%0 Journal Article
%A Flies, Christina Maria
%A Friedrich, Michel
%A Lohmann, Philipp
%A van Garderen, Karin Alida
%A Smits, Marion
%A Tonn, Joerg-Christian
%A Weller, Michael
%A Galldiks, Norbert
%A Snijders, Tom Jan
%T Treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide
%J Neuro-Oncology
%V 26
%N 5
%@ 1522-8517
%C Oxford
%I Oxford Univ. Press
%M FZJ-2024-01743
%P 902-910
%D 2024
%X Background: Radiological progression may originate from progressive disease (PD) or pseudoprogression/treatment-associated changes. We assessed radiological progression in MGMT promoter-methylated glioblastoma treated with standard-of-care chemoradiotherapy with or without the integrin inhibitor cilengitide according to the modified RANO criteria of 2017.Methods: Patients with ≥3 follow-up MRIs were included. Preliminary PD was defined as a ≥25% increase of the sum of products of perpendicular diameters (SPD) of a new or increasing lesion compared to baseline. PD required a second ≥25% increase of the SPD. Treatment-associated changes required stable or regressing disease after preliminary PD.Results: Of the 424 evaluable patients, 221 patients (52%) were randomized into the cilengitide, and 203 patients (48%) into the control arm. After chemoradiation with or without cilengitide, preliminary PD occurred in 274 patients (65%) during available follow-up, and 88 of these patients (32%) had treatment-associated changes, whereas 67 patients (25%) had PD. The remaining 119 patients (43%) had no further follow-up after preliminary PD. Treatment-associated changes were more common in the cilengitide arm than in the standard-of-care arm (24% vs. 17%; relative risk, 1.3; 95% confidence interval, 1.004-1.795; p=0.047). Treatment-associated changes occurred mainly during the first six months after RT (54% after three months vs. 13% after six months).Conclusion: With the modified RANO criteria, the rate of treatment-associated changes was low compared to previous studies in MGMT promoter-methylated glioblastoma. This rate was higher after cilengitide compared to standard-of-care treatment. Confirmatory scans, as recommended in the modified RANO criteria, were not always available reflecting current clinical practice.Keywords: glioma; modified RANO criteria; pseudoprogression; temozolomide.
%F PUB:(DE-HGF)16
%9 Journal Article
%$ 38219019
%U <Go to ISI:>//WOS:001154554300001
%R 10.1093/neuonc/noad247
%U https://juser.fz-juelich.de/record/1023537