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01-06-2016 | Topic Review

Perfusion MRI as the predictive/prognostic and pharmacodynamic biomarkers in recurrent malignant glioma treated with bevacizumab: a systematic review and a time-to-event meta-analysis

Authors: Sang Hyun Choi, Seung Chai Jung, Kyung Won Kim, Ja Youn Lee, Yoonseok Choi, Seong Ho Park, Ho Sung Kim

Published in: Journal of Neuro-Oncology | Issue 2/2016

Abstract

This study aims to evaluate the value of perfusion MRI as a predictive/prognostic biomarker and a pharmacodynamic biomarker in patients with recurrent glioma treated with a bevacizumab-based regimen. We identified thirteen literature reports that investigated dynamic susceptibility-contrast (DSC) MRI or dynamic contrast-enhanced (DCE) MRI for predicting the patient outcome and analyzing the anti-angiogenic effect of bevacizumab by performing a systematic search of MEDLINE and EMBASE. The relative cerebral volume (rCBV) of DSC-MRI is currently the most common perfusion MRI parameter used as a predictive/prognostic biomarker. Pooled hazard ratios between responders and non-responders, as determined by rCBV, were 0.46 (95 % CI 0.28–0.76) for progression-free survival from five articles with a total 226 patients and 0.47 (95 % CI 0.29–0.76) for overall survival from six articles with a total 247 patients, and thus indicating that rCBV is helpful for predicting disease progression and the eventual outcome after treatment. Regarding the pharmacodynamic value of perfusion MRI parameters derived from either DSC-MRI or DCE-MRI, most perfusion MRI parameters (rCBV, K_trans, CBV_max, Kps_max, f_pv, V_e and K_ep) demonstrated a consistent decrease on the follow-up MRI after treatment, indicating that perfusion MRI may be helpful for evaluating the anti-angiogenic effect of a bevacizumab-based treatment regimen. However, the lack of standardization of imaging acquisition and analysis techniques for various perfusion MRI parameters needs to be resolved in the future. Despite these unsolved issues, the current evidence favoring the use of perfusion MRI as a predictive/prognostic or pharmacodynamic biomarker should be considered in patients with glioma treated using a bevacizumab-based regimen.

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Title: Perfusion MRI as the predictive/prognostic and pharmacodynamic biomarkers in recurrent malignant glioma treated with bevacizumab: a systematic review and a time-to-event meta-analysis
Authors: Sang Hyun Choi
Seung Chai Jung
Kyung Won Kim
Ja Youn Lee
Yoonseok Choi
Seong Ho Park
Ho Sung Kim
Publication date: 01-06-2016
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 2/2016
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-016-2102-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perfusion MRI as the predictive/prognostic and pharmacodynamic biomarkers in recurrent malignant glioma treated with bevacizumab: a systematic review and a time-to-event meta-analysis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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