Response assessment criteria for brain metastases: proposal from the RANO group

Lin, Nancy U.; Lee, Eudocia Q.; Aoyama, Hidefumi; Barani, Igor J.; Barboriak, Daniel P.; Baumert, Brigitta G.; Bendszus, Martin; Brown, Paul D.; Camidge, D. Ross; Chang, Susan M.; Dancey, Janet; Vries, Elisabeth G.E. de; Gaspar, Laurie E.; Harris, Gordon J.; Hodi, F. Stephen; Kalkanis, Steven N.; Linskey, Mark E.; Macdonald, David R.; Margolin, Kim; Mehta, Minesh P.; Schiff, David; Soffietti, Riccardo; Suh, John H.; Bent, Martin J. van den; Vogelbaum, Michael A.; Wen, Patrick Y.

doi:10.1016/s1470-2045(15)70057-4

Cited by 746 publications

(590 citation statements)

References 19 publications

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“…All patients receive an optimal systemic therapy for their basic disease. Primary outcome is time to cerebral progression based on the RANO-BM Criteria (68). Secondary outcomes include time to neurocognitive failure, OS, RR, QoL, and toxicity.…”

Section: Ttfields In Brain Metastasis From Nsclcmentioning

confidence: 99%

Tumor-Treating Fields: A Fourth Modality in Cancer Treatment

Mun

Babiker

Weinberg³

et al. 2018

Clinical Cancer Research

260

185

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Despite major advances in therapy, cancer continues to be a leading cause of mortality. In addition, toxicities of traditional therapies pose a significant challenge to tolerability and adherence. TTFields, a noninvasive anticancer treatment modality, utilizes alternating electric fields at specific frequencies and intensities to selectively disrupt mitosis in cancerous cells. TTFields target proteins crucial to the cell cycle, leading to mitotic arrest and apoptosis. TTFields also facilitate an antitumor immune response. Clinical trials of TTFields have proven safe and efficacious in patients with glioblastoma multiforme (GBM), and are FDA approved for use in newly diagnosed and recurrent GBM. Trials in other localized solid tumors are ongoing. Clin Cancer Res; 24(2); 266-75. Ó2017 AACR.

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Section: Ttfields In Brain Metastasis From Nsclcmentioning

confidence: 99%

Tumor-Treating Fields: A Fourth Modality in Cancer Treatment

Mun

Babiker

Weinberg³

et al. 2018

Clinical Cancer Research

260

185

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“…For gliomas, PET and perfusion imaging are important for differentiation. For brain metastases, the data are limited, and progression is defined according to the RANO criteria for brain metastases [12,24,26,27,33,34]. In this study, recurrent tumor was proven histopathologically in 3 of 6 cases with local recurrence.…”

Section: Discussionmentioning

confidence: 94%

“…The date of FLAIR signal intensity change, date of MRI examination at recurrent disease/follow-up, date of previous MRI, and date of surgery and previous radiotherapy were recorded. Tumor progression/tumor recurrence was defined according to the RANO criteria for brain metastases and in an interdisciplinary consensus (neuroradiology, neurosurgery, radiation oncology, nuclear medicine) [12]. The date of change in further treatment (e. g. surgery, radiotherapy) was defined as the date of tumor recurrence/tumor progression.…”

Section: Patient Populationmentioning

confidence: 99%

Increase in FLAIR Signal of the Fluid Within the Resection Cavity as Early Recurrence Marker: Also Valid for Brain Metastases?

Bette

Gempt

Wiestler

et al. 2016

Fortschr Röntgenstr

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Results 3 of 6 cases with local tumor recurrence showed a FLAIR signal increase (sensitivity 50.0 %, specificity 100.0 %). In one case, this sign was observed even about 3 months before tumor recurrence.The specificity of FLAIR signal increase for overall tumor recurrence (local and distant) was also 100.0 %, but with a lower sensitivity of 13.0 %.Quantitative analysis showed significant differences for signal intensity of the resection cavity as well as for the change of signal intensity of the resection cavity in cases with or without local tumor recurrence.Conclusion An increase in FLAIR signal of the fluid within the resection cavity might be a highly specific and early sign of local tumor recurrence/tumor progression also for brain metastases. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.Key points: ▪ An increase in FLAIR signal intensity of the fluid within the resection cavity is also observed in previously resected brain metastases. ▪ The pathophysiology of this sign might be due to a cell-proliferative process.

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“…74 Thus, as the use of immunomodulatory systemic therapies increases, a consensus recommendation based on clinical outcomes of those treated in combination with SRS will be needed to standardize outcomes reporting and clinical decision making. 75 …”

Section: It Is Unknown Whether Improved Survival In Those Reportsmentioning

confidence: 99%

Irradiation and immunotherapy: From concept to the clinic

Salama

Postow

Salama

2016

Cancer

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In recent years, an increased understanding of T‐cell–regulatory mechanisms has led to the development of a novel class of immune‐checkpoint inhibitors that have robust clinical activity against a broad array of malignancies—even those that historically were not believed to be sensitive to immune therapy. With this, there has been renewed interest in the potential for synergy with more traditional forms of anticancer therapy like radiation therapy (RT). The role of RT in palliation or as definitive treatment for certain malignancies has been well established. Yet, in recent years, the concept has come to light that RT could be an attractive partner for use in combination with other immunotherapies. The effects of RT include not only control of an irradiated tumor but also multiple immunomodulatory effects on both the tumor and the microenvironment, priming tumors for an immune‐mediated response. Herein, the authors summarize relevant preclinical data and rationale supporting the synergy of combined RT and immunotherapy and highlight recent clinical work on promising combination strategies. Cancer 2016;122:1659‐71. © 2016 American Cancer Society.

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Response assessment criteria for brain metastases: proposal from the RANO group

Cited by 746 publications

References 19 publications

Tumor-Treating Fields: A Fourth Modality in Cancer Treatment

Tumor-Treating Fields: A Fourth Modality in Cancer Treatment

Increase in FLAIR Signal of the Fluid Within the Resection Cavity as Early Recurrence Marker: Also Valid for Brain Metastases?

Irradiation and immunotherapy: From concept to the clinic

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