scholarly journals Response assessment in high-grade glioma: tumor volume as endpoint

2017 ◽  
Vol 19 (6) ◽  
pp. 744-745 ◽  
Author(s):  
Raymond Huang
Keyword(s):  
Tumor Volume ◽  
High Grade Glioma ◽  
Response Assessment ◽  
High Grade ◽  
Glioma Tumor

scholarly journals Impact of mass effect, tumor location, age, and surgery on the cognitive outcome of patients with high-grade gliomas: a longitudinal study

2017 ◽  
Vol 4 (4) ◽  
pp. 229-240 ◽  
Author(s):  
Monica Dallabona ◽  
Silvio Sarubbo ◽  
Stefano Merler ◽  
Francesco Corsini ◽  
Giuseppe Pulcrano ◽  
...  
Keyword(s):  
Tumor Volume ◽  
High Grade Glioma ◽  
Joint Effect ◽  
Cognitive Outcome ◽  
Tumor Localization ◽  
High Grade ◽  
Patient Age ◽  
Patient Âgé ◽  
High Grade Gliomas

Abstract Background High-grade gliomas are the most frequently occurring brain tumors and carry unfavorable prognosis. Literature is controversial regarding the effects of surgery on cognitive functions. Methods We analyzed a homogenous population of 30 patients with high-grade glioma who underwent complete resection. Patients underwent extensive neuropsychological analysis before surgery, 7 days after surgery, and approximately 40 days after surgery, before adjuvant treatments. Thirty-four neuropsychological tests were administered in the language, memory, attention, executive functions, and praxis domains. Results The preoperative percentage of patients with impairment in the considered tests ranged from 0% to 53.3% (mean 20.9%). Despite a general worsening at early follow-up, a significant recovery was observed at late follow-up. Preoperative performances in language and verbal memory tasks depended on the joint effect of tumor volume, volume of surrounding edema, and tumor localization, with major deficits in patients with left lateralized tumor, especially insular and temporal. Preoperative performances in attention and constructive abilities tasks depended on the joint effect of tumor volume, volume of surrounding edema, and patient age, with major deficits in patients ≥ 65 years old. Recovery at late follow-up depended on the volume of resected tumor, edema resorption, and patient age. Conclusions Longitudinal neuropsychological performance of patients affected by high-grade glioma depends, among other factors, on the complex interplay of tumor volume, volume of surrounding edema, tumor localization, and patient age. Reported results support the definition of criteria for surgical indication based on the above factors. They may be used to propose more customized surgical, oncological, and rehabilitative strategies.

Current Concepts in Brain Tumor Imaging

2012 ◽  
pp. 119-124
Author(s):  
Andrew D. Norden ◽  
Whitney B. Pope ◽  
Susan M. Chang
Keyword(s):  
Standard Treatment ◽  
Tumor Imaging ◽  
High Grade Glioma ◽  
Response Assessment ◽  
Recurrent Glioblastoma ◽  
High Grade ◽  
Resonance Imaging ◽  
Imaging Tool ◽  
Magnetic Resonance Imaging Mri ◽  
New Criteria

Overview: Magnetic resonance imaging (MRI) is the most useful imaging tool in the evaluation of patients with brain tumors. Most information is supplied by standard anatomic images that were developed in the 1980s and 1990s. More recently, functional imaging including diffusion and perfusion MRI has been investigated as a way to generate predictive and prognostic biomarkers for high-grade glioma evaluation, but additional research is needed to establish the added benefits of these indices to standard MRI. Response critieria for high-grade gliomas have recently been updated by the Response Assessment in Neuro-Oncology (RANO) working group. The new criteria account for nonenhancing tumor in addition to the contrast-enhancing abnormalities on which older criteria relied. This issue has recently come to the fore with the introduction of the antiangiogenic agent bevacizumab into standard treatment for recurrent glioblastoma. Because of its potent antipermeability effect, contrast enhancement is markedly reduced in patients who receive bevacizumab. The RANO criteria also address the phenomenon of pseudoprogression, in which there may be transient MRI worsening of a glioblastoma following concurrent radiotherapy and temozolomide.

scholarly journals Current standards and new concepts in MRI and PET response assessment of antiangiogenic therapies in high-grade glioma patients

2014 ◽  
Vol 17 (6) ◽  
pp. 784-800 ◽  
Author(s):  
M. Hutterer ◽  
E. Hattingen ◽  
C. Palm ◽  
M. A. Proescholdt ◽  
P. Hau
Keyword(s):  
High Grade Glioma ◽  
Response Assessment ◽  
High Grade ◽  
Antiangiogenic Therapies ◽  
New Concepts ◽  
Current Standards

scholarly journals Prognostic Value of Metabolic Tumor Volume on 11C-Methionine PET in Predicting Progression-Free Survival in High-Grade Glioma

