Skip to main content

Neurosurgical involvement in clinical trials for CNS tumors

Abstract

Introduction

Most clinical trials in neurooncology are led by investigators primarily trained in neurology or medical oncology. While neurosurgeons are trained to be problem-solvers and innovators, research training has historically been focused on laboratory-based discovery approaches and formalized training in prospective clinical trials research is not part of routine graduate training.

Methods

We reviewed literature that demonstrates that innovation and problem-solving are integral to the practice of neurosurgery cite multiple examples of advances in technique and technology that may have had an empirical origin but that led to prospective clinical trials resulting in change in practice.

Results

Neurosurgeons have developed and led both traditional (clinical outcome-oriented) and translational prospective clinical trials that have evaluated the best use of currently available therapeutics or tested the ability of novel therapeutics to alter the biology and/or course of disease.

Conclusions

In this review, we focus on a number of the recently developed technologies and therapeutics that were evaluated in clinical trials led or co-led by neurosurgeons. We also highlight some of the barriers that need to be addressed in order to foster neurosurgical participation and leadership in the prospective development of novel therapeutics.

This is a preview of subscription content, access via your institution.

References

  1. Prada F, Perin A, Martegani A, Aiani L, Solbiati L, Lamperti M, Casali C, Legnani F, Mattei L, Saladino A, Saini M, DiMeco F (2014) Intraoperative contrast-enhanced ultrasound for brain tumor surgery. Neurosurgery 74(5):542–552

    Article  Google Scholar 

  2. Black PM, Moriarty T, Alexander E 3rd, Stieg P, Woodard EJ, Gleason PL, Martin CH, Kikinis R, Schwartz RB, Jolesz FA (1997) Development and implementation of intraoperative magnetic resonance imaging and its neurosurgical applications. Neurosurgery 41:831–842. https://doi.org/10.1097/00006123-199710000-00013; discussion 842–835

    CAS  Article  PubMed  Google Scholar 

  3. Claus EB (2007) Survival rates in patients with low-grade glioma after intraoperative magnetic resonance image guidance. Cancer 103(6):1227–1233

    Article  Google Scholar 

  4. Senft C, Bink A, Franz K, Vatter H, Gasser T, Seifert V (2011) Intraoperative MRI guideance and extent of resection in glioma surgery: a randomised, controlled trial. Lancet Oncol 12(11):997–1003

    Article  Google Scholar 

  5. Stummer W (2006) Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial. Lancet Oncol 7(5):392–401

    CAS  Article  Google Scholar 

  6. Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC, Werner-Wasik M, Demas W, Ryu J, Bahary J-P, Souhami L, Rotman M, Mehta MP, Curran WJ (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363:1665–1672. https://doi.org/10.1016/s0140-6736(04)16250-8

    Article  PubMed  Google Scholar 

  7. Brown PDJK, Ballman KV, Farace E, Cerhan JH, Anderson SK, Carrero XW, Barker FG 2nd, Deming R, Burri SH, Ménard C, Chung C, Stieber VW, Pollock BE, Galanis E, Buckner J, Asher A (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA 316(4):401–409

    Article  Google Scholar 

  8. Asher AL, Wiggins WF, Kelly RP, Boltes MO, Mehrlich M, Norton HJ, Fraser RW (2014) A new treatment paradigm: neoadjuvant radiosurgery before surgical resection of brain metastases with analysis of local tumor recurrence. Int J Radiat Oncol Biol Phys 88(4):899–906

    Article  Google Scholar 

  9. Sloan AE, Ahluwalia MS, Valerio-Pascua J, Manjila S, Torchia MG, Jones SE, Sunshine JL, Phillips M, Griswold MA, Clampitt M, Brewer C, Jochum J, McGraw MV, Diorio D, Ditz G, Barnett GH (2013) Results of the NeuroBlate System first-in-humans Phase I clinical trial for recurrent glioblastoma: clinical article. J Neurosurg 118:1202–1219. https://doi.org/10.3171/2013.1.JNS1291

