Citations

Abstract Glioblastoma is the most common type of malignant primary brain tumor and a major cause of morbidity and mortality. In 2021, the World Health Organization updated the classification of Central Nervous System (CNS) tumors to restrict glioblastomas to isocitrate dehydrogenase-wildtype (IDHwt) tumors, improving understanding of the prognosis and optimal therapy for these tumors. This revision also enables more homogeneous populations of patients to be enrolled in clinical trials, facilitating the evaluation of novel therapies. In this updated consensus review from the Society for Neuro-Oncology (SNO) and the European Association of Neuro-Oncology (EANO), the current management of patients with glioblastoma is discussed. In addition, novel therapies such as immunotherapies, viral therapies, targeted molecular therapies, theranostics, and antibody–drug conjugates will be reviewed, as well as the current challenges and future directions for research.

Abstract Background Loperamide is a µ-opioid receptor agonist that reduces intestinal peristalsis and is used to treat diarrhea. We previously described significant cross-reactivity of loperamide with 2 fentanyl immunoassays. Since then, new fentanyl immunoassays, including a CLIA-waived point-of-care device, have been approved for clinical use. Methods We evaluated new fentanyl immunoassays for cross-reactivity to loperamide and its major metabolites, N-desmethyl loperamide (dLop) and N-didesmethyl loperamide (ddLop). Previously characterized assays were tested for cross-reactivity to ddLop, which recently became commercially available. Loperamide, dLop, and ddLop were spiked in drug-free urine for analysis by 5 enzyme immunoassays run on automated chemistry analyzers and one lateral flow assay for the detection of fentanyl. Results Loperamide and its metabolites produced positive results in 3 fentanyl immunoassays. The Immunalysis HEIA was previously determined to be reactive to both loperamide and dLop, but it was not reactive to ddLop. The Immunalysis SEFRIA was reactive to loperamide, dLop, and ddLop at minimum concentrations of 14.7 mg/L, 13.1 mg/L, and 17.0 mg/L. The Thermo Fisher DRI was previously determined to be reactive to loperamide and dLop, and it was reactive to ddLop at a minimum concentration of 33.1 mg/L. The Abbott iCassette, ARK Fentanyl II, and Lin-Zhi LZI II fentanyl assays showed no cross-reactivity to loperamide or its metabolites. Conclusions The cross-reactivity of loperamide, dLop, and ddLop in several fentanyl immunoassays has the potential to cause false-positive results during urine drug screening.

ABSTRACT Background Multimodality therapy incorporating a combination of cytoreductive surgery (CRS), intraperitoneal (IP) and systemic therapy continues to evolve for peritoneal carcinomatosis (PC) However, treatment and outcomes vary depending on tumor of origin. Aims To develop Appropriate Use Criteria (AUC) guidelines to facilitate treatment decision‐making for patients with PC based on available evidence. Materials and Methods The American Radium Society (ARS) multidisciplinary expert panel performed a comprehensive systematic review. Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) methodology was used. These studies were used to inform the expert panel, which then rated the appropriateness of various treatments in seven representative clinical scenarios through a well‐established modified Delphi consensus methodology. Results Treatment of PC is often treated with a combination of CRS and IP ± systemic chemotherapy but specific recommendations exist for different tumor types and outcomes vary. Discussion Treatment of PC is complex and varies depending on origin of primary tumor and extent of disease. These AUC assist in patient and treatment selection for different clinical scenarios. Conclusion A summary of recommendations is outlined to guide practitioners on the management of PC from different tumor origins.