Journal ArticleDOI
Updated Response Assessment Criteria for High-Grade Gliomas: Response Assessment in Neuro-Oncology Working Group
Patrick Y. Wen,David R. Macdonald,David A. Reardon,Timothy F. Cloughesy,A. Gregory Sorensen,Evanthia Galanis,John DeGroot,Wolfgang Wick,Mark R. Gilbert,Andrew B. Lassman,Christina Tsien,Tom Mikkelsen,Eric T. Wong,Marc C. Chamberlain,Roger Stupp,Kathleen R. Lamborn,Michael A. Vogelbaum,Martin J. van den Bent,Susan M. Chang +18 more
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TLDR
The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies.Abstract:
Currently, the most widely used criteria for assessing response to therapy in high-grade gliomas are based on two-dimensional tumor measurements on computed tomography (CT) or magnetic resonance imaging (MRI), in conjunction with clinical assessment and corticosteroid dose (the Macdonald Criteria). It is increasingly apparent that there are significant limitations to these criteria, which only address the contrast-enhancing component of the tumor. For example, chemoradiotherapy for newly diagnosed glioblastomas results in transient increase in tumor enhancement (pseudoprogression) in 20% to 30% of patients, which is difficult to differentiate from true tumor progression. Antiangiogenic agents produce high radiographic response rates, as defined by a rapid decrease in contrast enhancement on CT/MRI that occurs within days of initiation of treatment and that is partly a result of reduced vascular permeability to contrast agents rather than a true antitumor effect. In addition, a subset of patients treated with antiangiogenic agents develop tumor recurrence characterized by an increase in the nonenhancing component depicted on T2-weighted/fluid-attenuated inversion recovery sequences. The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies. The Response Assessment in Neuro-Oncology Working Group is an international effort to develop new standardized response criteria for clinical trials in brain tumors. In this proposal, we present the recommendations for updated response criteria for high-grade gliomas.read more
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MRI combined with PET-CT of different tracers to improve the accuracy of glioma diagnosis: a systematic review and meta-analysis
TL;DR: A systematic review and meta-analysis evaluating the pros and cons and the accuracy of different examinations of positron emission tomography-computed tomography combined with magnetic resonance imaging (MRI) in the diagnosis of glioma found that the combination of MRI and PET-CT can definitively improve the diagnostic accuracy ofglioma.
Journal ArticleDOI
Comparison of ADC metrics and their association with outcome for patients with newly diagnosed glioblastoma being treated with radiation therapy, temozolomide, erlotinib and bevacizumab.
Qiuting Wen,Laleh Jalilian,Janine M. Lupo,Annette M. Molinaro,Susan M. Chang,Jennifer Clarke,Michael D. Prados,Sarah J. Nelson +7 more
TL;DR: The value of ADC metrics obtained from the T2L at the post-RT time point is emphasized as non-invasive biomarkers for assessing residual tumor in patients with newly diagnosed GBM being treated with combination therapy that includes the anti-angiogenic agent bevacizumab.
Journal ArticleDOI
The use of tumour volumetrics to assess response to therapy in anticancer clinical trials.
TL;DR: Measurements of entire tumour volumes may overcome some of the limitations of linear tumour measurements, improving the ability to detect small changes reliably and increasing statistical power per subject in a trial.
Journal ArticleDOI
Peri-ictal pseudoprogression in patients with brain tumor.
Sylvain Rheims,Damien Ricard,Martin J. van den Bent,Luc Taillandier,Véronique Bourg,Virginie Desestret,Stéphanie Cartalat-Carel,Marc Hermier,Annick Monjour,Jean-Yves Delattre,Marc Sanson,Jérôme Honnorat,François Ducray +12 more
TL;DR: In patients with brain tumor, especially in long-term survivors of radiotherapy, the appearance of new cortical and/or leptomeningeal contrast-enhancing lesions in a context of frequent seizures should raise the suspicion of peri-ictal pseudoprogression.
Journal ArticleDOI
Comparing Glioblastoma Surgery Decisions Between Teams Using Brain Maps of Tumor Locations, Biopsies, and Resections.
Domenique M J Müller,Pierre A. Robe,Roelant S Eijgelaar,Marnix G. Witte,Marjolein Visser,Jan C. de Munck,Marieke L D Broekman,Tatjana Seute,Jeroen Hendrikse,David P. Noske,William P. Vandertop,Frederik Barkhof,Frederik Barkhof,Mathilde C.M. Kouwenhoven,Emmanuel Mandonnet,Mitchel S. Berger,Philip C. De Witt Hamer +16 more
TL;DR: In this paper, a volumetric voxel-wise method for direct comparison between two multidisciplinary teams of glioblastoma surgery decisions throughout the brain was presented.
References
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Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma
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Malignant Gliomas in Adults
Patrick Y. Wen,Santosh Kesari +1 more
TL;DR: The authors found that approximately 5% of patients with malignant gliomas have a family history of glioma and most of these familial cases are associated with rare genetic syndromes, such as neurofibromatosis types 1 and 2, the Li−Fraumeni syndrome (germ-line p53 mutations associated with an increased risk of several cancers), and Turcot's syndrome (intestinal polyposis and brain tumors).
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