    Article  PubMed  Google Scholar 

  10. Alkins RD, Mainprize TG (2018) High-intensity focused ultrasound ablation therapy of gliomas. Prog Neurol Surg 32:39–47. https://doi.org/10.1159/000469678

    Article  PubMed  Google Scholar 

  11. Brem H, Mahaley MS Jr, Vick NA, Black KL, Schold SC Jr, Burger PC, Friedman AH, Ciric IS, Eller TW, Cozzens JW, Kenealy JN (1991) Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas. J Neurosurg 74:441–446

    CAS  Article  Google Scholar 

  12. Brem H, Piantadosi S, Burger PC, Walker M, Selker R, Vick NA, Black K, Sisti M, Brem S, Mohr G et al (1995) Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 345:1008–1012

    CAS  Article  Google Scholar 

  13. Westphal M, Hilt D, Bortey E, Delavault P, Olivares R, Warnke P, Whittle I, Jaaskelainen J, Ram Z (2003) A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro-Oncology 5:79–88

    CAS  Article  Google Scholar 

  14. Ram Z, Culver KW, Oshiro EM, Viola JJ, DeVroom HL, Otto E, Long Z, Chiang Y, McGarrity GJ, Muul LM, Katz D, Blaese RM, Oldfield EH (1997) Therapy of malignant brain tumors by intratumoral implantation of retroviral vector-producing cells. Nat Med 3:1354–1361

    CAS  Article  Google Scholar 

  15. Culver KW, Ram Z, Wallbridge S, Ishii H, Oldfield EH, Blaese RM (1992) In vivo gene transfer with retroviral vector-producer cells for treatment of experimental brain tumors. Science 256:1550–1552

    CAS  Article  Google Scholar 

  16. Degen JW, Walbridge S, Vortmeyer AO, Oldfield EH, Lonser RR (2003) Safety and efficacy of convection-enhanced delivery of gemcitabine or carboplatin in a malignant glioma model in rats. J Neurosurg 99:893–898. https://doi.org/10.3171/jns.2003.99.5.0893

    CAS  Article  PubMed  Google Scholar 

  17. Murad GJ, Walbridge S, Morrison PF, Garmestani K, Degen JW, Brechbiel MW, Oldfield EH, Lonser RR (2006) Real-time, image-guided, convection-enhanced delivery of interleukin 13 bound to pseudomonas exotoxin. Clin Cancer Res 12:3145–3151. https://doi.org/10.1158/1078-0432.CCR-05-2583

    CAS  Article  PubMed  Google Scholar 

  18. Parney IF, Kunwar S, McDermott M, Berger M, Prados M, Cha S, Croteau D, Puri RK, Chang SM (2005) Neuroradiographic changes following convection-enhanced delivery of the recombinant cytotoxin interleukin 13-PE38QQR for recurrent malignant glioma. J Neurosurg 102:267–275. https://doi.org/10.3171/jns.2005.102.2.0267

    CAS  Article  PubMed  Google Scholar 

  19. Kunwar S, Prados MD, Chang SM, Berger MS, Lang FF, Piepmeier JM, Sampson JH, Ram Z, Gutin PH, Gibbons RD, Aldape KD, Croteau DJ, Sherman JW, Puri RK, Cintredekin Besudotox Intraparenchymal Study G (2007) Direct intracerebral delivery of cintredekin besudotox (IL13-PE38QQR) in recurrent malignant glioma: a report by the Cintredekin Besudotox Intraparenchymal Study Group. J Clin Oncol 25:837–844. https://doi.org/10.1200/JCO.2006.08.1117

    CAS  Article  Google Scholar 

  20. Kunwar S, Chang S, Westphal M, Vogelbaum M, Sampson J, Barnett G, Shaffrey M, Ram Z, Piepmeier J, Prados M, Croteau D, Pedain C, Leland P, Husain SR, Joshi BH, Puri RK, Group PS (2010) Phase III randomized trial of CED of IL13-PE38QQR vs Gliadel wafers for recurrent glioblastoma. Neuro-Oncology 12:871–881. https://doi.org/10.1093/neuonc/nop054

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. Mueller S, Polley MY, Lee B, Kunwar S, Pedain C, Wembacher-Schroder E, Mittermeyer S, Westphal M, Sampson JH, Vogelbaum MA, Croteau D, Chang SM (2011) Effect of imaging and catheter characteristics on clinical outcome for patients in the PRECISE study. J Neurooncol 101:267–277. https://doi.org/10.1007/s11060-010-0255-0

    Article  PubMed  Google Scholar 

  22. Vogelbaum MA, Brewer C, Barnett GH, Mohammadi AM, Peereboom DM, Ahluwalia MS, Gao S (2018) First-in-human evaluation of the Cleveland Multiport Catheter for convection-enhanced delivery of topotecan in recurrent high-grade glioma: results of pilot trial 1. J Neurosurg. https://doi.org/10.3171/2017.10.JNS171845

    Article  PubMed  Google Scholar 

  23. Souweidane MM, Kramer K, Pandit-Taskar N, Zhou Z, Haque S, Zanzonico P, Carrasquillo JA, Lyashchenko SK, Thakur SB, Donzelli M, Turner RS, Lewis JS, Cheung NV, Larson SM, Dunkel IJ (2018) Convection-enhanced delivery for diffuse intrinsic pontine glioma: a single-centre, dose-escalation, phase 1 trial. Lancet Oncol 19:1040–1050. https://doi.org/10.1016/S1470-2045(18)30322-X

    Article  PubMed  PubMed Central  Google Scholar 

  24. Heiss JD, Jamshidi A, Shah S, Martin S, Wolters PL, Argersinger DP, Warren KE, Lonser RR (2018) Phase I trial of convection-enhanced delivery of IL13-Pseudomonas toxin in children with diffuse intrinsic pontine glioma. J Neurosurg Pediatr 23:333–342. https://doi.org/10.3171/2018.9.PEDS17225

    Article  PubMed  PubMed Central  Google Scholar 

  25. Brooks WH, Markesbery WR, Gupta GD, Rozman TL (1978) Relationship of lymphocytic invasion and survival in brain tumor patients. Ann Neurol 4:219–224

    CAS  Article  Google Scholar 

  26. Mahaley MS, Bigner DD, Dudka LF, Wilds PR, Williams DH, Bouldin TW, Whitaker JN, Bynum JM (1983) Immunobiology of primary intracranial tumors. Part 7: Active immunization of patients with anaplastic human glioma cells: a pilot study. J Neurosurg 59:201–207

    Article  Google Scholar 

  27. Liau L, Black K, Martin N, Sykes S, Bronstein J, Jouben-Steele L, Belldegrun A, Cloughesy T (2000) Treatment of a glioblastoma patient by vaccination with autologous dendritic cells pulsed with allogeneic major histocompatibility complex class I-matched tumor peptides. Neurosurg Focus 9:1–4

    Article  Google Scholar 

  28. Liau L, Black K, Martin N, Sykes S, Bronstein J, Jouben-Steele L, Belldegrun A, Cloughesy T Phase I trial of DC therapy for glioma. Congress of Neurological Surgeons/American Association of Neurological Surgeons Immunotherapy Task Force, Chicago, IL

  29. Liau LM, Ashkan K, Tran DD, Campian JL, Trusheim JE, Cobbs CS, Heth JA, Salacz M, Taylor S, D'Andre SD, Iwamoto FM, Dropcho EJ, Moshel YA, Walter KA, Pillainayagam CP, Aiken R, Chaudhary R, Goldlust SA, Bota DA, Duic P, Grewal J, Elinzano H, Toms SA, Lillehei KO, Mikkelsen T, Walbert T, Abram SR, Brenner AJ, Brem S, Ewend MG, Khagi S, Portnow J, Kim LJ, Loudon WG, Thompson RC, Avigan DE, Fink KL, Geoffroy FJ, Lindhorst S, Lutzky J, Sloan AE, Schackert G, Krex D, Meisel HJ, Wu J, Davis RP, Duma C, Etame AB, Mathieu D, Kesari S, Piccioni D, Westphal M, Baskin DS, New PZ, Lacroix M, May SA, Pluard TJ, Tse V, Green RM, Villano JL, Pearlman M, Petrecca K, Schulder M, Taylor LP, Maida AE, Prins RM, Cloughesy TF, Mulholland P, Bosch ML (2018) First results on survival from a large Phase 3 clinical trial of an autologous dendritic cell vaccine in newly diagnosed glioblastoma. J Transl Med 16:142. https://doi.org/10.1186/s12967-018-1507-6

