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001023537 1001_ $$00000-0002-9160-4058$$aFlies, Christina Maria$$b0$$eFirst author
001023537 245__ $$aTreatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide
001023537 260__ $$aOxford$$bOxford Univ. Press$$c2024
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001023537 520__ $$aBackground: Radiological progression may originate from progressive disease (PD) or pseudoprogression/treatment-associated changes. We assessed radiological progression in MGMT promoter-methylated glioblastoma treated with standard-of-care chemoradiotherapy with or without the integrin inhibitor cilengitide according to the modified RANO criteria of 2017.Methods: Patients with ≥3 follow-up MRIs were included. Preliminary PD was defined as a ≥25% increase of the sum of products of perpendicular diameters (SPD) of a new or increasing lesion compared to baseline. PD required a second ≥25% increase of the SPD. Treatment-associated changes required stable or regressing disease after preliminary PD.Results: Of the 424 evaluable patients, 221 patients (52%) were randomized into the cilengitide, and 203 patients (48%) into the control arm. After chemoradiation with or without cilengitide, preliminary PD occurred in 274 patients (65%) during available follow-up, and 88 of these patients (32%) had treatment-associated changes, whereas 67 patients (25%) had PD. The remaining 119 patients (43%) had no further follow-up after preliminary PD. Treatment-associated changes were more common in the cilengitide arm than in the standard-of-care arm (24% vs. 17%; relative risk, 1.3; 95% confidence interval, 1.004-1.795; p=0.047). Treatment-associated changes occurred mainly during the first six months after RT (54% after three months vs. 13% after six months).Conclusion: With the modified RANO criteria, the rate of treatment-associated changes was low compared to previous studies in MGMT promoter-methylated glioblastoma. This rate was higher after cilengitide compared to standard-of-care treatment. Confirmatory scans, as recommended in the modified RANO criteria, were not always available reflecting current clinical practice.Keywords: glioma; modified RANO criteria; pseudoprogression; temozolomide.
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001023537 7001_ $$0P:(DE-Juel1)184842$$aFriedrich, Michel$$b1
001023537 7001_ $$0P:(DE-Juel1)145110$$aLohmann, Philipp$$b2
001023537 7001_ $$0P:(DE-HGF)0$$avan Garderen, Karin Alida$$b3
001023537 7001_ $$00000-0001-5563-2871$$aSmits, Marion$$b4
001023537 7001_ $$0P:(DE-HGF)0$$aTonn, Joerg-Christian$$b5
001023537 7001_ $$00000-0002-1748-174X$$aWeller, Michael$$b6
001023537 7001_ $$0P:(DE-Juel1)143792$$aGalldiks, Norbert$$b7
001023537 7001_ $$00000-0003-0857-081X$$aSnijders, Tom Jan$$b8$$eCorresponding author
001023537 773__ $$0PERI:(DE-600)2094060-9$$a10.1093/neuonc/noad247$$gp. noad247$$n5$$p902-910$$tNeuro-Oncology$$v26$$x1522-8517$$y2024
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