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Immunotherapy response assessment in neuro-oncology: a report of the RANO working group.

Publication ,  Journal Article
Okada, H; Weller, M; Huang, R; Finocchiaro, G; Gilbert, MR; Wick, W; Ellingson, BM; Hashimoto, N; Pollack, IF; Brandes, AA; Franceschi, E ...
Published in: Lancet Oncol
November 2015

Immunotherapy is a promising area of therapy in patients with neuro-oncological malignancies. However, early-phase studies show unique challenges associated with the assessment of radiological changes in response to immunotherapy reflecting delayed responses or therapy-induced inflammation. Clinical benefit, including long-term survival and tumour regression, can still occur after initial disease progression or after the appearance of new lesions. Refinement of the response assessment criteria for patients with neuro-oncological malignancies undergoing immunotherapy is therefore warranted. Herein, a multinational and multidisciplinary panel of neuro-oncology immunotherapy experts describe immunotherapy Response Assessment for Neuro-Oncology (iRANO) criteria based on guidance for the determination of tumour progression outlined by the immune-related response criteria and the RANO working group. Among patients who demonstrate imaging findings meeting RANO criteria for progressive disease within 6 months of initiating immunotherapy, including the development of new lesions, confirmation of radiographic progression on follow-up imaging is recommended provided that the patient is not significantly worse clinically. The proposed criteria also include guidelines for the use of corticosteroids. We review the role of advanced imaging techniques and the role of measurement of clinical benefit endpoints including neurological and immunological functions. The iRANO guidelines put forth in this Review will evolve successively to improve their usefulness as further experience from immunotherapy trials in neuro-oncology accumulate.

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Published In

Lancet Oncol

DOI

EISSN

1474-5488

Publication Date

November 2015

Volume

16

Issue

15

Start / End Page

e534 / e542

Location

England

Related Subject Headings

  • Practice Guidelines as Topic
  • Oncology & Carcinogenesis
  • Nervous System Neoplasms
  • Immunotherapy
  • Humans
  • Disease Progression
  • Algorithms
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

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ICMJE
MLA
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Okada, H., Weller, M., Huang, R., Finocchiaro, G., Gilbert, M. R., Wick, W., … Reardon, D. A. (2015). Immunotherapy response assessment in neuro-oncology: a report of the RANO working group. Lancet Oncol, 16(15), e534–e542. https://doi.org/10.1016/S1470-2045(15)00088-1
Okada, Hideho, Michael Weller, Raymond Huang, Gaetano Finocchiaro, Mark R. Gilbert, Wolfgang Wick, Benjamin M. Ellingson, et al. “Immunotherapy response assessment in neuro-oncology: a report of the RANO working group.Lancet Oncol 16, no. 15 (November 2015): e534–42. https://doi.org/10.1016/S1470-2045(15)00088-1.
Okada H, Weller M, Huang R, Finocchiaro G, Gilbert MR, Wick W, et al. Immunotherapy response assessment in neuro-oncology: a report of the RANO working group. Lancet Oncol. 2015 Nov;16(15):e534–42.
Okada, Hideho, et al. “Immunotherapy response assessment in neuro-oncology: a report of the RANO working group.Lancet Oncol, vol. 16, no. 15, Nov. 2015, pp. e534–42. Pubmed, doi:10.1016/S1470-2045(15)00088-1.
Okada H, Weller M, Huang R, Finocchiaro G, Gilbert MR, Wick W, Ellingson BM, Hashimoto N, Pollack IF, Brandes AA, Franceschi E, Herold-Mende C, Nayak L, Panigrahy A, Pope WB, Prins R, Sampson JH, Wen PY, Reardon DA. Immunotherapy response assessment in neuro-oncology: a report of the RANO working group. Lancet Oncol. 2015 Nov;16(15):e534–e542.
Journal cover image

Published In

Lancet Oncol

DOI

EISSN

1474-5488

Publication Date

November 2015

Volume

16

Issue

15

Start / End Page

e534 / e542

Location

England

Related Subject Headings

  • Practice Guidelines as Topic
  • Oncology & Carcinogenesis
  • Nervous System Neoplasms
  • Immunotherapy
  • Humans
  • Disease Progression
  • Algorithms
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis