A5102869170- Glioma Diagnosis and Treatment
- Immune cells in cancer
- Radiomics and Machine Learning in Medical Imaging
- Neuroinflammation and Neurodegeneration Mechanisms
- Ferroptosis and cancer prognosis
- Cancer Treatment and Pharmacology
- Meningioma and schwannoma management
- Computational Drug Discovery Methods
- Science, Research, and Medicine
- Advanced MRI Techniques and Applications
- Health Systems, Economic Evaluations, Quality of Life
- Statistical Methods in Clinical Trials
- Biosimilars and Bioanalytical Methods
- MicroRNA in disease regulation
- Inflammatory Biomarkers in Disease Prognosis
- Biomedical Ethics and Regulation
- Extracellular vesicles in disease
- Functional Brain Connectivity Studies
- Epigenetics and DNA Methylation
Neurological Surgery
2018-2024
University of California, San Francisco
2018-2024
City College of San Francisco
2023
Abstract Background Tumor-based classification of human glioma portends patient prognosis, but considerable unexplained survival variability remains. Host factors (eg, age) also strongly influence times, partly reflecting a compromised immune system. How blood epigenetic measures characteristics and age augment molecular classifications in has not been investigated. We assess the prognostic impact cell fractions archived across subtypes for first time. Methods evaluated from University...
Abstract BACKGROUND Gliomas are often in close proximity to functional regions of the brain; therefore, electrocortical stimulation (ECS) mapping is a common technique utilized during glioma resection identify areas. Stimulation-induced seizure (SIS) remains most reason for aborted procedures. Few studies have focused on oncological factors impacting cortical thresholds. OBJECTIVE To examine thought impact threshold order understand whether linear relationship exists between current and...
Abstract Introduction: Despite the enactment of 1993 NIH Revitalization Act to improve accrual women and minorities in clinical trials, these groups remain underrepresented. This study aims uncover drivers therapeutic trial enrollment that are unique minority patients with low- high-grade glioma. Methods: Adult glioma who received care from UCSF Brain Tumor Center between 1997-2017 were identified a prospective registry. Dividing cohort into subgroups by gender NIH-designated status, factors...
1614 Background: Despite the unique ability of machine learning (ML) techniques to uncover complex interactive effects in datasets, studies exploring predictors clinical trial enrollment have largely used standard statistical methods discern associations. Furthermore, there been limited applications ML close existing disparities underrepresented patients neuro-oncology. This study aims use supervised define and validate primary contributors therapeutic for a) all patients, b) women c)...
Abstract BACKGROUND Despite changes in national policy, women and minority patients remain under-accrued glioma clinical trials. Supervised machine learning may serve as a novel approach to understanding which variables their complex interplay most influence enrollment for underrepresented patients. We aimed design externally validate models predict therapeutic trial a) all patients, b) women, c) NIH-designated with low- high-grade glioma. METHODS In 20-year retrospective cohort of 1042...
Abstract Background Variations in survival among patients with oligodendroglioma are unexplained by known prognostic factors. To assess the impact of peripheral immune profiles on prognosis, we applied immunomethylomics analyses—DNA methylation archived whole blood samples, to characterize cells. Methods We compared proportions cells from other glioma subtypes and controls. used recursive partitioning analysis (RPA) within oligodendrogliomas correlate survival. Results Patients (141) were...
Abstract BACKGROUND Non-invasive determination of IDH mutational status in patients with glioma could offer significant therapeutic opportunities. While wildtype (WT) tumors typically show enhancement on MRI, mutant (MUT) often lack this enhancement. However, relying solely anatomic radiology may lead to misclassification, and currently, tissue acquisition is the primary method for assessing IDH-status gliomas. These limitations hamper development neoadjuvant or intraoperative strategies...
Abstract BACKGROUND Though patients with oligodendroglioma have improved outcomes versus astrocytomas, there remains marked variability in their survival experience that is unexplained by known prognostic factors. Immunomethylomics uses DNA methylation as a substitute for flow cytometry to characterize immune cells whole blood. METHODS We applied immunomethylomics archived blood samples from enrolled the UCSF Adult Glioma Study including oligodendrogliomas (141); other adult diffuse glioma...
Abstract Immune dysregulation is a known characteristic of glioma, however there little about the peripheral immune status lower-grade (LrGG) glioma patients across course disease. Using immunomethylomic (deconvoluted blood DNA methylation) data from UCSF Profiles Study, we explore changes in patient cell profiles newly diagnosed and recurrent LrGG patients. For receiving radiation (RT) temozolomide (TMZ) (n = 75), collected pre-RT/TMZ, post-RT/TMZ, before, during, after adjuvant TMZ (if...
Glioma patients demonstrate abnormalities in peripheral blood leukocytes that have been associated with survival time. Here we assessed immune cell profiles archival samples obtained 5–25 years ago using a novel epigenetic approach called immunomethylomics. We first validated the to measure proportions of CD4 T cells, CD8 B NK neutrophils, and monocytes new 850,000 feature EPIC Illumina methylation bead array. The immunomethylomic assay was shown match performance multiparametric flow...
Although the overall prognostic significance of maximal surgical resection contrast-enhancing tumor in glioblastoma patients is well established, prior studies have not evaluated combined importance resection, molecular markers, patient characteristics, and chemoradiation. Incorporation these factors may redefine relative benefit cytoreductive surgery establish differing thresholds for extent varying clinical presentations. In first study its kind, we examine interactive effects volumetric...
Abstract Changes in glioma patients’ immune profiles over the course of disease may predict outcomes. DNA based immunomethylomics quantifies blood cells on cell specific methylation signatures. To assess changes profiles, we are longitudinally collecting samples from patients pre-surgery and at other clinically relevant time points. Here report profiles. All underwent biopsy or resection a presumed new recurrent lower grade glioma. Blood was assessed with Illumina EPIC arrays. Relative...
Abstract Lineage-specific DNA methylation marks differentiate leukocyte cell types while individual biological aging mechanisms impact other alterations. Human glioma incidence and survival times have been shown to be associated with aberrant immune profiles a strong dependency on age. Here we developed single epigenetic analysis framework evaluate both fractions age in peripheral blood. We examined these measures archived blood from 197 triple-negative patients (TNG; IDH wildtype, 1p19q...
Abstract BACKGROUND The overall prognostic significance of maximal surgical resection in patients with diffuse low-grade glioma has been well established. Nonetheless, prior studies omit the combined importance molecular subclass, patient characteristics, and chemoradiation. Similar to findings recently published newly diagnosed glioblastoma, incorporation these interactive factors may redefine relative benefit cytoreductive surgery. METHODS We examine effects volumetric extent clinical...
Abstract BACKGROUND The prognostic importance of maximal resection contrast enhancing and non-contrast disease has been established. Nonetheless, glioblastomas exist within the framework complex neural circuitry serving cognition, movement, behavior consequential leading to neurological impairments. impairments on survival remains poorly understood. METHODS This is a retrospective, single cohort study from UCSF including 316 eligible patients diagnosed over 20 years with 9.6 follow-up. All...