Photo of Lakshmi Nayak,  MD

Lakshmi Nayak, MD

Dana-Farber Cancer Institute

Dana-Farber Cancer Institute
Phone: (617) 632-6177


lakshmi_nayak@dfci.harvard.edu

Lakshmi Nayak, MD

Dana-Farber Cancer Institute

EDUCATIONAL TITLES

  • Assistant Professor, Neurology, Harvard Medical School
  • Physician, Center for Neuro-Oncology, Dana-Farber Cancer Institute

DF/HCC PROGRAM AFFILIATION

Research Abstract

My research interest is in the development of phase I and II clinical trials utilizing novel therapeutic agents in high-grade gliomas and primary central nervous system lymphoma (PCNSL).

I submitted a letter of intent in response to a mass-solicitation request from Cancer Therapy Evaluation Program (CTEP) for a phase I study of MLN0128 (mTOR1/2 inhibitor) in combination with bevacizumab for solid tumors including glioblastomas, which was accepted among many other competitive proposals submitted to CTEP. I am leading this multicenter phase I trial in collaboration with the early drug development center (EDDC) at DFCI and Ohio State University. This is one of the first few multicenter phase I trials involving both systemic cancers and brain cancer.

I have special interest in PCNSL and have helped to establish a referral base at DFCI for patients with this rare cancer. Over my last 4 years at DFCI, the volume of patients with PCNSL and secondary CNSL seen in the center for neuro-oncology clinic and admitted to the in-patient service for chemotherapy has increased. I am the site PI for a multicenter randomized trial for treatment of newly diagnosed PCNSL.

I am on a national panel of the Joint Guidelines Committee of the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) which has recently drafted guidelines for management of progressive glioblastoma, as well as on the Neuro-Oncology Guidelines Committee for the American Academy of Neurology (AAN).

I am co-leading an international effort in collaboration with key leaders in neuro-oncology as a part of the Neurologic Assessment in Neuro-Oncology (NANO) working group to develop the NANO scale as an objective and quantifiable measure of neurologic function to facilitate comparison across clinical trials and therapeutic interventions. I led an international, multi-institutional study to assess the reliability and the inter-observer variability of the scale which was recently completed and demonstrated a high agreement rate between observers. I am currently working on further development of this tool as a ClinRO (clinician-reported outcome) measure for outcome assessment in brain tumor trials.

