Bio

Dr. Toni Qian Cao is a board-certified, fellowship-trained neuro-oncologist with Stanford Health Care. She is also a clinical instructor in the Department of Neurology and Neurological Sciences, Division of Neuro-Oncology at Stanford University School of Medicine.

Dr. Cao specializes in caring for brain and spine tumors, including glioma and glioblastoma. She also has expertise in cancer that has spread (metastasized) to parts of the central nervous system (CNS), such as the brain and the tissues that surround the brain and spinal cord (leptomeninges). She is committed to providing the highest quality care while prioritizing the goals and needs of her patients. She offers compassionate treatment and cancer management, with deep knowledge of tumor therapies and neurological complications of cancer.

Dr. Cao’s research focuses on improving the identification and treatment of brain tumors and metastases. She has investigated factors that impact the development of brain metastases from breast cancer, as well as treatment for leptomeningeal metastases from breast cancer. She has studied combination treatments for glioblastoma, a type of malignant brain tumor. She is also interested in novel neuroimaging techniques for both primary and metastatic CNS tumors.

Dr. Cao has published her research in peer-reviewed journals, including Journal of Neuro-Oncology; Neurology; and the International Journal of Radiation Oncology, Biology, Physics. She has also written a book chapter on common early symptoms of CNS metastases.

Dr. Cao has presented her findings nationally at annual meetings of the American Academy of Neurology, American Society of Clinical Oncology, and Society for Neuro-Oncology. She has also spoken on panels and at regional conferences, including the Annual NeuroTech Convention of Society for Brain Mapping and Therapeutics.

Dr. Cao is a member of the American Academy of Neurology, American Society of Clinical Oncology, and Society for Neuro-Oncology.

Clinical Focus

  • Neuro-oncology
  • Brain metastases
  • Metabolic neuroimaging
  • Neurology

Academic Appointments

Administrative Appointments

  • Ad Hoc Reviewer, Archives of Gynecology and Obstetrics (2025 - Present)
  • Ad Hoc Reviewer, Journal of Neuro-Oncology (2025 - Present)

Boards, Advisory Committees, Professional Organizations

  • Member, Society for Neuro-Oncology (2023 - Present)
  • Member, American Society of Clinical Oncology (2023 - Present)
  • Member, American Academy of Neurology (2020 - Present)

Professional Education

  • Fellowship: Stanford Hospital and Clinics Neuro-Oncology Fellowship (2025) CA
  • Board Certification: American Board of Psychiatry and Neurology, Neurology (2023)
  • Residency: McGaw Medical Center of Northwestern University (2023) IL
  • Internship: McGaw Medical Center of Northwestern University (2020) IL
  • Medical Education: Northwestern University Feinberg School of Medicine (2019) IL
  • Board Certification, American Board of Psychiatry and Neurology, Neurology (2023)
  • Residency, McGaw Medical Center of Northwestern University, Neurology (2023)
  • MD, Northwestern Feinberg School of Medicine (2019)

Contact

  • Clinical (Primary)  Neuro-Oncology 875 Blake Wilbur Dr Rm 2240 MC 6560 Stanford, CA 94305 (650) 724-3556 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 5237

All Publications

  • 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

  • Precision medicine approaches to CNS metastatic disease. Advances in cancer research Cao, T., Roy-O'Reilly, M., Nagpal, S. 2025; 165: 57-114

    Abstract

    Brain metastases (BrM) and leptomeningeal metastases (LM) are increasingly common neurologic complications of cancer. The era of precision oncology has ushered in a deeper understanding of the molecular alterations that drive oncogenesis, subsequently informing and accelerating the drug development process. New systemic treatments, including oral tyrosine kinase inhibitors (TKIs), immune checkpoint inhibitors (ICIs) as well as antibody-drug conjugates (ADCs), have substantial intracranial efficacy with meaningful clinical benefit for BrM patients. Our understanding of LM continues to evolve with the development of improved detection methods and an increasing number of brain penetrant therapies. Targeted therapeutics continue to transform the existing treatment landscape and add both choice and complexity to the clinician's calculus when managing patients with BrM and/or LM. Multidisciplinary discussion should ultimately guide all treatment decisions and explore both the benefits and toxicities of various therapy options. Systemic targeted therapies should be considered for patients with asymptomatic or minimally symptomatic small BrM and/or LM. Future studies investigating treatment timing and effective combinatorial strategies are urgently needed.

    View details for DOI 10.1016/bs.acr.2025.04.005

    View details for PubMedID 40518193

  • 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 phase II study of plerixafor combined with whole brain radiation therapy (WBRT) for patients with newly diagnosed glioblastoma Cao, T., Gu, Y., Yagmurlu, B., Yerraballa, H., Bertrand, S., Naya, L., Miller, K., Iv, M., Soltys, S. G., Patel, C. B., Nagpal, S., Thomas, R., Brown, M., Recht, L. LIPPINCOTT WILLIAMS & WILKINS. 2024

    View details for Web of Science ID 001275557400433

  • Ready to INDIGO: Vorasidenib Ushers in the Era of Isocitrate Dehydrogenase Inhibition in Low-Grade Glioma. International journal of radiation oncology, biology, physics Lanman, T. A., Cao, T. Q., Miller, J. J., Nagpal, S. 2024; 118 (2): 334-336

    View details for DOI 10.1016/j.ijrobp.2023.10.045

    View details for PubMedID 38220256

  • Differential Diagnosis of Tumor-like Brain Lesions. Neurology. Clinical practice Perez Giraldo, G. S., Singer, L., Cao, T., Jamshidi, P., Dixit, K., Kontzialis, M., Castellani, R., Pytel, P., Anadani, N., Bevan, C. J., Grebenciucova, E., Balabanov, R., Cohen, B. A., Graham, E. L. 2023; 13 (5): e200182

    Abstract

    Tumor-like brain lesions are rare and commonly suggest a neoplastic etiology. Failure to rapidly identify non-neoplastic causes can lead to increased morbidity and mortality. In this review, we describe 10 patients who presented with atypical, non-neoplastic tumor-like brain lesions in which brain biopsy was essential for a correct diagnosis and treatment.There has been increasing recognition of autoimmune conditions affecting the nervous system, and many of those diseases can cause tumor-like brain lesions. Currently available reports of non-neoplastic tumor-like brain lesions are scarce. Most case series focus on tumefactive demyelinating lesions, and a comprehensive review including other neuroimmunological conditions such as CNS vasculitis, neurosarcoidosis, histiocytic and infectious etiologies is lacking.We review the literature on tumor-like brain lesions intending to increase the awareness and differential diagnosis of non-neoplastic brain tumor mimics. We advocate for earlier brain biopsies, which, in our case series, significantly changed diagnosis, management, and outcomes.

    View details for DOI 10.1212/CPJ.0000000000200182

    View details for PubMedID 37664132

    View details for PubMedCentralID PMC10468256

  • Next Steps for Immunotherapy in Glioblastoma. Cancers Cao, T. Q., Wainwright, D. A., Lee-Chang, C., Miska, J., Sonabend, A. M., Heimberger, A. B., Lukas, R. V. 2022; 14 (16)

    Abstract

    Outcomes for glioblastoma (GBM) patients undergoing standard of care treatment remain poor. Here we discuss the portfolio of previously investigated immunotherapies for glioblastoma, including vaccine therapy and checkpoint inhibitors, as well as novel emerging therapeutic approaches. In addition, we explore the factors that potentially influence response to immunotherapy, which should be considered in future research aimed at improving immunotherapy efficacy.

    View details for DOI 10.3390/cancers14164023

    View details for PubMedID 36011015

    View details for PubMedCentralID PMC9406905

  • Clinical Reasoning: A 77-Year-Old Man With Involuntary Movements, Sleep Changes, Falls, Bulbar Symptoms, and Cognitive Complaints. Neurology Cao, T. Q., Harris, G. R., Lineback, C. M., Sokol, L. L., Mencacci, N., Opal, P. 2022; 99 (1): 26-30

    Abstract

    A 77-year-old-man presents with chorea, parasomnias, dysarthria and dysphagia, and cognitive issues. A broad workup reveals positive anti-IgLON5 antibody. This case report represents a textbook example of anti-IgLON5 syndrome.

    View details for DOI 10.1212/WNL.0000000000200705

    View details for PubMedID 35487699

  • Factors affecting time to brain metastases for stage 2 and 3 breast cancer patients: A large single-institutional analysis with potential screening implications. Neuro-oncology advances Cao, T. Q., Dixit, K., Santa-Maria, C., Kumthekar, P. 2021; 3 (1): vdab009

    Abstract

    Breast cancer is the second most common cancer associated with brain metastases. The purpose of this study was to identify factors that impact the time to brain metastases in breast cancer patients at a single institution.Single institution retrospective study that captured all consecutive stage 2 and stage 3 breast cancer patients from 2003 to 2010. Patient characteristics analyzed included age, hormone status, HER2 receptor status, grade, stage, and time from breast cancer diagnosis to brain metastasis.A total of 1218 patients were eligible for the final analysis. 849 (69.7%) patients were ER+/HER2-, 90 (7.4%) were HER2+, and 279 (22.9%) were triple-negative (TN). Overall, 74 patients (6.1%) developed brain metastases over a median follow up time of 92 months. Median times to brain metastases for HER2+, TN, and ER+/HER2- patients were 20, 26, and 57 months, respectively. Multivariate analysis demonstrated that TN disease (HR = 2.043, P = .015), grade (HR = 1.667, P = .024) and stage (HR = 3.851, P < .001) were independent risk factors for earlier brain metastases. Median times to brain metastases were 34 and 52 months for stage 3 and 2 patients, and 30, 49, and 71 months for grade 3, 2, and 1 tumors, respectively.This single-institutional case series demonstrates that TN breast cancer, higher stage, and higher histologic grade are associated with earlier brain metastases in multivariate analysis. Additional prospective studies are warranted to investigate the impact of brain metastases screening on survival outcome in this high-risk defined group.

    View details for DOI 10.1093/noajnl/vdab009

    View details for PubMedID 33738445

    View details for PubMedCentralID PMC7954098