderly patients in these trials. Our project objectives are: 1) to devise better ways to assess prognosis in patients with glioblastomas;2) to evaluate patterns of care of elderly patients with CNS tumors in the SEER-Medicare database;3) to evaluate underlying molecular and neuroimaging differences between younger and older patients with gliomas (in collaboration with Howard Fine's group).

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Investigator-Initiated Intramural Research Projects (ZIA)
Project #
1ZIABC011348-01
Application #
8157784
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
2010
Total Cost
$125,936
Indirect Cost
Name
National Cancer Institute Division of Basic Sciences
Department
Type
DUNS #
City
State
Country
Zip Code
Scott, Jacob G; Bauchet, Luc; Fraum, Tyler J et al. (2012) Recursive partitioning analysis of prognostic factors for glioblastoma patients aged 70 years or older. Cancer 118:5595-600
Lehky, T J; Iwamoto, F M; Kreisl, T N et al. (2011) Neuromuscular junction toxicity with tandutinib induces a myasthenic-like syndrome. Neurology 76:236-41
Iwamoto, Fabio M; Hottinger, Andreas F; Karimi, Sasan et al. (2011) Serum YKL-40 is a marker of prognosis and disease status in high-grade gliomas. Neuro Oncol 13:1244-51
Fraum, Tyler J; Kreisl, Teri N; Sul, Joohee et al. (2011) Ischemic stroke and intracranial hemorrhage in glioma patients on antiangiogenic therapy. J Neurooncol 105:281-9
Kreisl, Teri N; Zhang, Weiting; Odia, Yazmin et al. (2011) A phase II trial of single-agent bevacizumab in patients with recurrent anaplastic glioma. Neuro Oncol 13:1143-50
Ballangrud, Ase M; Lymberis, Stella; Thakur, Sunitha B et al. (2011) Magnetic resonance spectroscopy imaging in radiotherapy planning for recurrent glioma. Med Phys 38:2724-30
Iwamoto, Fabio M; Hottinger, Andreas F; Karimi, Sasan et al. (2011) Longitudinal prospective study of matrix metalloproteinase-9 as a serum marker in gliomas. J Neurooncol 105:607-12
Iwamoto, Fabio M; Lamborn, Kathleen R; Kuhn, John G et al. (2011) A phase I/II trial of the histone deacetylase inhibitor romidepsin for adults with recurrent malignant glioma: North American Brain Tumor Consortium Study 03-03. Neuro Oncol 13:509-16
Lassman, Andrew B; Iwamoto, Fabio M; Cloughesy, Timothy F et al. (2011) International retrospective study of over 1000 adults with anaplastic oligodendroglial tumors. Neuro Oncol 13:649-59
Hottinger, Andreas F; Iwamoto, Fabio M; Karimi, Sasan et al. (2011) YKL-40 and MMP-9 as serum markers for patients with primary central nervous system lymphoma. Ann Neurol 70:163-9

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