Publications

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  • Arvold ND, Shi DD, Aizer AA, Norden AD, Reardon DA, Lee EQ, Nayak L, Dunn IF, Golby AJ, Johnson MD, Claus EB, Chiocca EA, Ligon KL, Wen PY, Alexander BM. Salvage re-irradiation for recurrent high-grade glioma and comparison to bevacizumab alone. J. Neurooncol. 2017. PubMed
  • DeFilipp Z, Li S, El-Jawahri A, Armand P, Nayak L, Wang N, Batchelor TT, Chen YB. High-dose chemotherapy with thiotepa, busulfan, and cyclophosphamide and autologous stem cell transplantation for patients with primary central nervous system lymphoma in first complete remission. Cancer 2017. PubMed
  • Nayak L, Iwamoto FM, LaCasce A, Mukundan S, Roemer MGM, Chapuy B, Armand P, Rodig SJ, Shipp MA. PD-1 blockade with nivolumab in relapsed/refractory primary central nervous system and testicular lymphoma. Blood 2017. PubMed
  • Nayak L, de Groot J, Wefel JS, Cloughesy TF, Lieberman F, Chang SM, Omuro A, Drappatz J, Batchelor TT, DeAngelis LM, Gilbert MR, Aldape KD, Yung AW, Fisher J, Ye X, Chen A, Grossman S, Prados M, Wen PY. Phase I trial of aflibercept (VEGF trap) with radiation therapy and concomitant and adjuvant temozolomide in patients with high-grade gliomas. J. Neurooncol. 2017. PubMed
  • Nayak L, DeAngelis LM, Brandes AA, Peereboom DM, Galanis E, Lin NU, Soffietti R, Macdonald DR, Chamberlain M, Perry J, Jaeckle K, Mehta M, Stupp R, Muzikansky A, Pentsova E, Cloughesy T, Iwamoto FM, Tonn JC, Vogelbaum MA, Wen PY, van den Bent MJ, Reardon DA. The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria. 2017; 19:625-635. PubMed
  • Butowski N, Colman H, De Groot JF, Omuro AM, Nayak L, Wen PY, Cloughesy TF, Marimuthu A, Haidar S, Perry A, Huse J, Phillips J, West BL, Nolop KB, Hsu HH, Ligon KL, Molinaro AM, Prados M. Orally administered colony stimulating factor 1 receptor inhibitor PLX3397 in recurrent glioblastoma: an Ivy Foundation Early Phase Clinical Trials Consortium phase II study. 2016; 18:557-64. PubMed
  • Castillo JJ, D'Sa S, Lunn MP, Minnema MC, Tedeschi A, Lansigan F, Palomba ML, Varettoni M, Garcia-Sanz R, Nayak L, Lee EQ, Rinne ML, Norden AD, Ghobrial IM, Treon SP. Central nervous system involvement by Waldenström macroglobulinaemia (Bing-Neel syndrome): a multi-institutional retrospective study. British Journal of Haematology 2016; 172:709-15. PubMed
  • Lee EQ, Muzikansky A, Drappatz J, Kesari S, Wong ET, Fadul CE, Reardon DA, Norden AD, Nayak L, Rinne ML, Alexander BM, Arvold ND, Doherty L, Stefanik J, LaFrankie D, Ruland SF, Pulverenti J, Smith KH, Gaffey SC, Hammond S, Wen PY. A randomized, placebo-controlled pilot trial of armodafinil for fatigue in patients with gliomas undergoing radiotherapy. 2016. PubMed
  • Nayak L, DeAngelis LM, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas JR, Peereboom DM, Rosenfeld SS, Muzikansky A, Zheng M, Urban P, Abrey LE, Omuro A, Wen PY. Multicenter phase 2 study of patupilone for recurrent or progressive brain metastases from non-small cell lung cancer. Cancer 2015. PubMed
  • Huang RY, Rahman R, Ballman KV, Felten SJ, Anderson SK, Ellingson BM, Nayak L, Lee EQ, Abrey LE, Galanis E, Reardon DA, Pope WB, Cloughesy TF, Wen PY. The Impact of T2/FLAIR Evaluation per RANO Criteria on Response Assessment of Recurrent Glioblastoma Patients Treated with Bevacizumab. Clin Cancer Res 2015. PubMed
  • Gounder MM, Nayak L, Sahebjam S, Muzikansky A, Sanchez AJ, Desideri S, Ye X, Ivy SP, Nabors LB, Prados M, Grossman S, DeAngelis LM, Wen PY. Evaluation of the Safety and Benefit of Phase I Oncology Trials for Patients With Primary CNS Tumors. J Clin Oncol 2015; 33:3186-92. PubMed
  • Ramkissoon SH, Bi WL, Schumacher SE, Ramkissoon LA, Haidar S, Knoff D, Dubuc A, Brown L, Burns M, Cryan JB, Abedalthagafi M, Kang YJ, Schultz N, Reardon DA, Lee EQ, Rinne ML, Norden AD, Nayak L, Ruland S, Doherty LM, LaFrankie DC, Horvath M, Aizer AA, Russo A, Arvold ND, Claus EB, Al-Mefty O, Johnson MD, Golby AJ, Dunn IF, Chiocca EA, Trippa L, Santagata S, Folkerth RD, Kantoff P, Rollins BJ, Lindeman NI, Wen PY, Ligon AH, Beroukhim R, Alexander BM, Ligon KL. Clinical implementation of integrated whole-genome copy number and mutation profiling for glioblastoma. 2015. PubMed
