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Published in:

01-02-2011

Response Assessment in Neuro-Oncology

Authors: Eudocia C. Quant, Patrick Y. Wen

Published in: Current Oncology Reports | Issue 1/2011

Abstract

Accuracy and reproducibility in determining response to therapy and tumor progression can be difficult to achieve for nervous system tumors. Current response criteria vary depending on the pathology and have several limitations. Until recently, the most widely used criteria for gliomas were “Macdonald criteria,” based on two-dimensional tumor measurements on neuroimaging studies. However, the Response Assessment in Neuro-Oncology (RANO) Working Group has published new recommendations in high-grade gliomas and is working on recommendations for other nervous system tumors. This article reviews current response criteria for high-grade glioma, low-grade glioma, brain metastasis, meningioma, and schwannoma.

American Cancer Society. Cancer Facts & Figures 2010. Atlanta, GA: American Cancer Society, Inc.; 2010.

Wen PY, Black PM, Loeffler JS: Metastatic brain cancer. In: Cancer: Principles and Practice of Oncology. Edited by DeVita V, Hellman S, Rosenberg SA. Philadelphia: Lippincott, Williams, & Wilkins; 2001:2655–2670.

Louis DN, Ohgaki, H., Wiestler, O.D., Cavenee, W.K., Burger, P.C., Jouvet, A., Scheithauer, B.W., and Kleihues, O.: The 2007 WHO classification of tumors of the central nervous system. Lyon, France: IARC Press; 2007.

Wen PY, Kesari S: Malignant gliomas in adults. N Engl J Med 2008, 359:492–507.CrossRefPubMed

van den Bent MJ, Afra D, de Witte O et al: Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet 2005, 366:985–990.CrossRefPubMed

FDA: Clinical Trial Endpoints for the Approval of Cancer Drugs and Biologics: US Department of Health and Human Services; 2007.

Therasse P, Arbuck S, Eisenhauer E et al: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000, 92:205–216.CrossRefPubMed

Eisenhauer EA, Therasse P, Bogaerts J et al: New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009, 45:228–247.CrossRefPubMed

Macdonald D, Cascino T, Schold SJ, Cairncross J: Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 1990, 8:1277–1280.PubMed

10.

Sorensen AG, Batchelor TT, Wen PY et al: Response criteria for glioma. Nat Clin Pract Oncol 2008, 5:634–644.CrossRefPubMed

11.

• Henson JW, Ulmer S, Harris GJ: Brain tumor imaging in clinical trials. AJNR Am J Neuroradiol 2008, 29:419–424. This article offers an excellent overview of imaging in brain tumor trials.

12.

•• van den Bent MJ, Vogelbaum MA, Wen PY et al: End point assessment in gliomas: novel treatments limit usefulness of classical Macdonald's Criteria. J Clin Oncol 2009, 27:2905–2908. This article highlights limitations of Macdonald criteria.

13.

Wen PY, Norden AD, Drappatz J, Quant E: Response assessment challenges in clinical trials of gliomas. Curr Oncol Rep 2010, 12:68–75.CrossRefPubMed

14.

•• Wen PY, Macdonald DR, Reardon DA et al: Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 2010, 28:1963–1972. This article, written by the RANO Working Group, provides recommendations for response assessment in high-grade gliomas.

15.

Henegar MM, Moran CJ, Silbergeld DL: Early postoperative magnetic resonance imaging following nonneoplastic cortical resection. J Neurosurg 1996, 84:174–179.CrossRefPubMed

16.

Ulmer S, Braga TA, Barker FG, 2nd et al: Clinical and radiographic features of peritumoral infarction following resection of glioblastoma. Neurology 2006, 67:1668–1670.CrossRefPubMed

17.

Finn MA, Blumenthal DT, Salzman KL, Jensen RL: Transient postictal MRI changes in patients with brain tumors may mimic disease progression. Surg Neurol 2007, 67:246–250; discussion 250.

18.

Kumar AJ, Leeds NE, Fuller GN et al: Malignant gliomas: MR imaging spectrum of radiation therapy- and chemotherapy-induced necrosis of the brain after treatment. Radiology 2000, 217:377–384.PubMed

19.

Cairncross JG, Macdonald DR, Pexman JH, Ives FJ: Steroid-induced CT changes in patients with recurrent malignant glioma. Neurology 1988, 38:724–726.PubMed

20.

Watling CJ, Lee DH, Macdonald DR, Cairncross JG: Corticosteroid-induced magnetic resonance imaging changes in patients with recurrent malignant glioma. J Clin Oncol 1994, 12:1886–1889.PubMed

21.

Brandes AA, Franceschi E, Tosoni A et al: MGMT promoter methylation status can predict the incidence and outcome of pseudoprogression after concomitant radiochemotherapy in newly diagnosed glioblastoma patients. J Clin Oncol 2008, 26:2192–2197.CrossRefPubMed

22.

Gerstner ER, McNamara MB, Norden AD et al: Effect of adding temozolomide to radiation therapy on the incidence of pseudo-progression. J Neurooncol 2009, 94:97–101.CrossRefPubMed

23.

Brandsma D, Stalpers L, Taal W et al: Clinical features, mechanisms, and management of pseudoprogression in malignant gliomas. Lancet Oncol 2008, 9:453–461.CrossRefPubMed

24.

Brandes AA, Tosoni A, Spagnolli F et al: Disease progression or pseudoprogression after concomitant radiochemotherapy treatment: pitfalls in neurooncology. Neuro Oncol 2008, 10:361–367.CrossRefPubMed

25.

Batchelor TT, Duda DG, di Tomaso E et al: Phase II study of cediranib, an oral pan-vascular endothelial growth factor receptor tyrosine kinase inhibitor, in patients with recurrent glioblastoma. J Clin Oncol 2010, 28:2817–2823.CrossRefPubMed

26.

Vredenburgh JJ, Desjardins A, Herndon JE, 2nd et al: Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol 2007, 25:4722–4729.CrossRefPubMed

27.

Friedman HS, Prados MD, Wen PY et al: Bevacizumab Alone and in Combination With Irinotecan in Recurrent Glioblastoma. J Clin Oncol 2009, 27:4733–4740.CrossRefPubMed

28.

Kreisl TN, Kim L, Moore K et al: Phase II trial of single-agent bevacizumab followed by bevacizumab plus irinotecan at tumor progression in recurrent glioblastoma. J Clin Oncol 2009, 27:740–745.CrossRefPubMed

29.

Norden AD, Young GS, Setayesh K et al: Bevacizumab for recurrent malignant gliomas: efficacy, toxicity, and patterns of recurrence. Neurology 2008, 70:779–787.CrossRefPubMed

30.

Narayana A, Raza S, Golfinos JG et al: Bevacizumab therapy in recurrent high grade glioma: Impact on local control and survival [abstract 13000]. Presented at the American Society of Clinical Oncology: Chicago, IL. May 30-June 3, 2008.

31.

Norden AD, Drappatz J, Wen PY: Antiangiogenic therapies for high-grade glioma. Nat Rev Neurol 2009, 5:610–620.CrossRefPubMed

32.

Zuniga RM, Torcuator R, Jain R et al: Efficacy, safety and patterns of response and recurrence in patients with recurrent high-grade gliomas treated with bevacizumab plus irinotecan. J Neurooncol 2009, 91:329–336.CrossRefPubMed

33.

Rubenstein J, Kim J, Ozawa T et al: Anti-VEGF antibody treatment of glioblastoma prolongs survival but results in increased vascular cooption. Neoplasia 2000, 2:306–314.CrossRefPubMed

34.

Paez-Ribes M, Allen E, Hudock J et al: Antiangiogenic therapy elicits malignant progression of tumors to increased local invasion and distant metastasis. Cancer Cell 2009, 15:220–231.CrossRefPubMed

35.

Bergers G, Hanahan D: Modes of resistance to anti-angiogenic therapy. Nat Rev Cancer 2008, 8:592–603.CrossRefPubMed

36.

de Groot JF, Fuller G, Kumar AJ et al: Tumor invasion after treatment of glioblastoma with bevacizumab: radiographic and pathologic correlation in humans and mice. Neuro Oncol 2010, 12:233–242.PubMed

37.

Gerstner E, Chen P-J, Wen P et al: Infiltrative patterns of glioblastoma spread detected via diffusion MRI after treatment with cediranib. Neuro-Oncology, In press.

38.

Eichler AF, Loeffler JS: Multidisciplinary management of brain metastases. Oncologist 2007, 12:884–898.CrossRefPubMed

39.

Lin NU, Carey LA, Liu MC et al: Phase II trial of lapatinib for brain metastases in patients with human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 2008, 26:1993–1999.CrossRefPubMed

40.

Addeo R, De Rosa C, Faiola V et al: Phase 2 trial of temozolomide using protracted low-dose and whole-brain radiotherapy for nonsmall cell lung cancer and breast cancer patients with brain metastases. Cancer 2008, 113:2524–2531.CrossRefPubMed

41.

Iwamoto FM, Omuro AM, Raizer JJ et al: A phase II trial of vinorelbine and intensive temozolomide for patients with recurrent or progressive brain metastases. J Neurooncol 2008, 87:85–90.CrossRefPubMed

42.

Lin NU, Dieras V, Paul D et al: Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer. Clin Cancer Res 2009, 15:1452–1459.CrossRefPubMed

43.

Asthagiri AR, Parry DM, Butman JA et al: Neurofibromatosis type 2. Lancet 2009, 373:1974–1986.CrossRefPubMed

44.

•• Plotkin SR, Halpin C, Blakeley JO et al: Suggested response criteria for phase II antitumor drug studies for neurofibromatosis type 2 related vestibular schwannoma. J Neurooncol 2009, 93:61–77. This article provides recommendations for response criteria in NF2-related vestibular schwannoma studies.

45.

Evans DG, Kalamarides M, Hunter-Schaedle K et al: Consensus recommendations to accelerate clinical trials for neurofibromatosis type 2. Clin Cancer Res 2009, 15:5032–5039.CrossRefPubMed

46.

Plotkin SR, Stemmer-Rachamimov AO, Barker FG, 2nd et al: Hearing improvement after bevacizumab in patients with neurofibromatosis type 2. N Engl J Med 2009, 361:358-367.CrossRefPubMed

47.

CBTRUS: Primary Brain Tumors in the United States, 2000–2004. Available at http://www.cbtrus.org/reports//2007-2008/2007report.pdf. Accessed December 1, 2008.

48.

Norden AD, Drappatz J, Wen PY: Advances in meningioma therapy. Curr Neurol Neurosci Rep 2009, 9:231–240.CrossRefPubMed

49.

Wen PY, Yung WK, Lamborn KR et al: Phase II study of imatinib mesylate for recurrent meningiomas (North American Brain Tumor Consortium study 01–08). Neuro Oncol 2009, 11:853–860.CrossRefPubMed

50.

Norden AD, Raizer JJ, Abrey LE et al: Phase II trials of erlotinib or gefitinib in patients with recurrent meningioma. J Neurooncol 2010, 96:211–217.CrossRefPubMed

51.

Zeidman LA, Ankenbrandt WJ, Du H et al: Growth rate of non-operated meningiomas. J Neurol 2008, 255:891–895.CrossRefPubMed

Title: Response Assessment in Neuro-Oncology
Authors: Eudocia C. Quant
Patrick Y. Wen
Publication date: 01-02-2011
Publisher: Current Science Inc.
Published in: Current Oncology Reports / Issue 1/2011
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI: https://doi.org/10.1007/s11912-010-0143-y

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