Value of dynamic contrast perfusion MRI to predict early response to bevacizumab in newly diagnosed glioblastoma: results from ACRIN 6686 multicenter trial
Open accessAbstract
Background: In Radiation Therapy Oncology Group (RTOG) 0825, a phase III trial of standard therapy with bevacizumab or without (placebo) in newly diagnosed glioblastoma, 44 patients underwent dynamic contrast enhanced (DCE) and/or dynamic susceptibility contrast (DSC) MRI in the American College of Radiology Imaging Network (ACRIN) trial 6686. The association between early changes in relative cerebral blood volume (rCBV) and volume transfer constant (Ktrans) with overall survival (OS) was evaluated. Methods: MRI was performed at postop baseline (S0), immediately before (S1), 1 day after (S2), and 7 weeks after (S3) bevacizumab or placebo initiation. Mean normalized and standardized rCBV (nRCBV, sRCBV) and Ktrans were measured within contrast-enhancing lesion. Wilcoxon rank sum tests compared parameter changes from S1–S2 and S1–S3. Association with OS and progression-free survival (PFS) were determined using Kaplan–Meier and log-rank tests. Treatment response for groups stratified by pretreatment nRCBV (S0, S1) was explored. The intraclass correlation coefficient and repeatability coefficient for the placebo arm (S1–S2) were used to assess repeatability. Results: Evaluable were 27–36 datasets per time point. Significant differences between treatment arms were found for changes in nRCBV and sRCBV from S1–S2 and S1–S3, and in Ktrans for S1–S3. Improved PFS (P = 0.05) but not OS (P = 0.46) was observed. High pretreatment rCBV predicted improved OS for bevacizumab-treated patients. Based on the intraclass correlation coefficient, sRCBV (0.92) was more repeatable than nRCBV (0.71) and Ktrans (0.75), consistent with repeatability coefficient values. Conclusions: Bevacizumab significantly changes rCBV but not Ktrans as early as 1 day posttreatment in newly diagnosed glioblastoma unrelated to outcomes. Improvements in clinical trial design to maximize rCBV benefit are indicated.
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One of the 6 out-of-sample sites (Site 11) contributed aggregated a priori data from a multi-site randomized clinical trial for newly diagnosed glioblastoma.
“One of these 6 out-of-sample sites (Site 11) contributed aggregated a priori data from a multi-site randomized clinical trial for newly diagnosed glioblastoma (ClinicalTrials.gov Identifier: NCT00884741, RTOG082572,73, ACRIN668674,75), with inherent diversity benefiting the intended generalizability validation purpose.”
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Federated learning enables big data for rare cancer boundary detection
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- Authors
- Schmainda, K. M., Prah, M. A., Marques, H., Kim, E., Barboriak, D. P., & Boxerman, J. L.
- Affiliations
- Medical College of Wisconsin (US)
- Brown University (US)
- Merck Research Laboratories, Kenilworth, New Jersey
- Duke Medical Center (US)
- Corresponding author
- Schmainda, Kathleen M
- Venue
- Neuro-Oncology
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-07-17
- Volume
- 23
- Issue
- 2
- Pages
- 314-323
- ISSN
- 1522-8517 (ISSN-L)
- 1523-5866
- PMC
- PMC7906067
- OpenAlex
- W3043182175
- Cited by
- 28
- References
- 41
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 7 · 2021: 4 · 2020: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Neuro-Oncology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (U10CA180820, U10CA180794, U01 CA176110, R01CA082500)
- Topics
- Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- glioblastoma, bevacizumab, dynamic contrast-enhanced MRI, relative cerebral blood volume, Ktrans, treatment response prediction, overall survival, progression-free survival
- MeSH terms
- Bevacizumab, Brain Neoplasms, Contrast Media, Glioblastoma, Humans, Magnetic Resonance Imaging, Perfusion
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