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  30. Liau LM, Black KL, Prins RM, Sykes SN, DiPatre P-L, Cloughesy TF, Becker DP, Bronstein JM (1999) Treatment of intracranial gliomas with bone marrow-derived dendritic cells pulsed with tumor antigens. J Neurosurg 90:1115–1124

    CAS  Article  Google Scholar 

  31. Liau LM, Prins RM, Kiertscher SM, Odesa SK, Kremen TJ, Giovannone AJ, Lin JW, Chute DJ, Mischel PS, Cloughesy TF, Roth MD (2005) Dendritic cell vaccination in glioblastoma patients induces systemic and intracranial T-cell responses modulated by the local central nervous system tumor microenvironment. Clin Cancer Res 11:5515–5525

    CAS  Article  Google Scholar 

  32. Sampson JH, Heimberger AB, Archer GE, Aldape KD, Friedman AH, Friedman HS, Gilbert MR, Herndon JE 2nd, McLendon RE, Mitchell DA, Reardon DA, Sawaya R, Schmittling RJ, Shi W, Vredenburgh JJ, Bigner DD (2010) Immunologic escape after prolonged progression-free survival with epidermal growth factor receptor variant III peptide vaccination in patients with newly diagnosed glioblastoma. J Clin Oncol 28:4722–4729. https://doi.org/10.1200/JCO.2010.28.6963

    Article  PubMed  PubMed Central  Google Scholar 

  33. Weller M, Butowski N, Tran DD, Recht LD, Lim M, Hirte H, Ashby L, Mechtler L, Goldlust SA, Iwamoto F, Drappatz J, O'Rourke DM, Wong M, Hamilton MG, Finocchiaro G, Perry J, Wick W, Green J, He Y, Turner CD, Yellin MJ, Keler T, Davis TA, Stupp R, Sampson JH, investigators AIt (2017) Rindopepimut with temozolomide for patients with newly diagnosed, EGFRvIII-expressing glioblastoma (ACT IV): a randomised, double-blind, international phase 3 trial. Lancet Oncol 18:1373–1385. https://doi.org/10.1016/S1470-2045(17)30517-X

    CAS  Article  PubMed  Google Scholar 

  34. Bloch O, Crane CA, Fuks Y, Kaur R, Aghi MK, Berger MS, Butowski NA, Chang SM, Clarke JL, McDermott MW, Prados MD, Sloan AE, Bruce JN, Parsa AT (2014) Heat-shock protein peptide complex-96 vaccination for recurrent glioblastoma: a phase II, single-arm trial. Neuro-Oncology 16:274–279. https://doi.org/10.1093/neuonc/not203

    CAS  Article  PubMed  Google Scholar 

  35. Bloch O, Shi Q, Anderson SK, Knopp M, Raizer J, Clarke J, Waziri A, Colman H, Bruce J, Olson JJ, Schwerkoske J, Parsa A, Uhm J, Kumthekar P, Galanis E, Parney I (2017) Alliance A071101: a phase II randomized trial comparing the efficacy of heat shock protein peptide complex-96 (Hsppc-96) vaccine given with bevacizumab versus bevacizumab alone in the treatment of surgically resectable recurrent glioblastoma. Neuro-Oncology 19:29–29

    Article  Google Scholar 

  36. Rubio DM, Schoenbaum EE, Lee LS, Schteingart DE, Marantz PR, Anderson KE, Platt LD, Baez A, Esposito K (2010) Defining translational research: implications for training. Acad Med 85:470–475. https://doi.org/10.1097/ACM.0b013e3181ccd618

