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Summer 2016
Shaping The Future Of Brain Tumor Care
Dr. Anthony Asher Co-Leads Brain Tumor Research Featured In The
Journal of the American Medical Association



An international brain tumor research study co-authored by Anthony Asher, MD, FACS, of Carolina Neurosurgery & Spine Associates was selected for publication in the July 26, 2016, issue of the Journal of the American Medical Association (JAMA). With 320,000 print subscribers and 16 million annual visits to the publication website, JAMA is the most widely circulated medical journal in the world.

"Publication in JAMA is a true honor and really shines a spotlight on the important cancer research that is emanating from Charlotte," said Dr. Asher. "It is deeply satisfying to have helped develop such a significant scientific project in close collaboration with other investigators around the nation to obtain support from the National Cancer Institute, then carry the trial to completion with publication of impactful results in one of the leading medical journals in the world."

JAMA has a highly selective, peer-review editorial process. Each year, more than 4,700 research studies are submitted to JAMA, but only 3.5% of these studies are selected for publication.

Earlier this year, Dr. Asher presented the study's research findings at the 2016 American Association of Neurological Surgeons (AANS) Annual Scientific Meeting, where he earned the Leksell Radiosurgery Award for his research.

About The Study
The article featured in JAMA included the results of a clinical research trial that originated in Charlotte over a decade ago. The original study protocol was co-developed by Dr. Asher and radiation oncologist Stuart Burri, MD, of Southeast Radiation Oncology Group. This international, multi-institutional, randomized cancer study ultimately showed that whole brain radiation therapy, a common treatment for patients with brain metastases (i.e., cancer that has spread to the brain), caused significant memory and information processing problems in patients without improving survival rates. The study specifically compared the effects of treating patients with a combination of whole brain radiation and focused radiation, versus treating patients with focused radiation alone.

Dr. Asher served as co-principal investigator of this study along with Paul Brown, MD, of the Mayo Clinic Health System. Other physicians and medical facilities throughout the United States and Canada were also involved with the study.

This research study demonstrated that focused, stereotactic radiosurgery did not cause the same negative cognitive effects as whole brain radiation.
Why Is This Study So Significant For Brain Cancer Care?
"First and most directly, this study provides definitive evidence that patients with one to three brain metastases should no longer receive routine whole brain radiation therapy, and should be treated with focused therapy alone to better preserve cognitive function and quality of life. The results from this clinical trial mark the end of an era in the treatment of brain metastases, and will spark a renewed emphasis on focused therapies, like radiosurgery, for these conditions." Asher added, "The real importance of this study, however, is its potential to make us think differently about what really matters in cancer therapy. Specifically, when two cancer therapies produce similar survival rates, it's essential to understand which therapy offers patients a better quality of life. The data from our study shows that clinicians can no longer simply rely on the results of traditional lab tests or imaging studies to assess the value of care. We have to understand the total impact of cancer therapies on our patients."

Metastatic brain cancer is remarkably common in society, impacting over 400,000 patients annually in the United States alone. More than half of those still receive whole brain radiation therapy as part of their treatment. In that respect, the results of this study have the potential to impact the care of tens of thousands of patients.

No other study to date has simultaneously assessed the impact of these therapies on neurocognition (i.e., memory, judgment, reasoning, thinking) and quality of life in patients with cerebral metastases.

"Having the data published in JAMA is validation of the importance of this research," said Asher. "We are hopeful the trial results will not only shift care patterns toward focused therapies for cerebral metastases, but will also be viewed in a broader context as part of the transition toward a truly patient-centered healthcare system."

To view the JAMA article, go to http://jama.jamanetwork.com/article.aspx?articleid=2536637.

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