Skip to main content
Journal cover image

Early post-bevacizumab progression on contrast-enhanced MRI as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 Central Reader Study.

Publication ,  Journal Article
Boxerman, JL; Zhang, Z; Safriel, Y; Larvie, M; Snyder, BS; Jain, R; Chi, TL; Sorensen, AG; Gilbert, MR; Barboriak, DP
Published in: Neuro Oncol
July 2013

BACKGROUND: RTOG 0625/ACRIN 6677 is a multicenter, randomized, phase II trial of bevacizumab with irinotecan or temozolomide in recurrent glioblastoma (GBM). This study investigated whether early posttreatment progression on FLAIR or postcontrast MRI assessed by central reading predicts overall survival (OS). METHODS: Of 123 enrolled patients, 107 had baseline and at least 1 posttreatment MRI. Two central neuroradiologists serially measured bidimensional (2D) and volumetric (3D) enhancement on postcontrast T1-weighted images and volume of FLAIR hyperintensity. Progression status on all posttreatment MRIs was determined using Macdonald and RANO imaging threshold criteria, with a third neuroradiologist adjudicating discrepancies of both progression occurrence and timing. For each MRI pulse sequence, Kaplan-Meier survival estimates and log-rank test were used to compare OS between cases with or without radiologic progression. RESULTS: Radiologic progression occurred after 2 chemotherapy cycles (8 weeks) in 9 of 97 (9%), 9 of 73 (12%), and 11 of 98 (11%) 2D-T1, 3D-T1, and FLAIR cases, respectively, and 34 of 80 (43%), 21 of 58 (36%), and 37 of 79 (47%) corresponding cases after 4 cycles (16 weeks). Median OS among patients progressing at 8 or 16 weeks was significantly less than that among nonprogressors, as determined on 2D-T1 (114 vs 278 days and 214 vs 426 days, respectively; P < .0001 for both) and 3D-T1 (117 vs 306 days [P < .0001] and 223 vs 448 days [P = .0003], respectively) but not on FLAIR (201 vs 276 days [P = .38] and 303 vs 321 days [P = .13], respectively). CONCLUSION: Early progression on 2D-T1 and 3D-T1, but not FLAIR MRI, after 8 and 16 weeks of anti-vascular endothelial growth factor therapy has highly significant prognostic value for OS in recurrent GBM.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Neuro Oncol

DOI

EISSN

1523-5866

Publication Date

July 2013

Volume

15

Issue

7

Start / End Page

945 / 954

Location

England

Related Subject Headings

  • Young Adult
  • Temozolomide
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Boxerman, J. L., Zhang, Z., Safriel, Y., Larvie, M., Snyder, B. S., Jain, R., … Barboriak, D. P. (2013). Early post-bevacizumab progression on contrast-enhanced MRI as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 Central Reader Study. Neuro Oncol, 15(7), 945–954. https://doi.org/10.1093/neuonc/not049
Boxerman, Jerrold L., Zheng Zhang, Yair Safriel, Mykol Larvie, Bradley S. Snyder, Rajan Jain, T Linda Chi, A Gregory Sorensen, Mark R. Gilbert, and Daniel P. Barboriak. “Early post-bevacizumab progression on contrast-enhanced MRI as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 Central Reader Study.Neuro Oncol 15, no. 7 (July 2013): 945–54. https://doi.org/10.1093/neuonc/not049.
Boxerman JL, Zhang Z, Safriel Y, Larvie M, Snyder BS, Jain R, Chi TL, Sorensen AG, Gilbert MR, Barboriak DP. Early post-bevacizumab progression on contrast-enhanced MRI as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 Central Reader Study. Neuro Oncol. 2013 Jul;15(7):945–954.
Journal cover image

Published In

Neuro Oncol

DOI

EISSN

1523-5866

Publication Date

July 2013

Volume

15

Issue

7

Start / End Page

945 / 954

Location

England

Related Subject Headings

  • Young Adult
  • Temozolomide
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging