Aldave, G. (Guillermo)

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2011 - 20193

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    Dianas quirúrgicas en el tratamiento de enfermedades psiquiátricas. Desde el movimiento a las emociones
    (Sociedad Española de Neurocirugía, 2011) Aldave, G. (Guillermo); Guridi-Legarra, J. (Jorge)
    Deep brain stimulation (DBS) for psychiatric disorders refractory to conventional treatments are currently been performed based in the knowledgment obtained in the motor disorder surgery and mainly in Parkinson´s disease. Depression, obsessive-compulsive disorder (OCD) and Tourette syndrome, all of them are cortico-striato-thalamo-cortical pathological process involved in the limbic loop of the basal ganglia. This review describes the different targets in these pathological neuro-psychiatric disorders. For OCD there are currently two targets, ventral striatum (VS) Accumbens nucleus (Nacc) and the subthalamic nucleus (STN). In refractory depression the subgenual area (25 Brodmann area) and VS/Nacc. For Tourette syndrome the ventralis oralis internus and centromedianum/ parafascicularis of the thalamus (Voi and CM/Pf) and the internal part of the globus pallidus (GPi). Currently there are no specific surgical target for each pathological disorder because clinical results reported are very similar after stimulation surgery. In other point, a selected surgical target also may improve different pathologies.
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    Factors associated with a higher rate of distant failure after primary treatment for glioblastoma
    (Springer, 2014) Aldave, G. (Guillermo); Marigil, M. (Miguel); Domínguez-Echávarri, P.D. (Pablo Daniel); Tejada-Solis, S. (Sonia); Diez-Valle, R. (Ricardo); Gallego-Perez-Larraya, J. (Jaime)
    Our purpose was to analyze the pattern of failure in glioblastoma (GBM) patients at first recurrence after radiotherapy and temozolomide and its relationship with different factors. From 77 consecutive GBM patients treated at our institution with fluorescence guided surgery and standard radiochemotherapy, 58 first recurrences were identified and included in a retrospective review. Clinical data including age, Karnofsky performance score, preoperative tumor volume and location, extend of resection, MGMT promoter methylation status, time to progression (PFS), overall survival (OS) and adjuvant therapies were reviewed for every patient. Recurrent tumor location respect the original lesion was the end point of the study. The recurrence pattern was local only in 65.5% of patients and non-local in 34.5%. The univariate and multivariate analysis showed that greater preoperative tumor volume in T1 gadolinium enhanced sequences, was the only variable with statistical signification (p < 0.001) for increased rate of non-local recurrences, although patients with MGMT methylation and complete resection of enhancing tumor presented non-local recurrences more frequently. PFS was longer in patients with non-local recurrences (13.8 vs. 6.4 months; p = 0.019, log-rank). However, OS was not significantly different in both groups (24.0 non-local vs. 19.3 local; p = 0.9). Rate of non-local recurrences in our series of patients treated with fluorescence guided surgery and standard radiochemotherapy was higher than previously published in GBM, especially in patients with longer PFS. Greater preoperative enhancing tumor volume was associated with increased rate of non-local recurrences.
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    The oncolytic virus Delta-24-RGD elicits an antitumor effect in pediatric glioma and DIPG mouse models
    (Springer Science and Business Media LLC, 2019) Mackay, A. (Alan); Patiño-García, A. (Ana); Aldave, G. (Guillermo); Alonso-Roldán, M.M. (Marta María); El-Habr, E. (Elías); Gomez-Manzano, C. (Candelaria); Chneiweiss, H. (Hervé); Zalacain, M. (Marta); Martinez-Velez, N. (Naiara); Marigil, M. (Miguel); Raabe, E. (Eric); Aristu-Mendioroz, J.J. (José Javier); García-Barchino, M.J. (María José); Martinez-Climent, J.A. (José Ángel); Gonzalez-Huarriz, M. (Marisol); Tejada-Solis, S. (Sonia); Monje, M. (Michelle); Marrodán, L. (Lucía); Ramos, L.I. (Luis Isaac); Diez-Valle, R. (Ricardo); Garcia-Moure, M. (Marc); Junier, M.P. (Marie Pierre); Varela-Guruceaga, M. (Maider); Puigdelloses-Vallcorba, M. (Montserrat); Laspidea, V. (Virginia); Fueyo, J. (Juan); Gallego-Perez-Larraya, J. (Jaime); Becher, O.J. (Oren J.); Jiang, H. (Hong); Jones, C. (Chris)
    Pediatric high-grade glioma (pHGG) and diffuse intrinsic pontine gliomas (DIPGs) are aggressive pediatric brain tumors in desperate need of a curative treatment. Oncolytic virotherapy is emerging as a solid therapeutic approach. Delta-24-RGD is a replication competent adenovirus engineered to replicate in tumor cells with an aberrant RB pathway. This virus has proven to be safe and effective in adult gliomas. Here we report that the administration of Delta-24-RGD is safe in mice and results in a significant increase in survival in immunodeficient and immunocompetent models of pHGG and DIPGs. Our results show that the Delta-24-RGD antiglioma effect is mediated by the oncolytic effect and the immune response elicited against the tumor. Altogether, our data highlight the potential of this virus as treatment for patients with these tumors. Of clinical significance, these data have led to the start of a phase I/II clinical trial at our institution for newly diagnosed DIPG (NCT03178032).