2015 ◽  
Vol 49 (4) ◽  
pp. 291-297 ◽  
Author(s):  
Min Young Yoo ◽  
Jin Chul Paeng ◽  
Gi Jeong Cheon ◽  
Dong Soo Lee ◽  
June-Key Chung ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Tumor Volume ◽  
Progression Free Survival ◽  
High Grade Glioma ◽  
Metabolic Tumor Volume ◽  
High Grade ◽  
Free Survival

Urotensin II receptor endogenous ligands as new candidates involved in high grade glioma tumor growth and neo-angiogenesis

2012 ◽  
Vol 177 ◽  
pp. S26
Author(s):  
V. Le Joncour ◽  
C. Lecointre ◽  
M. Jarry ◽  
J.E. Joubert ◽  
M.T. Schouft ◽  
...  
Keyword(s):  
Tumor Growth ◽  
High Grade Glioma ◽  
High Grade ◽  
Urotensin Ii ◽  
Endogenous Ligands ◽  
Glioma Tumor

Explainable prediction of survival using clinical, molecular, and radiomic profiles in recurrent high-grade glioma patients treated with CAR T-cell therapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 104-104
Author(s):  
Chi Wah Wong ◽  
Aleksandr Filippov ◽  
Kimberley-Jane C. Bonjoc ◽  
Christine Brown ◽  
Behnam Badie ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Therapy ◽  
Surface Area ◽  
Tumor Volume ◽  
High Grade Glioma ◽  
High Grade ◽  
T Cell Therapy ◽  
Car T Cell ◽  
Car T Cell Therapy ◽  
Car T

104 Background: High-grade glioma (HGG) is an aggressive heterogeneous primary CNS neoplasm with high recurrence rate and poor survival. Multiple ongoing clinical trials are leveraging targeted molecular and immunologic therapeutics (e.g., pembrolizumab, Chimeric Antigen Receptor [CAR] T-cell therapy) in effort to improve survival. Explainable predictive models have shown value in identifying biomarkers predictive of treatment response as well as informing prognosis. In this study, we developed an explainable machine learning model leveraging clinical, molecular and radiomic (imaging) features to predict overall survival in patients suffering from HGG treated with CAR T-cell therapy. Methods: In this IRB-approved phase 1 clinical trial, 60 patients (39 males, median age = 49) suffering from HGG underwent surgical resection and CAR T-cell therapy1. All patients underwent baseline MRI scans prior to both surgical resection and CAR T-cell administration in the resection cavity. Using contrast-enhanced T1-weighted MRIs, we segmented the enhancing tumor (ET) and generated radiomic features. For predictive modeling, we incorporated the following features: Age, gender, race, ethnicity, histology, tumor grade (WHO), IL-13 receptor alpha 2 (IL-13Rα2) expression (H score), unifocal or multifocal lesions, tumor location (lobe), shape-based radiomics (tumor volume, surface area, and sphericity). We utilized gradient-boosted tree models to classify whether survival is above or below 180 days with two-loop nested cross-validation. For the inner validation loop, we optimized the model with hyper-parameter tuning. For the outer validation loop, we tested the optimal model on the hold-out data and the predictions were used as survival scores (0 – 1). Larger scores imply better predicted survival. For prediction explanations, we adopted the Shapley additive explanation (SHAP) framework. Results: The outer validation loop Area Under the Receiver Operating Characteristic Curve and Area under the Precision-Recall Curve were 0.76 and 0.81, respectively. Among the top five most important features calculated from SHAP; patients with larger tumor surface area, tumor volume and age have reduced survival scores while patients with larger IL-13Rα2 and tumor sphericity have increased survival scores. We stratified the patients into two distinct prognostic sub-groups (30 patients each group) using the survival scores obtained from the outer loop, with a log-rank test p < 0.01. Conclusions: In patients with HGG treated with CAR T-cell therapy, we found that tumor surface area/volume and age are inversely related to survival while increased IL-13Rα2 expression and tumor sphericity were positive predictor of survival. Our model can potentially be used to optimize clinical trial enrollment through more precise patient screening and treatment planning.

scholarly journals Dynamics of circulating hypoxia-mediated miRNAs and tumor response in patients with high-grade glioma treated with bevacizumab

2016 ◽  
Vol 125 (4) ◽  
pp. 1008-1015 ◽  
Author(s):  
Tali Siegal ◽  
Hanna Charbit ◽  
Iddo Paldor ◽  
Bracha Zelikovitch ◽  
Tamar Canello ◽  
...  
Keyword(s):  
Tumor Response ◽  
High Grade Glioma ◽  
Response Assessment ◽  
High Rate ◽  
Normal Brain ◽  
High Grade ◽  
Serum Samples ◽  
Antiangiogenic Effect ◽  
Bevacizumab Treatment ◽  
Fluid Attenuated Inversion Recovery

