TY - JOUR
T1 - Paradoxical Association Between Relative Cerebral Blood Volume Dynamics Following Chemoradiation and Increased Progression-Free Survival in Newly Diagnosed IDH Wild-Type MGMT Promoter Methylated Glioblastoma With Measurable Disease
AU - Goldman, Jodi
AU - Hagiwara, Akifumi
AU - Yao, Jingwen
AU - Raymond, Catalina
AU - Ong, Christian
AU - Bakhti, Rojin
AU - Kwon, Elizabeth
AU - Farhat, Maguy
AU - Torres, Carlo
AU - Erickson, Lily G.
AU - Curl, Brandon J.
AU - Lee, Maggie
AU - Pope, Whitney B.
AU - Salamon, Noriko
AU - Nghiemphu, Phioanh L.
AU - Ji, Matthew
AU - Eldred, Blaine S.
AU - Liau, Linda M.
AU - Lai, Albert
AU - Cloughesy, Timothy F.
AU - Chung, Caroline
AU - Ellingson, Benjamin M.
N1 - Publisher Copyright:
Copyright © 2022 Goldman, Hagiwara, Yao, Raymond, Ong, Bakhti, Kwon, Farhat, Torres, Erickson, Curl, Lee, Pope, Salamon, Nghiemphu, Ji, Eldred, Liau, Lai, Cloughesy, Chung and Ellingson.
PY - 2022/3/8
Y1 - 2022/3/8
N2 - Background and Purpose: While relative cerebral blood volume (rCBV) may be diagnostic and prognostic for survival in glioblastoma (GBM), changes in rCBV during chemoradiation in the subset of newly diagnosed GBM with subtotal resection and the impact of MGMT promoter methylation status on survival have not been explored. This study aimed to investigate the association between rCBV response, MGMT methylation status, and progression-free (PFS) and overall survival (OS) in newly diagnosed GBM with measurable enhancing lesions. Methods: 1,153 newly diagnosed IDH wild-type GBM patients were screened and 53 patients (4.6%) had measurable post-surgical tumor (>1mL). rCBV was measured before and after patients underwent chemoradiation. Patients with a decrease in rCBV >10% were considered rCBV Responders, while patients with an increase or a decrease in rCBV <10% were considered rCBV Non-Responders. The association between change in enhancing tumor volume, change in rCBV, MGMT promotor methylation status, and PFS or OS were explored. Results: A decrease in tumor volume following chemoradiation trended towards longer OS (p=0.12; median OS=26.8 vs. 16.3 months). Paradoxically, rCBV Non-Responders had a significantly improved PFS compared to Responders (p=0.047; median PFS=9.6 vs. 7.2 months). MGMT methylated rCBV Non-Responders exhibited a significantly longer PFS compared to MGMT unmethylated rCBV Non-Responders (p<0.001; median PFS=0.5 vs. 7.1 months), and MGMT methylated rCBV Non-Responders trended towards longer PFS compared to methylated rCBV Responders (p=0.089; median PFS=20.5 vs. 13.8 months). Conclusions: This preliminary report demonstrates that in newly diagnosed IDH wild-type GBM with measurable enhancing disease after surgery (5% of patients), an enigmatic non-response in rCBV was associated with longer PFS, particularly in MGMT methylated patients.
AB - Background and Purpose: While relative cerebral blood volume (rCBV) may be diagnostic and prognostic for survival in glioblastoma (GBM), changes in rCBV during chemoradiation in the subset of newly diagnosed GBM with subtotal resection and the impact of MGMT promoter methylation status on survival have not been explored. This study aimed to investigate the association between rCBV response, MGMT methylation status, and progression-free (PFS) and overall survival (OS) in newly diagnosed GBM with measurable enhancing lesions. Methods: 1,153 newly diagnosed IDH wild-type GBM patients were screened and 53 patients (4.6%) had measurable post-surgical tumor (>1mL). rCBV was measured before and after patients underwent chemoradiation. Patients with a decrease in rCBV >10% were considered rCBV Responders, while patients with an increase or a decrease in rCBV <10% were considered rCBV Non-Responders. The association between change in enhancing tumor volume, change in rCBV, MGMT promotor methylation status, and PFS or OS were explored. Results: A decrease in tumor volume following chemoradiation trended towards longer OS (p=0.12; median OS=26.8 vs. 16.3 months). Paradoxically, rCBV Non-Responders had a significantly improved PFS compared to Responders (p=0.047; median PFS=9.6 vs. 7.2 months). MGMT methylated rCBV Non-Responders exhibited a significantly longer PFS compared to MGMT unmethylated rCBV Non-Responders (p<0.001; median PFS=0.5 vs. 7.1 months), and MGMT methylated rCBV Non-Responders trended towards longer PFS compared to methylated rCBV Responders (p=0.089; median PFS=20.5 vs. 13.8 months). Conclusions: This preliminary report demonstrates that in newly diagnosed IDH wild-type GBM with measurable enhancing disease after surgery (5% of patients), an enigmatic non-response in rCBV was associated with longer PFS, particularly in MGMT methylated patients.
KW - chemoradiation
KW - dynamic susceptibility contrast perfusion MRI
KW - glioblastoma
KW - MGMT methylation
KW - rCBV
UR - http://www.scopus.com/inward/record.url?scp=85127272606&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85127272606&partnerID=8YFLogxK
U2 - 10.3389/fonc.2022.849993
DO - 10.3389/fonc.2022.849993
M3 - Article
C2 - 35371980
AN - SCOPUS:85127272606
SN - 2234-943X
VL - 12
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 849993
ER -