David Spencer Rogawski

All Publications

• The climb toward intracranial efficacy: Zorifertinib in EGFR-mutant NSCLC with CNS metastases in the EVEREST trial. Med (New York, N.Y.) Roy-O'Reilly, M., Rogawski, D. 2025; 6 (1): 100525

  Abstract

  The phase III EVEREST trial evaluating zorifertinib in the treatment of metastatic EGFR-mutant NSCLC was groundbreaking in its specific inclusion of patients with brain metastases.1 Zorifertinib prolonged systemic and intracranial progression-free survival compared with first-generation EGFR inhibitors, yet questions remain about its efficacy and toxicity compared with osimertinib.

  View details for DOI 10.1016/j.medj.2024.10.002

  View details for PubMedID 39798551

• Durable responses to trastuzumab deruxtecan in patients with leptomeningeal metastases from breast cancer with variable HER2 expression. Journal of neuro-oncology Rogawski, D., Cao, T., Ma, Q., Roy-O'Reilly, M., Yao, L., Xu, N., Nagpal, S. 2024

  Abstract

  PURPOSE: Emerging data suggest that trastuzumab deruxtecan (T-DXd) is an active treatment for brain metastases from HER2+breast cancer. We aimed to characterize the activity of T-DXd in the treatment of leptomeningeal metastases (LM) from a range of HER2-altered cancers.METHODS: We reviewed neuro-oncology clinic records between July 2020 and December 2023 to identify patients who received T-DXd to treat LM.RESULTS: Of 18 patients identified, 6 had HER2+breast cancer, 8 had HER2-low/negative breast cancer, 2 had HER2+gastroesophageal cancer, and 2 had HER2-mutant non-small cell lung cancer (NSCLC). 10/18 (56%) patients had cytologically confirmed LM by CSF cytology or circulating tumor cell (CTC) capture. A partial response (PR) on MRI using the EORTC/RANO-LM Revised-Scorecard occurred in 4/6 (67%) patients with HER2+breast LM, 2/8 (25%) patients with HER2-low/negative breast cancer, and 0/4 (0%) patients with HER2+gastroesophageal cancer or HER2-mutant NSCLC. Median overall survival after initiating T-DXd was 5.8 months. Survival after initiating T-DXd was numerically longer for HER2+breast cancer patients compared with HER2-low/negative breast and HER2-altered non-breast cancer patients (13.9 months vs. 5.2 months and 4.6 months, respectively). Landmark analysis showed that patients with radiologic LM response to T-DXd by 2.5 months had longer survival than non-responders (14.2 months vs. 2.6 months, HR 0.18, 95% CI 0.05-0.63, p<0.05), and landmark analyses at 3.5 and 4.5 months after starting T-DXd showed a similar but nonsignificant trend.CONCLUSION: T-DXd induces LM responses in a subset of patients, and such responses may be associated with prolongation of survival. Prospective trials are needed to clarify the role of T-DXd in treating LM and which patients are most likely to benefit.

  View details for DOI 10.1007/s11060-024-04788-y

  View details for PubMedID 39073687

• A rare non-gadolinium enhancing sarcoma brain metastasis with microenvironment dominated by tumor-associated macrophages. Acta neuropathologica communications Rogawski, D., Wheeler, J., Nie, E., Zhu, W., Villanueva, E., Coffey, G., Ma, Q., Ganjoo, K., Fischbein, N., Iv, M., Vogel, H., Nagpal, S. 2024; 12 (1): 15

  Abstract

  Brain metastases occur in 1% of sarcoma cases and are associated with a median overall survival of 6 months. We report a rare case of a brain metastasis with unique radiologic and histopathologic features in a patient with low grade fibromyxoid sarcoma (LGFMS) previously treated with immune checkpoint inhibitor (ICI) therapy. The lone metastasis progressed in the midbrain tegmentum over 15 months as a non-enhancing, T2-hyperintense lesion with peripheral diffusion restriction, mimicking a demyelinating lesion. Histopathology of the lesion at autopsy revealed a rich infiltrate of tumor-associated macrophages (TAMs) with highest density at the leading edge of the metastasis, whereas there was a paucity of lymphocytes, suggestive of an immunologically cold environment. Given the important immunosuppressive and tumor-promoting functions of TAMs in gliomas and carcinoma/melanoma brain metastases, this unusual case provides an interesting example of a dense TAM infiltrate in a much rarer sarcoma brain metastasis.