OBJECTIVE Bevacizumab is an antiangiogenic agent under investigation for use in patients with high-grade glioma. It produces a high rate of radiological response; however, this response should be interpreted with caution because it may reflect normalization of the tumor vasculature and not necessarily a true antitumor effect. The authors previously demonstrated that 4 hypoxia-mediated microRNAs (miRNA)—miR-210, miR-21, miR-10b, and miR-196b—are upregulated in glioma as compared with normal brain tissue. The authors hypothesized that the regulation and expression of these miRNAs would be altered in response to bevacizumab treatment. The object of this study was to perform longitudinal monitoring of circulating miRNA levels in patients undergoing bevacizumab treatment and to correlate it with tumor response. METHODS A total of 120 serum samples from 28 patients with high-grade glioma were prospectively collected prior to bevacizumab (n = 15) or temozolomide (TMZ; n = 13) treatment and then longitudinally during treatment. Quantification of the 4 miRNAs was evaluated by real-time polymerase chain reaction using total RNA extracted from the serum. At each time point, tumor response was assessed by Response Assessment in Neuro-Oncology criteria and by performing MRI using fluid attenuated inversion recovery (FLAIR) and contrast-enhanced images. RESULTS As compared with pretreatment levels, high levels of miR-10b and miR-21 were observed in the majority of patients throughout the bevacizumab treatment period. miR-10b and miR-21 levels correlated negatively and significantly with changes in enhancing tumor diameters (r = −0.648, p < 0.0001) in the bevacizumab group but not in the TMZ group. FLAIR images and the RANO assessment did not correlate with the sum quantification of these miRNAs in either group. CONCLUSIONS Circulating levels of miR-10b and miR-21 probably reflect the antiangiogenic effect of therapy, but their role as biomarkers for tumor response remains uncertain and requires further investigation.

scholarly journals Large volume re-irradiation with bevacizumab is a feasible salvage option for patients with refractory high-grade glioma

2014 ◽  
Vol 2 (1) ◽  
pp. 48-53 ◽  
Author(s):  
Michael Back ◽  
Cecelia E. Gzell ◽  
Marina Kastelan ◽  
Linxin Guo ◽  
Helen R. Wheeler
Keyword(s):  
Median Survival ◽  
Large Volume ◽  
Small Volume ◽  
Tumor Volume ◽  
High Grade Glioma ◽  
Target Volume ◽  
Tumor Diameter ◽  
High Grade ◽  
Kaplan Meier ◽  
Maximum Tumor Diameter

AbstractBackgroundClinical studies of re-irradiation (ReRT) for relapsed high-grade glioma (HGG) have generally reported the use of small volume ReRT techniques such as stereotactic radiosurgery in selected patients with isolated focal relapse. This study reports the outcome with large-volume ReRT to manage the more common mescenario of extensive diffuse relapse of HGG.MethodsAll HGG patients managed with an overlapping second course of radiation therapy (RT) for refractory progression of HGG between October 2009 and April 2013 were included. ReRT was initially used with bevacizumab (BEV), then used when disease was refractory to BEV, and finally used upfront with BEV-naïve patients. Tumor volume (GTV) and specific RT dosimetry factors, including the target volume treated (PTV), and cumulative RT dose maximum (Dmax), were analyzed. Median survival post ReRT was calculated using the Kaplan-Meier method and SPPS v19 software.ResultsEighteen HGG participants with refractory, bulky contrast-enhancing disease received ReRT. Thirteen participants had a maximum tumor diameter &gt;5 cm, and median GTV was 54 cm3. Seven participants had BEV-refractory disease, and 8 participants were BEV naïve. ReRT dose was 35–40 Gy in 15 fractions; median PTV was 133 cm3, and median Dmax was 98.2 Gy. Median survival post ReRT for all participants was 8 months (95%CI, 5.8–10.2 months); with 10 months and 3 months for the BEV-naïve and BEV-refractory participants, respectively (P = .024). Two early participants, who were managed without BEV, were later salvaged with BEV, including one who required craniotomy for radiation necrosis at 6 weeks post RT. No other significant morbidity was reported.ConclusionReRT combined with BEV is a feasible salvage treatment option for diffuse refractory HGG.

scholarly journals P04.05 Improving treatment response assessment of high grade glioma: classification of lesion area into tumor and non-tumor components

2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii40-iii41
Author(s):  
D. T. Blumenthal ◽  
M. Artzi ◽  
G. Liberman ◽  
Bokstein ◽  
O. Aizenstein ◽  
...  
Keyword(s):  
Treatment Response ◽  
High Grade Glioma ◽  
Response Assessment ◽  
High Grade ◽  
Lesion Area ◽  
Treatment Response Assessment ◽  
Glioma Classification
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