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Treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide
- Source :
- Flies , C M , Friedrich , M , Lohmann , P , van Garderen , K A , Smits , M , Tonn , J-C , Weller , M , Galldiks , N & Snijders , T J 2024 , ' Treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide ' , Neuro-Oncology , vol. 26 , no. 5 , noad247 , pp. 902-910 .
- Publication Year :
- 2024
-
Abstract
- Background Radiological progression may originate from progressive disease (PD) or pseudoprogression/treatment-associated changes. We assessed radiological progression in O6-methylguanine-DNA methyltransferase (MGMT) promoter-methylated glioblastoma treated with standard-of-care chemoradiotherapy with or without the integrin inhibitor cilengitide according to the modified response assessment in neuro-oncology (RANO) criteria of 2017.Methods Patients with >= 3 follow-up MRIs were included. Preliminary PD was defined as a >= 25% increase of the sum of products of perpendicular diameters (SPD) of a new or increasing lesion compared to baseline. PD required a second >= 25% increase of the SPD. Treatment-associated changes require stable or regressing disease after preliminary PD.Results Of the 424 evaluable patients, 221 patients (52%) were randomized into the cilengitide and 203 patients (48%) into the control arm. After chemoradiation with or without cilengitide, preliminary PD occurred in 274 patients (65%) during available follow-up, and 88 of these patients (32%) had treatment-associated changes, whereas 67 patients (25%) had PD. The remaining 119 patients (43%) had no further follow-up after preliminary PD. Treatment-associated changes were more common in the cilengitide arm than in the standard-of-care arm (24% vs. 17%; relative risk, 1.3; 95% CI, 1.004-1.795; P = .047). Treatment-associated changes occurred mainly during the first 6 months after RT (54% after 3 months vs. 13% after 6 months).Conclusions With the modified RANO criteria, the rate of treatment-associated changes was low compared to previous studies in MGMT promoter-methylated glioblastoma. This rate was higher after cilengitide compared to standard-of-care treatment. Confirmatory scans, as recommended in the modified RANO criteria, were not always available reflecting current clinical practice.
Details
- Database :
- OAIster
- Journal :
- Flies , C M , Friedrich , M , Lohmann , P , van Garderen , K A , Smits , M , Tonn , J-C , Weller , M , Galldiks , N & Snijders , T J 2024 , ' Treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide ' , Neuro-Oncology , vol. 26 , no. 5 , noad247 , pp. 902-910 .
- Notes :
- application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1422762345
- Document Type :
- Electronic Resource