Neoplasms

Nervous System Diseases

All Conditions

Brain Neoplasms

Central Nervous System Neoplasms

Nervous System Neoplasms

Brain Diseases

Central Nervous System Diseases

Archived CNS neoplasm specimens, in which primary diagnostic studies are complete, and for which there is excess tissue for analysis in the form of unstained slides or paraffin blocks

Terri S Armstrong, C.R.N.P.

Background:

The number of people who get tumors of the brain or central nervous system (CNS) is lower than other cancers. But these tumors cause a higher rate of serious effects and even death. Researchers want to test existing samples of tissue from these tumors to learn more about them. This may lead to better treatment.

Objective:

To study stored samples of CNS tumors to learn more about the tumors and explore new ways to diagnose them.

Eligibility:

The study will use tissue samples already collected at NIH from people with brain or CNS tumors.

Design:

The participants will have given their consent in a previous study.

Researchers will review the tissue samples and any data collected about them.

Researchers will do lab tests and scans on the samples.

All data will be kept secure.

BACKGROUND

* Central Nervous System (CNS) and brain tumors are a heterogeneous group of neoplasms. They can be broadly categorized to tumors of neuroepithelial tissue, meninges, hematopoietic system, germ cells, and sella.
* The Central Brain Tumor Registry of the United States reports an overall average annual age-adjusted incidence rate for the years 2006-2010 for primary brain and CNS tumors as 21.03 per 100,000. This leads to an estimated mortality of over 13,000 deaths per year. Although this number is small compared to other more common cancers, due to the location of CNS (brain and spinal cord) tumors, they are responsible for disproportionately high morbidity and mortality among cancer patients.
* Although much progress has been made on overall understanding of CNS tumors, not much is known about mechanisms responsible for intratumoral heterogeneity, disease relapse, progression into higher grades, and in vivo invasive mechanisms. This may involve new mutations, selection of specific clones of cells by either therapeutic pressure or as part of natural tumor evolution leading to progression, microenvironmental cues or combinations.
* This study will review the molecular pathological alterations of archived human CNS tumor specimens at initial presentation and at subsequent relapse. We will request archived brain tumor tissue samples from the NCI CCR Laboratory of Pathology at multiple time points to determine the expression of cellular proteins and surrogate markers involved in growth, proliferation, differentiation, invasion, and survival of brain tumor cells. Such information will be pooled with imaging data (MRI, PET, etc.) to identify potential surrogate markers of disease resistance.
* This study has the potential to uncover key molecular events underlying disease progression and thereby contribute to the understanding of CNS tumor pathogenesis without active patient intervention.

OBJECTIVES

-To study archived specimens of CNS tumors from the NCI CCR Laboratory of Pathology to explore potential new biomarkers for diagnosis and to better understand CNS tumor pathogenesis.

ELIGIBILITY

* Diagnosis of CNS neoplasm.
* Eligible cases include those in which primary diagnostic studies are complete, and for which there is excess tissue for analysis in the form of unstained slides or paraffin blocks archived in the NCI CCR Laboratory of Pathology as well as imaging stored in the NIH medical records system.
* We also request permission to extend this analysis, as may be relevant in the future, to surplus materials to be accrued under existing NCI protocols, upon completion of all superseding diagnostic tests and medical/scientific studies.

DESIGN

* We anticipate obtaining approximately 500 archived specimens in the NCI CCR Laboratory of Pathology from patients with CNS neoplasms to analyze parameters in order to better understand the biology and pathogenesis of disease.
* To identify potential specimens, medical records of patients seen in the Neuro-Oncology and Neurosurgery Clinics will be reviewed. Additional medical records will be reviewed in order to identify archived specimens and to obtain ancillary information such as result of imaging studies.
* Existing biomarker data will be analyzed in conjunction with review of histological features and clinical data existing in laboratory and imaging data to arrive at improved criteria for diagnosis, and to recognize newly identified, as yet undescribed, disease entities. New biomarkers, as they may become available, will be utilized to improve on current diagnostic methods for disease definition.
* Tissue may be collected from pathology to be processed for specific research question at a future time point. Time of processing may be contingent on accumulating sufficient number of specimens.

