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1. Meningioma: International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients.

Author

Wang, Justin, Landry, Alexander, Raleigh, David, Sahm, Felix, Walsh, Kyle, Goldbrunner, Roland, Yefet, Leeor, Tonn, Jörg, Gui, Chloe, Ostrom, Quinn, Barnholtz-Sloan, Jill, Perry, Arie, Ellenbogen, Yosef, Hanemann, C, Jungwirth, Gerhard, Jenkinson, Michael, Tabatabai, Ghazaleh, Mathiesen, Tiit, McDermott, Mike, Tatagiba, Marcos, la Fougère, Christian, Maas, Sybren, Galldiks, Norbert, Albert, Nathalie, Brastianos, Priscilla, Ehret, Felix, Minniti, Giuseppe, Lamszus, Katrin, Ricklefs, Franz, Schittenhelm, Jens, Drummond, Katharine, Dunn, Ian, Pathmanaban, Omar, Cohen-Gadol, Aaron, Sulman, Erik, Tabouret, Emeline, Le Rhun, Emelie, Mawrin, Christian, Moliterno, Jennifer, Weller, Michael, Bi, Wenya, Gao, Andrew, Yip, Stephen, Niyazi, Maximilian, Aldape, Kenneth, Wen, Patrick, Short, Susan, Preusser, Matthias, Nassiri, Farshad, and Zadeh, Gelareh

Subjects
extra-axial, meningioma, methylation, molecular, neurofibromatosis 2, nonmalignant, radiotherapy, Humans, Meningioma, Meningeal Neoplasms, Consensus, Biomarkers, Tumor
Abstract

Meningiomas are the most common primary intracranial tumors in adults and are increasing in incidence due to the aging population and increased access to neuroimaging. While most exhibit nonmalignant behavior, a subset of meningiomas are biologically aggressive and are associated with treatment resistance, resulting in significant neurologic morbidity and even mortality. In recent years, meaningful advances in our understanding of the biology of these tumors have led to the incorporation of molecular biomarkers into their grading and prognostication. However, unlike other central nervous system (CNS) tumors, a unified molecular taxonomy for meningiomas has not yet been established and remains an overarching goal of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-Not Official World Health Organization (cIMPACT-NOW) working group. Additionally, clinical equipoise still remains on how specific meningioma cases and patient populations should be optimally managed. To address these existing gaps, members of the International Consortium on Meningiomas including field-leading experts, have prepared this comprehensive consensus narrative review directed toward clinicians, researchers, and patients. Included in this manuscript are detailed overviews of proposed molecular classifications, novel biomarkers, contemporary treatment strategies, trials on systemic therapies, health-related quality-of-life studies, and management strategies for unique meningioma patient populations. In each section, we discuss the current state of knowledge as well as ongoing clinical and research challenges to road map future directions for further investigation.

Published
2024

2. Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0

Author

Verger, Antoine, Tolboom, Nelleke, Cicone, Francesco, Chang, Susan M., Furtner, Julia, Galldiks, Norbert, Gempt, Jens, Guedj, Eric, Huang, Raymond Y., Johnson, Derek R., Law, Ian, Le Rhun, Emilie, Short, Susan C., Bent, M. J. Van den, Weehaeghe, Donatienne Van, Vogelbaum, Michael A., Wen, Patrick Y., Albert, Nathalie L., and Preusser, Matthias

Published
2025
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4. Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor ligands: version 1.0

Author

Albert, Nathalie L., Preusser, Matthias, Traub-Weidinger, Tatjana, Tolboom, Nelleke, Law, Ian, Palmer, Joshua D., Guedj, Eric, Furtner, Julia, Fraioli, Francesco, Huang, Raymond Y., Johnson, Derek R., Deroose, Christophe M., Herrmann, Ken, Vogelbaum, Michael, Chang, Susan, Tonn, Joerg-Christian, Weller, Michael, Wen, Patrick Y., van den Bent, Martin J., Verger, Antoine, Ivanidze, Jana, and Galldiks, Norbert

Published
2024
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5. PET-based response assessment criteria for diffuse gliomas (PET RANO 1.0): a report of the RANO group.