  • Aizer AA, Abedalthagafi M, Linda Bi W, Horvath MC, Arvold ND, Al-Mefty O, Lee EQ, Nayak L, Rinne ML, Norden AD, Reardon DA, Wen PY, Ligon KL, Ligon AH, Beroukhim R, Dunn IF, Santagata S, Alexander BM. A prognostic cytogenetic scoring system to guide the adjuvant management of patients with atypical meningioma. 2015. PubMed
  • Aizer AA, Bi WL, Kandola MS, Lee EQ, Nayak L, Rinne ML, Norden AD, Beroukhim R, Reardon DA, Wen PY, Al-Mefty O, Arvold ND, Dunn IF, Alexander BM. Extent of resection and overall survival for patients with atypical and malignant meningioma. Cancer 2015. PubMed
  • Rahman R, Catalano PJ, Reardon DA, Norden AD, Wen PY, Lee EQ, Nayak L, Beroukhim R, Dunn IF, Golby AJ, Johnson MD, Chiocca EA, Claus EB, Alexander BM, Arvold ND. Incidence, risk factors, and reasons for hospitalization among glioblastoma patients receiving chemoradiation. J. Neurooncol. 2015; 124:137-46. PubMed
  • Lee EQ, Reardon DA, Schiff D, Drappatz J, Muzikansky A, Grimm SA, Norden AD, Nayak L, Beroukhim R, Rinne ML, Chi AS, Batchelor TT, Hempfling K, McCluskey C, Smith KH, Gaffey SC, Wrigley B, Ligon KL, Raizer JJ, Wen PY. Phase II study of panobinostat in combination with bevacizumab for recurrent glioblastoma and anaplastic glioma. 2015. PubMed
  • Arvold ND, Tanguturi SK, Aizer AA, Wen PY, Reardon DA, Lee EQ, Nayak L, Christianson LW, Horvath MC, Dunn IF, Golby AJ, Johnson MD, Claus EB, Chiocca EA, Ligon KL, Alexander BM. Hypofractionated versus standard radiation therapy with or without temozolomide for older glioblastoma patients. Int J Radiat Oncol Biol Phys 2015. PubMed
  • Nayak L, Panageas KS, Reiner AS, Huse JT, Pentsova E, Braunthal SG, Abrey LE, DeAngelis LM, Lassman AB. Radiotherapy and temozolomide for anaplastic astrocytic gliomas. J. Neurooncol. 2015; 123:129-34. PubMed
  • Nayak L, Pentsova E, Batchelor TT. Primary CNS lymphoma and neurologic complications of hematologic malignancies. Continuum (Minneap Minn) 2015; 21:355-72. PubMed
  • Schiff D, Lee EQ, Nayak L, Norden AD, Reardon DA, Wen PY. Medical management of brain tumors and the sequelae of treatment. 2015; 17:488-504. PubMed
  • Chen YB, Batchelor T, Li S, Hochberg E, Brezina M, Jones S, Del Rio C, Curtis M, Ballen KK, Barnes J, Chi AS, Dietrich J, Driscoll J, Gertsner ER, Hochberg F, LaCasce AS, McAfee SL, Spitzer TR, Nayak L, Armand P. Phase 2 trial of high-dose rituximab with high-dose cytarabine mobilization therapy and high-dose thiotepa, busulfan, and cyclophosphamide autologous stem cell transplantation in patients with central nervous system involvement by non-Hodgkin lymphoma. Cancer 2015. PubMed
  • Norden AD, Schiff D, Ahluwalia MS, Lesser GJ, Nayak L, Lee EQ, Rinne ML, Muzikansky A, Dietrich J, Purow B, Doherty LM, LaFrankie DC, Pulverenti JR, Rifenburg JA, Ruland SF, Smith KH, Gaffey SC, McCluskey C, Ligon KL, Reardon DA, Wen PY. Phase II trial of triple tyrosine kinase receptor inhibitor nintedanib in recurrent high-grade gliomas. J. Neurooncol. 2015. PubMed
  • Aizer AA, Arvold ND, Catalano P, Claus EB, Golby AJ, Johnson MD, Al-Mefty O, Wen PY, Reardon DA, Lee EQ, Nayak L, Rinne ML, Beroukhim R, Weiss SE, Ramkissoon SH, Abedalthagafi M, Santagata S, Dunn IF, Alexander BM. Adjuvant radiation therapy, local recurrence, and the need for salvage therapy in atypical meningioma. 2014. PubMed
  • Rahman R, Hempfling K, Norden AD, Reardon DA, Nayak L, Rinne ML, Beroukhim R, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Alexander BM, Huang RY, Wen PY, Lee EQ. Retrospective study of carmustine or lomustine with bevacizumab in recurrent glioblastoma patients who have failed prior bevacizumab. 2014; 16:1523-9. PubMed