    Article  PubMed  PubMed Central  Google Scholar 

  37. Sanai N, Li J, Boerner J, Stark K, Wu J, Kim S, Derogatis A, Mehta S, Dhruv HD, Heilbrun LK, Berens ME, LoRusso PM (2018) Phase 0 trial of AZD1775 in first-recurrence glioblastoma patients. Clin Cancer Res 24:3820–3828. https://doi.org/10.1158/1078-0432.CCR-17-3348

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  38. Tien AC, Li J, Bao X, Derogatis A, Kim S, Mehta S, Sanai N (2019) A phase 0 trial of ribociclib in recurrent glioblastoma patients incorporating a tumor pharmacodynamic- and pharmacokinetic-guided expansion cohort. Clin Cancer Res 25:5777–5786. https://doi.org/10.1158/1078-0432.CCR-19-0133

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  39. Lang FF, Conrad C, Gomez-Manzano C, Yung WKA, Sawaya R, Weinberg JS, Prabhu SS, Rao G, Fuller GN, Aldape KD, Gumin J, Vence LM, Wistuba I, Rodriguez-Canales J, Villalobos PA, Dirven CMF, Tejada S, Valle RD, Alonso MM, Ewald B, Peterkin JJ, Tufaro F, Fueyo J (2018) Phase I study of DNX-2401 (Delta-24-RGD) oncolytic adenovirus: replication and immunotherapeutic effects in recurrent malignant glioma. J Clin Oncol 36:1419–1427. https://doi.org/10.1200/JCO.2017.75.8219

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  40. Cloughesy TF, Mochizuki AY, Orpilla JR, Hugo W, Lee AH, Davidson TB, Wang AC, Ellingson BM, Rytlewski JA, Sanders CM, Kawaguchi ES, Du L, Li G, Yong WH, Gaffey SC, Cohen AL, Mellinghoff IK, Lee EQ, Reardon DA, O'Brien BJ, Butowski NA, Nghiemphu PL, Clarke JL, Arrillaga-Romany IC, Colman H, Kaley TJ, de Groot JF, Liau LM, Wen PY, Prins RM (2019) Neoadjuvant anti-PD-1 immunotherapy promotes a survival benefit with intratumoral and systemic immune responses in recurrent glioblastoma. Nat Med 25:477–486. https://doi.org/10.1038/s41591-018-0337-7

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  41. Brennan CW, Verhaak RG, McKenna A, Campos B, Noushmehr H, Salama SR, Zheng S, Chakravarty D, Sanborn JZ, Berman SH, Beroukhim R, Bernard B, Wu CJ, Genovese G, Shmulevich I, Barnholtz-Sloan J, Zou L, Vegesna R, Shukla SA, Ciriello G, Yung WK, Zhang W, Sougnez C, Mikkelsen T, Aldape K, Bigner DD, Van Meir EG, Prados M, Sloan A, Black KL, Eschbacher J, Finocchiaro G, Friedman W, Andrews DW, Guha A, Iacocca M, O'Neill BP, Foltz G, Myers J, Weisenberger DJ, Penny R, Kucherlapati R, Perou CM, Hayes DN, Gibbs R, Marra M, Mills GB, Lander E, Spellman P, Wilson R, Sander C, Weinstein J, Meyerson M, Gabriel S, Laird PW, Haussler D, Getz G, Chin L, Network TR (2013) The somatic genomic landscape of glioblastoma. Cell 155:462–477. https://doi.org/10.1016/j.cell.2013.09.034

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  42. Johnson BE, Mazor T, Hong C, Barnes M, Aihara K, McLean CY, Fouse SD, Yamamoto S, Ueda H, Tatsuno K, Asthana S, Jalbert LE, Nelson SJ, Bollen AW, Gustafson WC, Charron E, Weiss WA, Smirnov IV, Song JS, Olshen AB, Cha S, Zhao Y, Moore RA, Mungall AJ, Jones SJ, Hirst M, Marra MA, Saito N, Aburatani H, Mukasa A, Berger MS, Chang SM, Taylor BS, Costello JF (2014) Mutational analysis reveals the origin and therapy-driven evolution of recurrent glioma. Science 343:189–193. https://doi.org/10.1126/science.1239947

