Brain and spinal cord tumors are the second most common cancers in children, accounting for 1 out of 4 childhood cancers. Despite intensive treatment, children with histologically diagnosed high-risk medulloblastoma, supratentorial primitive neuroectodermal tumor of the central nervous system (CNS-PNET), and pineoblastoma (PBL) continue to have suboptimal outcomes. James M. Olson, MD, PhD, Professor of Pediatric Hematology/Oncology at University of Washington School of Medicine, and colleagues found that molecular profiling of patients with CNS-PNET/PBL revealed a significant proportion of patients were initially misdiagnosed and consequently overtreated and that other patients have a better prognosis than previously realized. i3 Health spoke with Dr. Olson about these findings and their implications for pediatric brain tumor practice.
Immunotherapies such as PD-1 inhibitors have improved survival for many patients with cancer. However, these therapies are associated with adverse events that, if not properly managed, impair quality of life and may lead to treatment interruptions or discontinuation. Pruritus is one of the most common immune-related adverse events, and while many cases may be managed with conventional therapy, some patients do not respond. Shawn Kwatra, MD and colleagues reported on a case of an 88-year-old woman receiving pembrolizumab, a PD-1 inhibitor, for metastatic lung adenocarcinoma who developed severe pruritus refractory to standard treatment. Dr. Kwatra and colleagues found that intravenous naloxone, an opioid antagonist, resulted in a reduction in pruritus severity from 10 to 1 (on a scale of 0 to 10) within 1 hour. i3 Health spoke with Dr. Kwatra, Assistant Professor of Dermatology at Johns Hopkins University School of Medicine, about his findings and the challenges, potential advances, and role of multidisciplinary care in the management of dermatologic immune-related adverse events.