DOI: 10.1007/s13311-016-0507-6 Pages: 1-14
Article Type: Review

Modified Criteria for Radiographic Response Assessment in Glioblastoma Clinical Trials

1. University of California Los Angeles, UCLA Brain Tumor Imaging Laboratory, Center for Computer Vision and Imaging Biomarkers

2. University of California Los Angeles, Department of Radiological Sciences

3. University of California Los Angeles, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine

4. Harvard Medical School, Center for Neuro-Oncology, Dana-Farber/Brigham and Women’s Cancer Center

5. University of California Los Angeles, UCLA Neuro-Oncology Program

6. University of California Los Angeles, Department of Neurology, David Geffen School of Medicine

Correspondence to:
Benjamin M. Ellingson
Tel: +1-310-4817572
Email: bellingson@mednet.ucla.edu

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Abstract

Radiographic endpoints including response and progression are important for the evaluation of new glioblastoma therapies. The current RANO criteria was developed to overcome many of the challenges identified with previous guidelines for response assessment, however, significant challenges and limitations remain. The current recommendations build on the strengths of the current RANO criteria, while addressing many of these limitations. Modifications to the current RANO criteria include suggestions for volumetric response evaluation, use contrast enhanced T1 subtraction maps to increase lesion conspicuity, removal of qualitative non-enhancing tumor assessment requirements, use of the post-radiation time point as the baseline for newly diagnosed glioblastoma response assessment, and “treatment-agnostic” response assessment rubrics for identifying pseudoprogression, pseudoresponse, and a confirmed durable response in newly diagnosed and recurrent glioblastoma trials.

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  • Online: Jan 20, 2017

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