    CAS  Article  PubMed  Google Scholar 

  43. Patel AP, Tirosh I, Trombetta JJ, Shalek AK, Gillespie SM, Wakimoto H, Cahill DP, Nahed BV, Curry WT, Martuza RL, Louis DN, Rozenblatt-Rosen O, Suva ML, Regev A, Bernstein BE (2014) Single-cell RNA-seq highlights intratumoral heterogeneity in primary glioblastoma. Science 344:1396–1401. https://doi.org/10.1126/science.1254257

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  44. Venteicher AS, Tirosh I, Hebert C, Yizhak K, Neftel C, Filbin MG, Hovestadt V, Escalante LE, Shaw ML, Rodman C, Gillespie SM, Dionne D, Luo CC, Ravichandran H, Mylvaganam R, Mount C, Onozato ML, Nahed BV, Wakimoto H, Curry WT, Iafrate AJ, Rivera MN, Frosch MP, Golub TR, Brastianos PK, Getz G, Patel AP, Monje M, Cahill DP, Rozenblatt-Rosen O, Louis DN, Bernstein BE, Regev A, Suva ML (2017) Decoupling genetics, lineages, and microenvironment in IDH-mutant gliomas by single-cell RNA-seq. Science. https://doi.org/10.1126/science.aai8478

    Article  PubMed  PubMed Central  Google Scholar 

  45. Stehr W, Nakayama DK (2014) Employment and hospital support among pediatric surgeons. Am Surg 80:1256–1259

    Article  Google Scholar 

  46. Vates GE, Kim DH, Day AL (2004) The neurosurgeon as clinician-scientist: the fundamentals. Clin Neurosurg 51:53–58

    PubMed  Google Scholar 

  47. Harbaugh RE (2018) The Future of Neurosurgical Education Part 1: Setting the Stage. AANS Neurosurgeon.

  48. Jahangiri A, Flanigan PM, Arnush M, Chandra A, Rick JW, Choi S, Chou A, Berger MS, Aghi MK (2019) From bench to bedside: trends in National Institutes of Health funding for neurosurgeons from 1991 to 2015. J Neurosurg. https://doi.org/10.3171/2019.1.JNS181531

    Article  PubMed  Google Scholar 

  49. Kaplan CP, Napoles AM, Dohan D, Shelley Hwang E, Melisko M, Nickleach D, Quinn JA, Haas J (2013) Clinical trial discussion, referral, and recruitment: physician, patient, and system factors. Cancer Causes Control 24:979–988. https://doi.org/10.1007/s10552-013-0173-5

    Article  PubMed  Google Scholar 

  50. Brem H, Mahaley MS Jr, Vick NA, Black KL, Schold SC Jr, Burger PC, Friedman AH, Ciric IS, Eller TW, Cozzens JW et al (1991) Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas. J Neurosurg 74:441–446. https://doi.org/10.3171/jns.1991.74.3.0441

    CAS  Article  PubMed  Google Scholar 

  51. Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK, Carrero XW, Barker FG 2nd, Deming R, Burri SH, Menard C, Chung C, Stieber VW, Pollock BE, Galanis E, Buckner JC, Asher AL (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA 316:401–409. https://doi.org/10.1001/jama.2016.9839

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

There was no funding for this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael A. Vogelbaum.

Ethics declarations

Conflict of interest

Michael A. Vogelbaum has indirect equity and royalty interest in Infuseon Therapeutics and has received honoraria from Celgene and Tocagen. Ian F. Parney has no conflicts to declare. J. Bradley Elder has received honoraria from JNJ, Varian and Medtronic. Daniel P. Cahill has received honoraria and travel reimbursement from Merck, and has served as a consultant for Lilly.

Research involving human participants or animals

This article does not contain any new studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vogelbaum, M.A., Parney, I.F., Elder, J.B. et al. Neurosurgical involvement in clinical trials for CNS tumors. J Neurooncol 151, 367–373 (2021). https://doi.org/10.1007/s11060-020-03438-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-020-03438-3

Keywords

  • Neurosurgery
  • Clinical trials
  • Gliomas
  • Brain metastases