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18 results on '"Freret, Morgan E."'

12. Assessment and Treatment Outcomes of Persistent Radiation-Induced Alopecia in Patients With Cancer

Author

Phillips, Gregory S., primary, Freret, Morgan E., additional, Friedman, Danielle Novetsky, additional, Trelles, Sabrina, additional, Kukoyi, Oluwaseun, additional, Freites-Martinez, Azael, additional, Unger, Robin H., additional, Disa, Joseph J., additional, Wexler, Leonard H., additional, Tinkle, Christopher L., additional, Mechalakos, James G., additional, Dusza, Stephen W., additional, Beal, Kathryn, additional, Wolden, Suzanne L., additional, and Lacouture, Mario E., additional

Published
2020
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13. The anatomic basis of leptomeningeal metastasis

Author

Freret, Morgan E. and Boire, Adrienne

Abstract

Leptomeningeal metastasis (LM), or spread of cancer to the cerebrospinal fluid (CSF)–filled space surrounding the central nervous system, is a fatal complication of cancer. Entry into this space poses an anatomical challenge for cancer cells; movement of cells between the blood and CSF is tightly regulated by the blood–CSF barriers. Anatomical understanding of the leptomeninges provides a roadmap of corridors for cancer entry. This Review describes the anatomy of the leptomeninges and routes of cancer spread to the CSF. Granular understanding of LM by route of entry may inform strategies for novel diagnostic and preventive strategies as well as therapies.

Published
2024
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17. Understanding Vision Loss from Optic Pathway Glioma in Neurofibromatosis Type 1

Author

Freret, Morgan E. and Gutmann, David H.

Subjects
musculoskeletal diseases, Optic Nerve Glioma, congenital, hereditary, and neonatal diseases and abnormalities, Evidence-Based Medicine, Neurofibromatosis 1, Optic Nerve Neoplasms, eye diseases, Article, nervous system diseases, Practice Guidelines as Topic, Humans, Visual Pathways, Child, neoplasms
Abstract

Neurofibromatosis type 1 (NF1) is a common cancer predisposition syndrome caused by mutations in the NF1 gene. The NF1-encoded protein (neurofibromin) functions as an inhibitor of RAS to control cell growth and survival. Individuals with NF1 are prone to developing low-grade tumors of the optic nerves, chiasm, tracts, and radiations, termed optic pathway gliomas (OPGs), which can cause vision loss. A paucity of surgical tumor specimens and patient-derived xenografts for investigative studies has limited our understanding of human NF1-associated OPG (NF1-OPG). However, mice genetically engineered to harbor Nf1 gene mutations develop optic gliomas that share many features of their human counterparts. These genetically engineered mouse (GEM) strains have provided important insights into the cellular and molecular determinants that underlie mouse Nf1 optic glioma development, maintenance, and associated vision loss, with relevance to human NF1-OPG disease. Herein, we review our current understanding of NF1-OPG pathobiology and describe the mechanisms responsible for tumor initiation, growth, and associated vision loss in Nf1 GEM models. We also discuss how Nf1 GEM strains and other preclinical models can be deployed to identify and evaluate molecularly targeted therapies for OPG, particularly as they pertain to future strategies aimed at preventing or improving tumor-associated vision loss in children with NF1.

Published
2007

18. Early Detection of Leptomeningeal Metastases Among Patients Undergoing Spinal Stereotactic Radiosurgery.

Author

Freret ME, Wijetunga NA, Shamseddine AA, Higginson DS, Schmitt AM, Yamada Y, Lis E, Boire A, Yang JT, and Xu AJ

Abstract

Purpose: The management of patients with advanced solid malignancies increasingly uses stereotactic body radiation therapy (SBRT). Advanced cancer patients are at risk for developing leptomeningeal metastasis (LM), a fatal complication of metastatic cancer. Cerebrospinal fluid (CSF) is routinely collected during computed tomography (CT) myelography for spinal SBRT planning, offering an opportunity for early LM detection by CSF cytology in the absence of radiographic LM or LM symptoms (subclinical LM). This study tested the hypothesis that early detection of tumor cells in CSF in patients undergoing spine SBRT portends a similarly poor prognosis compared with clinically overt LM., Methods and Materials: We retrospectively analyzed clinical records for 495 patients with metastatic solid tumors who underwent CT myelography for spinal SBRT planning at a single institution from 2014 to 2019., Results: Among patients planned for SBRT, 51 (10.3%) developed LM. Eight patients (1.6%) had subclinical LM. Median survival with LM was similar between patients with subclinical versus clinically evident LM (3.6 vs 3.0 months, P  = .30). Patients harboring both parenchymal brain metastases and LM (29/51) demonstrated shorter survival than those with LM alone (2.4 vs 7.1 months, P  = .02)., Conclusions: LM remains a fatal complication of metastatic cancer. Subclinical LM detected by CSF cytology in spine SBRT patients has a similarly poor prognosis compared with standardly detected LM and warrants consideration of central nervous system-directed therapies. As aggressive local therapies are increasingly used for metastatic patients, more sensitive CSF evaluation may further identify patients with subclinical LM and should be evaluated prospectively., (© 2022 The Authors.)

Published
2022
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