  • Olson JJ, Nayak L, Ormond DR, Wen PY, Kalkanis SN, Ryken TC, . The role of targeted therapies in the management of progressive glioblastoma : a systematic review and evidence-based clinical practice guideline. J. Neurooncol. 2014. PubMed
  • Olson JJ, Nayak L, Ormond DR, Wen PY, Kalkanis SN, . The role of cytotoxic chemotherapy in the management of progressive glioblastoma : a systematic review and evidence-based clinical practice guideline. J. Neurooncol. 2014. PubMed
  • Christman MP, Turbett SE, Sengupta S, Bakhadirov KU, Williamson CA, Nayak L, Milligan T, Katz JT. Recurrence of herpes simplex encephalitis associated with temozolomide chemoradiation for malignant glioma: a case report and review of the literature. Oxf Med Case Reports 2015; 2014:1-4. PubMed
  • Nayak L, Batchelor TT. Recent advances in treatment of primary central nervous system lymphoma. Curr Treat Options Oncol 2013; 14:539-52. PubMed
  • Zhang JP, Lee EQ, Nayak L, Doherty L, Kesari S, Muzikansky A, Norden AD, Chen H, Wen PY, Drappatz J. Retrospective study of pemetrexed as salvage therapy for central nervous system lymphoma. J. Neurooncol. 2013; 115:71-7. PubMed
  • Rinne ML, Lee EQ, Nayak L, Norden AD, Beroukhim R, Wen PY, Reardon DA. Update on bevacizumab and other angiogenesis inhibitors for brain cancer. Expert Opin Emerg Drugs 2013. PubMed
  • Lee EQ, Nayak L, Wen PY, Reardon DA. Treatment options in newly diagnosed glioblastoma. Curr Treat Options Neurol 2013. PubMed
  • Villano JL, Wen PY, Lee EQ, Nayak L, Reardon DA, Rosenfeld MR. PCV for anaplastic oligodendrogliomas: back to the future or a step backwards? A point/counterpoint discussion. J. Neurooncol. 2013. PubMed
  • Nayak L, Fleisher M, Gonzalez-Espinoza R, Lin O, Panageas K, Reiner A, Liu CM, Deangelis LM, Omuro A. Rare cell capture technology for the diagnosis of leptomeningeal metastasis in solid tumors. Neurology 2013; 80:1598-605; discussion 1603. PubMed
  • Nayak L, Abrey LE, Drappatz J, Gilbert MR, Reardon DA, Wen PY, Prados M, Deangelis LM, Omuro A, . Multicenter phase II study of rituximab and temozolomide in recurrent primary central nervous system lymphoma. Leuk Lymphoma 2012; 54:58-61. PubMed
  • Scott JG, Bauchet L, Fraum TJ, Nayak L, Cooper AR, Chao ST, Suh JH, Vogelbaum MA, Peereboom DM, Zouaoui S, Mathieu-Daudé H, Fabbro-Peray P, Rigau V, Taillandier L, Abrey LE, DeAngelis LM, Shih JH, Iwamoto FM. Recursive partitioning analysis of prognostic factors for glioblastoma patients aged 70 years or older. Cancer 2012; 118:5595-600. PubMed
  • Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Lee EQ, Drappatz J, Omuro A, Kaley TJ. Atypical and anaplastic meningiomas treated with bevacizumab. J. Neurooncol. 2012; 109:187-93. PubMed
  • Graber JJ, Nayak L, Deangelis LM. Use of recombinant tissue plasminogen activator in cancer patients with acute stroke. J. Neurooncol. 2012; 107:571-3. PubMed
  • Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Curr Oncol Rep 2012. PubMed
  • Nayak L, Hedvat C, Rosenblum MK, Abrey LE, DeAngelis LM. Late relapse in primary central nervous system lymphoma: clonal persistence. 2011; 13:525-9. PubMed
  • Nayak L, Iwamoto FM. Primary brain tumors in the elderly. Curr Neurol Neurosci Rep 2010; 10:252-8. PubMed
  • Iwamoto FM, Reiner AS, Nayak L, Panageas KS, Elkin EB, Abrey LE. Prognosis and patterns of care in elderly patients with glioma. Cancer 2009; 115:5534-40. PubMed
  • Iwamoto FM, Cooper AR, Reiner AS, Nayak L, Abrey LE. Glioblastoma in the elderly: the Memorial Sloan-Kettering Cancer Center Experience (1997-2007). Cancer 2009; 115:3758-66. PubMed
  • Nayak L, Abrey LE, Iwamoto FM. Intracranial dural metastases. Cancer 2009; 115:1947-53. PubMed
  • Nayak L, Rubin M. Amphiphysin autoimmunity in paraneoplastic neurologic disease. Clin Adv Hematol Oncol 2009; 7:183-4. PubMed
  • Nayak L, Henchcliffe C. Rasagiline in treatment of Parkinson's disease. Neuropsychiatr Dis Treat 2008; 4:23-32. PubMed
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