Biomarker Analysis of Central Nervous System Tumors

To study archived specimens of CNS tumors from the NCI CCR Laboratory of Pathology to explore potential new biomarkers for diagnosis and to better understand CNS tumor pathogenesis.

National Cancer Institute (NCI)

Symptoms and General Pathology

Gland and Hormone Related Diseases

Diseases and Abnormalities at or Before Birth

Musculoskeletal Diseases

Blood and Lymph Conditions

Neoplasm Metastasis

Thyroid Diseases

Congenital Abnormalities

Thyroid Neoplasms

Bone Neoplasms

Bone Marrow Diseases

Neoplastic Processes

Endocrine System Diseases

Endocrine Gland Neoplasms

Head and Neck Neoplasms

Bone Diseases

Hematologic Diseases

All Drugs and Chemicals

Antibodies

Immunoglobulins

Evaluation of month and year of birth, sex, referent doctor and surgeon

Administrative data

Evaluation of diagnostic circumstances, vital status at last follow up

Clinical data

Evaluation of Pathology report of thyroid surgery

Histological data

Imaging data

Evaluation of thyroglobulin, antithyroglobulin antibodies

Biological data

Evaluation of surgery, radiotherapy, targeted therapy

Further treatment

Claire BOURNAUD, MD

Claire MARX

Bone radioiodine (RAI) uptake without structural abnormality in thyroid cancer (TC) patients may be related to false positive or to microscopic foci of metastatic tissue. In such cases, outcome is reported to be excellent.

Indeed, Robenshtok et al. reported a serie of patients with RAI-avid bone metastases of TC without structural abnormality on imaging studies who have more favorable long-term prognosis than those harbouring structurally visible bone metastases and do not undergo skeletal-related complications.

The investigators report the case of Mrs D., who had been operated for a pathologic tumor stage 3: pT3(m) poorly differentiated TC at the age of 43. The first post-therapeutic whole body scan revealed 3 foci of bone uptake (right clavicle, L2, L3). The elevated level of thyroglobulin (157ng/mL) favoured the hypothesis of bone metastases despite the absence of any structural lesion on CT and MRI. She received 7 courses of radioiodine therapy. The right clavicle RAI uptake persisted, and subsequent CT disclosed an osteolytic lesion which was treated by radiofrequency and external beam radiation. Twenty-five years after the diagnosis, she has a persistent morphological disease with a 30x8mm progressive lesion on the right clavicle, for which surgery is planned.

The aim of the present study is to describe the natural history and evolution of radioiodine avid bone metastases from thyroid cancer without structural abnormalities and to identify prognosis factors.

Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality

Radioiodine-avid Bone Metastases From Differentiated Thyroid Cancer Without Structural Abnormality, a Singular Entity With Heterogeneous Outcomes.

* Disappearance of pathologic radio iodine uptake, including bone uptake, on post-therapy scintigraphy
* No structural evidence of disease on high-resolution imaging
* Suppressed serum Tg \< 0.6 ng/mL, no detectable TgAb (thyroglobulin antibody)

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Biomarker Analysis of Central Nervous System Tumors	NCT02692898	Central Nervous... Primary Brain N... Neoplasms, Brai... Cancer of the B... Brain Cancer		- 99 Years	National Institutes of Health Clinical Center (CC)
Biomarker Analysis of Central Nervous System Tumors	NCT02692898	Central Nervous... Primary Brain N... Neoplasms, Brai... Cancer of the B... Brain Cancer		- 99 Years	National Institutes of Health Clinical Center (CC)
Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality	NCT04141306	Bone Metastases Thyroid Cancer	Administrative ... Clinical data Histological da... Imaging data Biological data Further treatme...	18 Years - 80 Years	Hospices Civils de Lyon
Radioiodine-avid Bone Metastases From Thyroid Cancer Without Structural Abnormality	NCT04141306	Bone Metastases Thyroid Cancer	Administrative ... Clinical data Histological da... Imaging data Biological data Further treatme...	18 Years - 80 Years	Hospices Civils de Lyon

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