  View details for DOI 10.1186/s40478-023-01713-8

  View details for PubMedID 38254244

  View details for PubMedCentralID 5021195

• A road map for the treatment of pediatric diffuse midline glioma. Cancer cell Koschmann, C., Al-Holou, W. N., Alonso, M. M., Anastas, J., Bandopadhayay, P., Barron, T., Becher, O., Cartaxo, R., Castro, M. G., Chung, C., Clausen, M., Dang, D., Doherty, R., Duchatel, R., Dun, M., Filbin, M., Franson, A., Galban, S., Garcia Moure, M., Garton, H., Gowda, P., Marques, J. G., Hawkins, C., Heath, A., Hulleman, E., Ji, S., Jones, C., Kilburn, L., Kline, C., Koldobskiy, M. A., Lim, D., Lowenstein, P. R., Lu, Q. R., Lum, J., Mack, S., Magge, S., Marini, B., Martin, D., Marupudi, N., Messinger, D., Mody, R., Morgan, M., Mota, M., Muraszko, K., Mueller, S., Natarajan, S. K., Nazarian, J., Niculcea, M., Nuechterlein, N., Okada, H., Opipari, V., Pai, M. P., Pal, S., Peterson, E., Phoenix, T., Prensner, J. R., Pun, M., Raju, G. P., Reitman, Z. J., Resnick, A., Rogawski, D., Saratsis, A., Sbergio, S. G., Souweidane, M., Stafford, J. M., Tzaridis, T., Venkataraman, S., Vittorio, O., Wadden, J., Wahl, D., Wechsler-Reya, R. J., Yadav, V. N., Zhang, X., Zhang, Q., Venneti, S. 2023

  Abstract

  Recent clinical trials for H3K27-altered diffuse midline gliomas (DMGs) have shown much promise. We present a consensus roadmap and identify three major barriers: (1) refinement of experimental models to include immune and brain-specific components; (2) collaboration among researchers, clinicians, and industry to integrate patient-derived data through sharing, transparency, and regulatory considerations; and (3) streamlining clinical efforts including biopsy, CNS-drug delivery, endpoint determination, and response monitoring. We highlight the importance of comprehensive collaboration to advance the understanding, diagnostics, and therapeutics for DMGs.

  View details for DOI 10.1016/j.ccell.2023.11.002

  View details for PubMedID 38039965

• Spinal Neurofibromatosis (NF): A Variant Phenotype of NF1. The Journal of pediatrics Rogawski, D. S., Tong, E., Campen, C. 2023: 113571

  View details for DOI 10.1016/j.jpeds.2023.113571

  View details for PubMedID 37339702

• Diagnostic and Therapeutic Updates in Leptomeningeal Disease. Current oncology reports Roy-O'Reilly, M. A., Lanman, T., Ruiz, A., Rogawski, D., Stocksdale, B., Nagpal, S. 2023

  Abstract

  PURPOSE OF REVIEW: Leptomeningeal disease (LMD) is a devastating complication of advanced metastatic cancer associated with a poor prognosis and limited treatment options. This study reviews the current understanding of the clinical presentation, pathogenesis, diagnosis, and treatment of LMD. We highlight opportunities for advances in this disease.RECENT FINDINGS: In recent years, the use of soluble CSF biomarkers has expanded, suggesting improved sensitivity over traditional cytology, identification of targetable mutations, and potential utility for monitoring disease burden. Recent studies of targeted small molecules and intrathecal based therapies have demonstrated an increase in overall and progression-free survival. In addition, there are several ongoing trials evaluating immunotherapy in LMD. Though overall prognosis of LMD remains poor, studies suggest a potential role for soluble CSF biomarkers in diagnosis and management and demonstrate promising findings in patient outcomes with targeted therapies for specific solid tumors. Despite these advances, there continues to be a gap of knowledge in this disease, emphasizing the importance of inclusion of LMD patients in clinical trials.

  View details for DOI 10.1007/s11912-023-01432-2

  View details for PubMedID 37256537

• A rare neuromyelitis optica mimic: Primary CNS histiocytic sarcoma. Multiple sclerosis (Houndmills, Basingstoke, England) Rogawski, D. S., Nirschl, J. J., McDonald, J., Nie, E., Schwartz, N. U., Vogel, H., Scott, B. J., Gold, C. A., Kipp, L. B. 2022; 28 (10): 1651-1654

  Abstract

  Primary central nervous system (CNS) histiocytic sarcoma is a rare hematolymphoid malignancy with features of mature histiocytes and carries a poor prognosis. We describe a unique case in which a 50-year-old woman presented with recurrent acute brainstem syndrome, area postrema syndrome, and myelitis with corresponding magnetic resonance imaging (MRI) lesions meeting diagnostic criteria for seronegative neuromyelitis optica spectrum disorder (NMOSD). Despite initial improvement with steroids and plasma exchange, she experienced recurrent symptoms over 10months referable to new and persistently enhancing lesions. At autopsy, neuropathology revealed a diffusely infiltrative primary CNS histiocytic sarcoma. This case represents a rare clinicoradiologic mimic of NMOSD, underscoring the importance of evaluation for infiltrative diseases in cases of atypical seronegative NMOSD.

  View details for DOI 10.1177/13524585221097564

  View details for PubMedID 35876468

• Primary central nervous system histiocytic sarcoma presenting as neuromyelitis optica Nirschl, J., Rogawski, D., McDonald, J., Nie, E., Schwartz, N., Scott, B., Gratzinger, D., Gold, C., Kipp, L., Vogel, H. OXFORD UNIV PRESS INC. 2022: 491

  View details for Web of Science ID 000798368400189

• NEUROPHYSIOLOGICAL SMALL MOLECULE SCREEN TO TARGET NEURON-GLIOMA INTERACTIONS IN PEDIATRIC HIGH-GRADE GLIOMAS Rogawski, D., Mulinyawe, S., Thomas, C., Monje, M. OXFORD UNIV PRESS INC. 2021: 17

  View details for DOI 10.1093/neuonc/noab090.068

  View details for Web of Science ID 000671540600069