This title appears in the Scientific Report :
2023
Please use the identifier:
http://dx.doi.org/10.1007/s11060-023-04444-x in citations.
Please use the identifier: http://dx.doi.org/10.34734/FZJ-2023-04876 in citations.
Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses
Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses
Purpose: In the randomized CeTeG/NOA-09 trial, lomustine/temozolomide (CCNU/TMZ) was superior to TMZ therapy regarding overall survival (OS) in MGMT promotor-methylated glioblastoma. Progression-free survival (PFS) and pseudoprogression rates (about 10%) were similar in both arms. Further evaluating...
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Personal Name(s): | Zeyen, Thomas |
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Paech, Daniel / Weller, Johannes / Schäfer, Niklas / Tzaridis, Theophilos / Duffy, Cathrina / Nitsch, Louisa / Schneider, Matthias / Potthoff, Anna-Laura / Steinbach, Joachim Peter / Hau, Peter / Schlegel, Uwe / Seidel, Clemens / Krex, Dietmar / Grauer, Oliver / Goldbrunner, Roland / Zeiner, Pia Susan / Tabatabai, Ghazaleh / Galldiks, Norbert / Stummer, Walter / Hattingen, Elke / Glas, Martin / Radbruch, Alexander / Herrlinger, Ulrich / Schaub, Christina (Corresponding author) | |
Contributing Institute: |
Kognitive Neurowissenschaften; INM-3 |
Published in: | Journal of neuro-oncology, 164 (2023) 3, S. 607 - 616 |
Imprint: |
Dordrecht [u.a.]
Springer Science + Business Media B.V
2023
|
DOI: |
10.1007/s11060-023-04444-x |
DOI: |
10.34734/FZJ-2023-04876 |
Document Type: |
Journal Article |
Research Program: |
Open-Access-Publikationskosten / 2022 - 2024 / Forschungszentrum Jülich (OAPKFZJ) Brain Dysfunction and Plasticity |
Link: |
OpenAccess |
Publikationsportal JuSER |
Please use the identifier: http://dx.doi.org/10.34734/FZJ-2023-04876 in citations.
Purpose: In the randomized CeTeG/NOA-09 trial, lomustine/temozolomide (CCNU/TMZ) was superior to TMZ therapy regarding overall survival (OS) in MGMT promotor-methylated glioblastoma. Progression-free survival (PFS) and pseudoprogression rates (about 10%) were similar in both arms. Further evaluating this discrepancy, we analyzed patterns of postprogression survival (PPS) and MRI features at first progression according to modified RANO criteria (mRANO).Methods: We classified the patients of the CeTeG/NOA-09 trial according to long vs. short PPS employing a cut-off of 18 months and compared baseline characteristics and survival times. In patients with available MRIs and confirmed progression, the increase in T1-enhancing, FLAIR hyperintense lesion volume and the change in ADC mean value of contrast-enhancing tumor upon progression were determined.Results: Patients with long PPS in the CCNU/TMZ arm had a particularly short PFS (5.6 months). PFS in this subgroup was shorter than in the long PPS subgroup of the TMZ arm (11.1 months, p = 0.01). At mRANO-defined progression, patients of the CCNU/TMZ long PPS subgroup had a significantly higher increase of mean ADC values (p = 0.015) and a tendency to a stronger volumetric increase in T1-enhancement (p = 0.22) as compared to long PPS patients of the TMZ arm.Conclusion: The combination of survival and MRI analyses identified a subgroup of CCNU/TMZ-treated patients with features that sets them apart from other patients in the trial: short first PFS despite long PPS and significant increase in mean ADC values upon mRANO-defined progression. The observed pattern is compatible with the features commonly observed in pseudoprogression suggesting mRANO-undetected pseudoprogressions in the CCNU/TMZ arm of CeTeG/NOA-09.Keywords: Glioblastoma; MGMT promotor methylation; MRI; Progression; Pseudoprogression. |