Journal Article

FZJ-2023-04876

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses

Zeyen, T. ; Paech, D. ; Weller, J. ; Schäfer, N. ; Tzaridis, T. ; Duffy, C. ; Nitsch, L. ; Schneider, M. ; Potthoff, A.-L. ; Steinbach, J. P. ; Hau, P. ; Schlegel, U. ; Seidel, C. ; Krex, D. ; Grauer, O. ; Goldbrunner, R. ; Zeiner, P. S. ; Tabatabai, G. ; Galldiks, N.FZJ* ; Stummer, W. ; Hattingen, E. ; Glas, M. ; Radbruch, A. ; Herrlinger, U. ; Schaub, C. (Corresponding author)

2023
Springer Science + Business Media B.V Dordrecht [u.a.]

This record in other databases:    

Please use a persistent id in citations: doi:10.1007/s11060-023-04444-x  doi:10.34734/FZJ-2023-04876

Abstract: Purpose: In the randomized CeTeG/NOA-09 trial, lomustine/temozolomide (CCNU/TMZ) was superior to TMZ therapy regarding overall survival (OS) in MGMT promotor-methylated glioblastoma. Progression-free survival (PFS) and pseudoprogression rates (about 10%) were similar in both arms. Further evaluating this discrepancy, we analyzed patterns of postprogression survival (PPS) and MRI features at first progression according to modified RANO criteria (mRANO).Methods: We classified the patients of the CeTeG/NOA-09 trial according to long vs. short PPS employing a cut-off of 18 months and compared baseline characteristics and survival times. In patients with available MRIs and confirmed progression, the increase in T1-enhancing, FLAIR hyperintense lesion volume and the change in ADC mean value of contrast-enhancing tumor upon progression were determined.Results: Patients with long PPS in the CCNU/TMZ arm had a particularly short PFS (5.6 months). PFS in this subgroup was shorter than in the long PPS subgroup of the TMZ arm (11.1 months, p = 0.01). At mRANO-defined progression, patients of the CCNU/TMZ long PPS subgroup had a significantly higher increase of mean ADC values (p = 0.015) and a tendency to a stronger volumetric increase in T1-enhancement (p = 0.22) as compared to long PPS patients of the TMZ arm.Conclusion: The combination of survival and MRI analyses identified a subgroup of CCNU/TMZ-treated patients with features that sets them apart from other patients in the trial: short first PFS despite long PPS and significant increase in mean ADC values upon mRANO-defined progression. The observed pattern is compatible with the features commonly observed in pseudoprogression suggesting mRANO-undetected pseudoprogressions in the CCNU/TMZ arm of CeTeG/NOA-09.Keywords: Glioblastoma; MGMT promotor methylation; MRI; Progression; Pseudoprogression.

Note: Erratum in Correction to: Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses. Zeyen T, Paech D, Weller J, Schäfer N, Tzaridis T, Duffy C, Nitsch L, Schneider M, Potthoff AL, Steinbach JP, Hau P, Schlegel U, Seidel C, Krex D, Grauer O, Goldbrunner R, Zeiner PS, Tabatabai G, Galldiks N, Stummer W, Hattingen E, Glas M, Radbruch A, Herrlinger U, Schaub C. J Neurooncol. 2023 Nov 3. doi: 10.1007/s11060-023-04488-z.

---

Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5252 - Brain Dysfunction and Plasticity (POF4-525) (POF4-525)
2. DFG project 491111487 - Open-Access-Publikationskosten / 2022 - 2024 / Forschungszentrum Jülich (OAPKFZJ) (491111487) (491111487)

Appears in the scientific report 2023

---

Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; Essential Science Indicators ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

---