Kate Therkelsen, MD

All Publications

• A phase 1 study of B7H3 CAR-T cells administered intracranially in recurrent glioblastoma. Li, G., Stocksdale, B. R., Song, K., Mahdi, J., Tanner, K., Bertrand, S., Iv, M., Threlkeld, Z., Ramakrishna, S., Sahaf, B., Egeler, E., Charu, V., Tunuguntla, R., Therkelsen, K., Nagpal, S., Lim, M., Monje, M., Scott, B., Mackall, C., Thomas, R. LIPPINCOTT WILLIAMS & WILKINS. 2025: 2018

  View details for DOI 10.1200/JCO.2025.43.16_suppl.2018

  View details for Web of Science ID 001509526200001

• Molecular testing and targeting for solid tumors with CNS metastases. Journal of neuro-oncology Therkelsen, K. E., Cao, T., Roy-O'Reilly, M., Stocksdale, B., Nagpal, S. 2025

  Abstract

  The landscape of molecular testing in solid tumors is rapidly expanding. Understanding testing options and limitations can inform treatment decisions for many patients with metastatic disease to the central nervous system (CNS).

  View details for DOI 10.1007/s11060-025-04947-9

  View details for PubMedID 40178767

  View details for PubMedCentralID 5737512

• A multi-institutional retrospective cohort of adult-onset medulloblastoma in the modern era. Neuro-oncology advances Bonm, A. V., Rutenberg, M. S., Therkelsen, K. E., Herbst, J., Sanaf, A., Sherwood, M. A., Rhee, J. Y., McGranahan, T. M., Cimino, P. J., Gonzalez Castro, L. N., Tsang, D. S., Karajannis, M. A., Nagpal, S., Amdur, R. J., Shih, H., Barber, J., Taylor, L. P. 2025; 7 (1): vdae231

  Abstract

  Adult onset medulloblastoma (aMB) is a rare tumor with limited available evidence. We present a large multi-institutional retrospective cohort of aMB patients treated in the modern era, with an emphasis on understanding the role of chemotherapy at initial diagnosis.We included 267 consecutive patients with aMB treated at 7 different institutions from 2000-present, controlling for chemotherapy regimen and cycles received.Treatment factors were highly intercorrelated with one another and with treating institution. Concurrent chemotherapy was not associated with overall survival (OS). Adjuvant chemotherapy was associated with OS on univariable analyses (HR = 0.55, P = .029) and on multivariable analysis when adjusting for risk status (HR 0.55, P = .026) but not when also adjusting for treating institution. Proton craniospinal irradiation was associated with improved survival on univariable (HR = 0.50, P = .019) and multivariable analysis adjusting for risk status (HR = 0.51, P = .024) but not when treating institution was also considered. On subgroup analysis, adjuvant chemotherapy was associated with improved survival in M0 (HR = 0.55, P = .043) but not M1 disease, in patients with subtotal resection (HR = 0.43, P = .048) but not those with GTR. Similarly, progression-free survival was improved with chemotherapy in patients with M0 (HR = 0.57, P = .032) but not M1 disease, and in patients with subtotal (HR = 0.50, P = .054) but not gross total resection.There was no benefit of concurrent chemotherapy. Adjuvant chemotherapy was associated with improved overall survival and this effect was driven by select subgroups, specifically those with M0 disease and those with residual tumor. We could not confirm that these associations are independent of the treating institution.

  View details for DOI 10.1093/noajnl/vdae231

  View details for PubMedID 39991182

  View details for PubMedCentralID PMC11842969

• Advances in Primary Central Nervous System Lymphoma. Current neurology and neuroscience reports Therkelsen, K. E., Omuro, A. 2024; 25 (1): 5

  Abstract

  Optimal initial management can have a significant impact in long-term outcome in primary CNS lymphoma. This article reviews recent advances and the state of the field.Genomic analysis of CSF cell-free DNA has emerged as a new diagnostic tool for PCNSL. Treatment options have likewise evolved, with mature data from first-line chemotherapy-based prospective trials disclosing excellent results in younger (< 60-65) patients, with a cure achieved in a majority. However, results in older patients remain dismal, with several new salvage options under investigation including BTK pathway-targeted therapies, and CAR-T cell treatments. Meanwhile, low-dose radiation has emerged as an additional alternative for consolidation therapy. For younger PCNSL patients, the goal of treatment is now a cure, with the next frontier being the development of therapies affording optimized neurocognitive outcome and lower toxicity. Treatment for older patients remains however an unmet need, with several promising clinical trials ongoing.

  View details for DOI 10.1007/s11910-024-01389-0

  View details for PubMedID 39585484

  View details for PubMedCentralID 3241537

• Long-term Outcomes in Primary CNS Lymphoma Following R-MVP and High Dose Chemotherapy With Autologous Hematopoietic Stem Cell Transplant. Neurology Therkelsen, K. E., Schaff, L. R., Nandakumar, S., Omuro, A. M., DeAngelis, L. M., Grommes, C. 2023

  Abstract

  BACKGROUND: Primary central nervous system lymphoma (PCNSL), a rare central nervous system malignancy, is usually treated with high-dose methotrexate in the first line setting, typically followed by consolidation therapy. Due to the broad range of currently available treatments for PCNSL, comparability in long-term follow up studies is limited and the data are scattered across small studies.METHODS: Here we report the long-term survival of patients with newly diagnosed, immunocompetent PCNSL, enrolled in a phase II trial from June 2005 to September 2011. Patients were treated using rituximab, methotrexate, vincristine, and procarbazine (R-MVP) chemotherapy followed by high dose chemotherapy (HDC) and autologous stem cell transplant (ASCT) in those with partial or complete response to R-MVP. In a post hoc analysis, clinical and imaging features were evaluated in those still alive.RESULTS: 26 of 32 patients underwent HDC-ACST consolidation. Of these, 3 patients died from treatment related toxicity, and 2 due to disease progression within one year of ASCT. None of the remaining 21 patients had disease progression with a median follow-up of 12.1 years and were included in the analysis. Compared to the post HDC-ASCT assessment, at last follow up there was no significant difference in the median Karnofsky Performance Status (KPS) (80 (range: 60-100) versus 90 (range: 70-100)), the median Neurologic Assessment in Neuro-Oncology (NANO) score (1 (range: 0-4) versus 1 (range 0-5)) and leukoencephalopathy score (1 (range 0-3) versus 1 (range: 1-4)).CONCLUSION: Long-term follow up demonstrated that treatment was well tolerated in most patients enrolled in this study, with stable leukoencephalopathy on imaging and stable clinical performance status. Disease recurrence was not observed beyond 2 years after HDC-ASCT consolidation.

  View details for DOI 10.1212/WNL.0000000000207490

  View details for PubMedID 37344228

• Real-world risk of brain metastases in stage III non-small cell lung cancer in the era of PET and MRI staging. Frontiers in oncology Alhusaini, S., Lanman, T. A., Ko, R. B., Therkelsen, K. E., Eyben, R. V., Diehn, M., Soltys, S. G., Pollom, E. L., Chin, A., Vitzthum, L., Wakelee, H. A., Padda, S. K., Ramchandran, K., Loo, B. W., Neal, J. W., Nagpal, S. 2023; 13: 1139940

