Baseline T1 hyperintense and diffusion-restricted lesions are not linked to prolonged survival in bevacizumab-treated glioblastoma patients of the GLARIUS trial

Kebir, Sied; Rohde, Veit; Gerlach, Rüdiger; Hattingen, Elke; Krex, Dietmar; Sabel, Michael; Proescholdt, Martin; Borchers, Christian; Seidel, Clemens; Belka, Claus; Weller, Johannes; Tzaridis, Theophilos; Vatter, Hartmut; Herrlinger, Ulrich; Junold, Nina; Schaub, Christina; Hau, Peter; Goldbrunner, Roland; Hänel, Mathias; Schlegel, Uwe; Bähr, Oliver; Galldiks, Norbert; Weyerbrock, Astrid; Mack, Frederic; Steinbach, Joachim P.; Tabatabai, Ghazaleh; Schäfer, Niklas; Glas, Martin; Schmidt-Graf, Friederike

doi:10.1007/s11060-019-03246-4

Journal Article

FZJ-2019-03906

Baseline T1 hyperintense and diffusion-restricted lesions are not linked to prolonged survival in bevacizumab-treated glioblastoma patients of the GLARIUS trial

Kebir, S. (Corresponding author) ; Schaub, C. ; Junold, N. ; Hattingen, E. ; Schäfer, N. ; Steinbach, J. P. ; Weyerbrock, A. ; Hau, P. ; Goldbrunner, R. ; Galldiks, N.FZJ* ; Weller, J. ; Mack, F. ; Tzaridis, T. ; Bähr, O. ; Seidel, C. ; Schlegel, U. ; Schmidt-Graf, F. ; Rohde, V. ; Borchers, C. ; Tabatabai, G. ; Hänel, M. ; Sabel, M. ; Gerlach, R. ; Krex, D. ; Belka, C. ; Vatter, H. ; Proescholdt, M. ; Glas, M. ; Herrlinger, U.

2019
Springer Science + Business Media B.V Dordrecht [u.a.]

Journal of neuro-oncology 144(3), 501-509 (2019) [10.1007/s11060-019-03246-4]

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Please use a persistent id in citations: doi:10.1007/s11060-019-03246-4

Abstract: PurposeThe phase II GLARIUS trial assigned patients with newly diagnosed, O-6-methylguanine-DNA methyltransferase promoter non-methylated glioblastoma to experimental bevacizumab/irinotecan (BEV/IRI) or standard temozolomide (TMZ). To identify subpopulations with a particularly favorable course, we assessed the prognostic potential of magnetic resonance imaging (MRI) markers before treatment onset.MethodsMRIs at baseline (before treatment onset) were analyzed for T1-hyperintense and diffusion-restricted lesions; as well as the presence of both hyperintense and diffusion-restricted (double positive) lesions. The MRI findings were correlated with overall and progression-free survival.ResultsMRI scans were evaluable in 71% of the GLARIUS modified intention-to-treat population (n = 121 of 170; 88 patients in the BEV/IRI arm, and 33 patients in the TMZ control arm). Diffusion-restricted and T1 hyperintense lesions were present in 60% and 65% of patients in BEV/IRI arm, while 57% and 63% were found in the TMZ arm, respectively. Double positive lesions were found in 37% of BEV/IRI patients and in 39% of TMZ patients. Neither the presence of T1-hyperintense, diffusion-restricted lesions, nor double positive lesions were associated with improved survival.ConclusionsBaseline T1-hyperintense and diffusion-restricted lesions are not suitable to predict progression-free or overall survival of patients treated with bevacizumab/irinotecan or temozolomide.

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