Vihang Nakhate, Gilbert Youssef, Aleksandra B Lasica, Patrick Y Wen
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Neuroimaging endpoints for clinical trials in gliomas: the neuro-oncologist perspective.
Purpose of review: Accurate and reliable determination of tumor response and progression on neuroimaging is critical to identify effective therapies for glioma in clinical trials. In this article, we review response assessment criteria for adult glioma including their evolution over time, current recommendations, limitations, and future directions.
Recent findings: Response Assessment in Neuro-Oncology (RANO) 2.0 delineates unified magnetic resonance imaging (MRI)-based criteria informed by patient data to evaluate endpoints of tumor response and tumor progression. The positron emission tomography (PET) RANO 1.0 criteria propose endpoints for tumor progression and response on amino acid PET imaging.
Summary: The RANO 2.0 criteria provide standardized recommendations to assess tumor response and progression across adult glioma clinical trials regardless of tumor grade, contrast enhancement, molecular profile or treatment modality. Additional validation and exploratory studies can facilitate future refinements to the criteria and possible incorporation of novel neuroimaging endpoints. Advanced imaging modalities such as perfusion MRI and amino acid PET may help overcome some limitations of MRI-based response assessment.
期刊介绍:
Current Opinion in Neurology is a highly regarded journal offering insightful editorials and on-the-mark invited reviews; covering key subjects such as cerebrovascular disease, developmental disorders, neuroimaging and demyelinating diseases. Published bimonthly, each issue of Current Opinion in Neurology introduces world renowned guest editors and internationally recognized academics within the neurology field, delivering a widespread selection of expert assessments on the latest developments from the most recent literature.