  Abstract

  The 2-year incidence of brain metastases (BrMs) in stage III non-small lung cell cancer (NSCLC) has been estimated to be around 30%. However, recent clinical trials have demonstrated considerably lower BrMs rates in this patient population. In this study, we aimed to review the real-world incidence, surveillance, and treatment patterns of BrMs in stage III NSCLC.Using a retrospective single-center study design, we identified patients with stage III NSCLC who received radiation with curative intent over a 10-year period. Outcome variables included BrMs incidence, overall survival (OS), and survival from date of BrMs. Additionally, we assessed patterns of BrMs surveillance in stage III NSCLC and treatment.We identified a total of 279 stage III NSCLC patients, of which 160 with adequate records were included in the final analyses [adenocarcinoma (n = 96), squamous cell carcinoma (n = 53), other histology subtype (n = 11)]. The median OS for the entire cohort was 41 months (95% CI, 28-53), while the median time from BrMs to death was 19 months (95% CI, 9-21). Twenty-three patients (14.4%) received planned surveillance brain MRIs at 6, 12, and 24 months after completion of treatment. The remaining 137 patients (85.6%) received brain MRIs at systemic recurrence (restaging) or when neurologically symptomatic. A total of 37 patients (23%) developed BrMs, with a 2-year cumulative BrMs incidence of 17% (95% CI, 11-23). A higher incidence of BrMs was identified in patients with adenocarcinoma relative to those with squamous cell carcinoma (p < 0.01). Similarly, a higher 2-year BrMs incidence was observed in patients who received planned surveillance brain MRI relative to those who did not, although statistical significance was not reached. Stereotactic radiosurgery (SRS) treated 29 of BrMs patients (78.4%) and was preferred over WBRT, which treated only 3 patients (8.1%).At our center, BrMs incidence in stage III NSCLC patients was lower than historically reported but notably higher than the incidence described in recent clinical trials. Routine BrMs surveillance potentially allows earlier detection of asymptomatic BrMs. However, asymptomatic BrMs were mostly detected on restaging MRI at the time of recurrence.

  View details for DOI 10.3389/fonc.2023.1139940

  View details for PubMedID 37035171

  View details for PubMedCentralID PMC10080021

• A MULTI-INSTITUTIONAL RETROSPECTIVE SERIES OF ADULT-ONSET MEDULLOBLASTOMA. Bonm, A., Rutenberg, M., Therkelsen, K., Ruiz, A., McGranahan, T., Cimino, P., Nagpal, S., Taylor, L. OXFORD UNIV PRESS INC. 2022: 85

  View details for Web of Science ID 000888571000324

• A Medical Legal Curriculum for Residents to Increase Physician Comfort in Patient Interactions Therkelsen, K., Yang, L. LIPPINCOTT WILLIAMS & WILKINS. 2019

  View details for Web of Science ID 000475965902090

• Utilizing Single Cell Immune Profiling to Identify Serum-based Biomarkers for Transient Ischemic Attacks Therkelsen, K., Tsai, A., Mlynash, M., Oh, B., Eyngorn, I., Gaudilliere, B., George, P. LIPPINCOTT WILLIAMS & WILKINS. 2019

  View details for Web of Science ID 000475965901285

• Current State of Immunotherapy for Treatment of Glioblastoma. Current treatment options in oncology McGranahan, T., Therkelsen, K. E., Ahmad, S., Nagpal, S. 2019; 20 (3): 24

  Abstract

  OPINION STATEMENT: At this time, there are no FDA-approved immune therapies for glioblastoma (GBM) despite many unique therapies currently in clinical trials. GBM is a highly immunosuppressive tumor and there are limitations to a safe immune response in the central nervous system. To date, there have been several failures of phase 3 immune therapy clinical trials in GBM. These trials have targeted single components of an antitumor immune response. Learning from these failures, the future of immunotherapy for GBM appears most hopeful for combination of immune therapies to overcome the profound immunosuppression of this disease. Understanding biomarkers for appropriate patient selection as well as tumor progression are necessary for implementation of immunotherapy for GBM.

  View details for PubMedID 30790064

• "But doctor, I googled it!": The "three Rs" of managing patients in the age of information overload. Clinics in dermatology Mundluru, S. N., Werbaneth, K., Therkelsen, K. E., Larson, A. R., Santini, V. E. 2019; 37 (1): 74–77

  Abstract

  Managing patient interactions in the age of the Internet can be particularly difficult due to the vast amount of information available. Dermatologists should be able to identify relevant patient concerns to adequately address them. We discuss the ethical issues involved in interacting with patients who use the Internet for medical knowledge, and we suggest a method, using the "three Rs" (reassure, redirect, refer), to conduct these interactions. Appropriate evaluation and categorization of patients with regard to their concerns and needs can help guide physicians on how to use the three Rs in managing patient care and expectations.

  View details for PubMedID 30554626