Author

Albert, Nathalie, Galldiks, Norbert, Ellingson, Benjamin, van den Bent, Martin, Chang, Susan, Cicone, Francesco, de Groot, John, Koh, Eng-Siew, Law, Ian, Le Rhun, Emilie, Mair, Maximilian, Minniti, Giuseppe, Rudà, Roberta, Scott, Andrew, Short, Susan, Smits, Marion, Suchorska, Bogdana, Tolboom, Nelleke, Traub-Weidinger, Tatjana, Tonn, Joerg-Christian, Verger, Antoine, Weller, Michael, Wen, Patrick, and Preusser, Matthias

Subjects
Humans, Glioma, Amino Acids, Internal Medicine, Neurology, Positron-Emission Tomography, Transcription Factors
Abstract

Response Assessment in Neuro-Oncology (RANO) response criteria have been established and were updated in 2023 for MRI-based response evaluation of diffuse gliomas in clinical trials. In addition, PET-based imaging with amino acid tracers is increasingly considered for disease monitoring in both clinical practice and clinical trials. So far, a standardised framework defining timepoints for baseline and follow-up investigations and response evaluation criteria for PET imaging of diffuse gliomas has not been established. Therefore, in this Policy Review, we propose a set of criteria for response assessment based on amino acid PET imaging in clinical trials enrolling participants with diffuse gliomas as defined in the 2021 WHO classification of tumours of the central nervous system. These proposed PET RANO criteria provide a conceptual framework that facilitates the structured implementation of PET imaging into clinical research and, ultimately, clinical routine. To this end, the PET RANO 1.0 criteria are intended to encourage specific investigations of amino acid PET imaging of gliomas.

Published
2024

6. Radiomics workflow definition & challenges - German priority program 2177 consensus statement on clinically applied radiomics

Author

Floca, Ralf, Bohn, Jonas, Haux, Christian, Wiestler, Benedikt, Zöllner, Frank G., Reinke, Annika, Weiß, Jakob, Nolden, Marco, Albert, Steffen, Persigehl, Thorsten, Norajitra, Tobias, Baeßler, Bettina, Dewey, Marc, Braren, Rickmer, Büchert, Martin, Fallenberg, Eva Maria, Galldiks, Norbert, Gerken, Annika, Götz, Michael, Hahn, Horst K., Haubold, Johannes, Haueise, Tobias, Große Hokamp, Nils, Ingrisch, Michael, Iuga, Andra-Iza, Janoschke, Marco, Jung, Matthias, Kiefer, Lena Sophie, Lohmann, Philipp, Machann, Jürgen, Moltz, Jan Hendrik, Nattenmüller, Johanna, Nonnenmacher, Tobias, Oerther, Benedict, Othman, Ahmed E., Peisen, Felix, Schick, Fritz, Umutlu, Lale, Wichtmann, Barbara D., Zhao, Wenzhao, Caspers, Svenja, Schlemmer, Heinz-Peter, Schlett, Christopher L., Maier-Hein, Klaus, and Bamberg, Fabian

Published
2024
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7. A framework for standardised tissue sampling and processing during resection of diffuse intracranial glioma: joint recommendations from four RANO groups

Author

Karschnia, Philipp, Smits, Marion, Reifenberger, Guido, Le Rhun, Emilie, Ellingson, Benjamin M, Galldiks, Norbert, Kim, Michelle M, Huse, Jason T, Schnell, Oliver, Harter, Patrick N, Mohme, Malte, Panel, Rater, Aldape, Kenneth, Baehring, Joachim M, Bello, Lorenzo, Brat, Daniel J, Cahill, Daniel P, Chung, Caroline, Colman, Howard, Dietrich, Jorg, Drummond, Katharine, Esquenazi, Yoshua, Gerstner, Elizabeth R, Furtner, Julia, Garibotto, Valentina, Kaufmann, Timothy J, Komori, Takashi, Kotecha, Rupesh, Liau, Linda M, Lupo, Janine M, Minniti, Giuseppe, Narita, Yoshitaka, Niyazi, Maximilian, Perry, Arie, Preusser, Matthias, Rudà, Roberta, Sanai, Nader, Schmidt, Nils-Ole, Steinbach, Joachim P, Thust, Stefanie C, Tolboom, Nelleke, van der Hoorn, Anouk, van der Vaart, Thijs, Verger, Antoine, Vik-Mo, Einar Osland, Watts, Colin, Westphal, Manfred, Wesseling, Pieter, Young, Jacob S, von Baumgarten, Louisa, Albert, Nathalie L, Huang, Raymond Y, Mehta, Minesh P, van den Bent, Martin, Weller, Michael, Vogelbaum, Michael A, Chang, Susan M, Berger, Mitchel S, and Tonn, Joerg-Christian

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Cancer, Brain Cancer, Brain Disorders, Rare Diseases, Neurosciences, Humans, Brain Neoplasms, Prospective Studies, Biological Specimen Banks, Neoplasm Recurrence, Local, Glioma, Expert Rater Panel, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

Surgical resection represents the standard of care for people with newly diagnosed diffuse gliomas, and the neuropathological and molecular profile of the resected tissue guides clinical management and forms the basis for research. The Response Assessment in Neuro-Oncology (RANO) consortium is an international, multidisciplinary effort that aims to standardise research practice in neuro-oncology. These recommendations represent a multidisciplinary consensus from the four RANO groups: RANO resect, RANO recurrent glioblastoma, RANO radiotherapy, and RANO/PET for a standardised workflow to achieve a representative tumour evaluation in a disease characterised by intratumoural heterogeneity, including recommendations on which tumour regions should be surgically sampled, how to define those regions on the basis of preoperative imaging, and the optimal sample volume. Practical recommendations for tissue sampling are given for people with low-grade and high-grade gliomas, as well as for people with newly diagnosed and recurrent disease. Sampling of liquid biopsies is also addressed. A standardised workflow for subsequent handling of the resected tissue is proposed to avoid information loss due to decreasing tissue quality or insufficient clinical information. The recommendations offer a framework for prospective biobanking studies.

Published
2023

8. Advances in PET imaging for meningioma patients.

Author

Galldiks, Norbert, Albert, Nathalie L, Wollring, Michael, Werner, Jan-Michael, Lohmann, Philipp, Villanueva-Meyer, Javier E, Fink, Gereon R, Langen, Karl-Josef, and Tonn, Joerg-Christian

Subjects
DOTATATE, FDG, FLT, SiTATE, amino acid PET, somatostatin receptor-expression, Brain Cancer, Brain Disorders, Biomedical Imaging, Cancer, Rare Diseases, Neurosciences, Detection, screening and diagnosis, 4.2 Evaluation of markers and technologies
Abstract

In patients with meningioma, diagnosis and treatment planning are predominantly based on anatomical imaging using MRI or CT. Constraints of these imaging modalities include precise meningioma delineation-especially at the skull base, in the case of trans-osseus growth, and in tumors with complex geometry-and the differentiation of post-therapeutic reactive changes from meningioma relapse. Advanced metabolic imaging using PET may help to characterize specific metabolic and cellular features providing additional information beyond the information derived from anatomical imaging alone. Accordingly, the use of PET in meningioma patients is steadily increasing. This review summarizes recent advances in PET imaging helpful for improving the clinical management of patients with meningioma.

Published
2023

10. Artificial intelligence (AI)-based decision support improves reproducibility of tumor response assessment in neuro-oncology: An international multi-reader study

Author

Vollmuth, Philipp, Foltyn, Martha, Huang, Raymond Y, Galldiks, Norbert, Petersen, Jens, Isensee, Fabian, van den Bent, Martin J, Barkhof, Frederik, Park, Ji Eun, Park, Yae Won, Ahn, Sung Soo, Brugnara, Gianluca, Meredig, Hagen, Jain, Rajan, Smits, Marion, Pope, Whitney B, Maier-Hein, Klaus, Weller, Michael, Wen, Patrick Y, Wick, Wolfgang, and Bendszus, Martin

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Biomedical Imaging, Rare Diseases, Cancer, Brain Disorders, Neurosciences, Brain Cancer, Bioengineering, Machine Learning and Artificial Intelligence, Orphan Drug, Humans, Glioblastoma, Brain Neoplasms, Artificial Intelligence, Reproducibility of Results, Glioma, Artificial intelligence (AI)-based decision support, RANO, tumor response assessment, tumor volumetry, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

BackgroundTo assess whether artificial intelligence (AI)-based decision support allows more reproducible and standardized assessment of treatment response on MRI in neuro-oncology as compared to manual 2-dimensional measurements of tumor burden using the Response Assessment in Neuro-Oncology (RANO) criteria.MethodsA series of 30 patients (15 lower-grade gliomas, 15 glioblastoma) with availability of consecutive MRI scans was selected. The time to progression (TTP) on MRI was separately evaluated for each patient by 15 investigators over two rounds. In the first round the TTP was evaluated based on the RANO criteria, whereas in the second round the TTP was evaluated by incorporating additional information from AI-enhanced MRI sequences depicting the longitudinal changes in tumor volumes. The agreement of the TTP measurements between investigators was evaluated using concordance correlation coefficients (CCC) with confidence intervals (CI) and P-values obtained using bootstrap resampling.ResultsThe CCC of TTP-measurements between investigators was 0.77 (95% CI = 0.69,0.88) with RANO alone and increased to 0.91 (95% CI = 0.82,0.95) with AI-based decision support (P = .005). This effect was significantly greater (P = .008) for patients with lower-grade gliomas (CCC = 0.70 [95% CI = 0.56,0.85] without vs. 0.90 [95% CI = 0.76,0.95] with AI-based decision support) as compared to glioblastoma (CCC = 0.83 [95% CI = 0.75,0.92] without vs. 0.86 [95% CI = 0.78,0.93] with AI-based decision support). Investigators with less years of experience judged the AI-based decision as more helpful (P = .02).ConclusionsAI-based decision support has the potential to yield more reproducible and standardized assessment of treatment response in neuro-oncology as compared to manual 2-dimensional measurements of tumor burden, particularly in patients with lower-grade gliomas. A fully-functional version of this AI-based processing pipeline is provided as open-source (https://github.com/NeuroAI-HD/HD-GLIO-XNAT).

Published
2023

12. Investigational PET tracers in neuro-oncology-What's on the horizon? A report of the PET/RANO group.

Author

Galldiks, Norbert, Langen, Karl-Josef, Albert, Nathalie L, Law, Ian, Kim, Michelle M, Villanueva-Meyer, Javier E, Soffietti, Riccardo, Wen, Patrick Y, Weller, Michael, and Tonn, Joerg C

Subjects
Cancer, Neurosciences, Rare Diseases, Brain Disorders, Brain Cancer, Bioengineering, Biomedical Imaging, 4.1 Discovery and preclinical testing of markers and technologies, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Neurological, Humans, Radiopharmaceuticals, Positron-Emission Tomography, Brain Neoplasms, fluciclovine, Immuno-PET, PSMA, somatostatin, TSPO, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

Many studies in patients with brain tumors evaluating innovative PET tracers have been published in recent years, and the initial results are promising. Here, the Response Assessment in Neuro-Oncology (RANO) PET working group provides an overview of the literature on novel investigational PET tracers for brain tumor patients. Furthermore, newer indications of more established PET tracers for the evaluation of glucose metabolism, amino acid transport, hypoxia, cell proliferation, and others are also discussed. Based on the preliminary findings, these novel investigational PET tracers should be further evaluated considering their promising potential. In particular, novel PET probes for imaging of translocator protein and somatostatin receptor overexpression as well as for immune system reactions appear to be of additional clinical value for tumor delineation and therapy monitoring. Progress in developing these radiotracers may contribute to improving brain tumor diagnostics and advancing clinical translational research.

Published
2022

13. Artificial Intelligence for Response Assessment in Neuro Oncology (AI-RANO), part 1: review of current advancements

Author

Villanueva-Meyer, Javier E, Bakas, Spyridon, Tiwari, Pallavi, Lupo, Janine M, Calabrese, Evan, Davatzikos, Christos, Bi, Wenya Linda, Ismail, Marwa, Akbari, Hamed, Lohmann, Philipp, Booth, Thomas C, Wiestler, Benedikt, Aerts, Hugo J W L, Rasool, Ghulam, Tonn, Joerg C, Nowosielski, Martha, Jain, Rajan, Colen, Rivka R, Pati, Sarthak, Baid, Ujjwal, Vollmuth, Philipp, Macdonald, David, Vogelbaum, Michael A, Chang, Susan M, Huang, Raymond Y, and Galldiks, Norbert

Published
2024
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14. Artificial Intelligence for Response Assessment in Neuro Oncology (AI-RANO), part 2: recommendations for standardisation, validation, and good clinical practice

Author

Bakas, Spyridon, Vollmuth, Philipp, Galldiks, Norbert, Booth, Thomas C, Aerts, Hugo J W L, Bi, Wenya Linda, Wiestler, Benedikt, Tiwari, Pallavi, Pati, Sarthak, Baid, Ujjwal, Calabrese, Evan, Lohmann, Philipp, Nowosielski, Martha, Jain, Rajan, Colen, Rivka, Ismail, Marwa, Rasool, Ghulam, Lupo, Janine M, Akbari, Hamed, Tonn, Joerg C, Macdonald, David, Vogelbaum, Michael, Chang, Susan M, Davatzikos, Christos, Villanueva-Meyer, Javier E, and Huang, Raymond Y

Published
2024
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16. Development of ‘Core Outcome Sets’ for Meningioma in Clinical Studies (The COSMIC Project): protocol for two systematic literature reviews, eDelphi surveys and online consensus meetings

Author

Millward, Christopher P, Armstrong, Terri S, Barrington, Heather, Bell, Sabrina, Brodbelt, Andrew R, Bulbeck, Helen, Crofton, Anna, Dirven, Linda, Georgious, Theo, Grundy, Paul L, Islim, Abdurrahman I, Javadpour, Mohsen, Keshwara, Sumirat M, Koszdin, Shelli D, Marson, Anthony G, McDermott, Michael W, Meling, Torstein R, Oliver, Kathy, Plaha, Puneet, Preusser, Matthias, Santarius, Thomas, Srikandarajah, Nisaharan, Taphoorn, Martin JB, Turner, Carole, Watts, Colin, Weller, Michael, Williamson, Paula R, Zadeh, Gelareh, Najafabadi, Amir H Zamanipoor, Jenkinson, Michael D, Aldape, Kenneth, Au, Karolyn, Barnhartz-Sloan, Jill, Bi, Wenya Linda, Behling, Felix, Brastianos, Priscilla K, Brodie, Chaya, Butowski, Nicholas, Carlotti, Carlos, Castro, Ana, Cohen-Gadol, Aaron, Couce, Marta, Cusimano, Michael D, DiMeco, Francesco, Drummond, Katharine, Dunn, Ian F, Erker, Craig, Felicella, Michelle, Fountain, Daniel M, Galanis, Evanthia, Galldiks, Norbert, Giannini, Caterina, Goldbrunner, Roland, Griffith, Brent, Hashizume, Rintaro, Hanemann, C Oliver, Herold-Mende, Christel, Hnenny, Luke, Horbinski, Craig, Huang, Raymond Y, James, David, Jungk, Christine, Jungwirth, Gerhard, Kaufmann, Timothy J, Krischek, Boris, Kurz, Sylvia, Lachance, Daniel, Lafougère, Christian, Lamszus, Katrin, Lee, Ian, Liu, Jeff C, Makarenko, Serge, Malta, Tathiana, Mamatjan, Yasin, Mansouri, Alireza, Mawrin, Christian, McDermott, Michael, Moliterno-Gunel, Jennifer, Morokoff, Andrew, Munoz, David, Nassiri, Farshad, Noushmehr, Houtan, Ng, Ho-Keung, Perry, Arie, Pirouzmand, Farhad, Poisson, Laila M, Pollo, Bianca, Ragunathan, Aditya, Raleigh, David, Renovanz, Mirjam, Ricklefs, Franz, Sahm, Felix, Saladino, Andrea, Santacroce, Antonio, Schittenhelm, Jens, and Schichor, Christian

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Neurosciences, Brain Disorders, Clinical Research, Clinical Trials and Supportive Activities, Cancer, Consensus, Delphi Technique, Humans, Meningeal Neoplasms, Meningioma, Research Design, Systematic Reviews as Topic, Treatment Outcome, EORTC BTG, ICOM, EANO, SNO, RANO-PRO, BNOS, SBNS, BIMS, TBTC, International Brain Tumour Alliance, Brainstrust, and Brain Tumour Foundation of Canada, clinical trial, core outcome set, meningioma, Public Health and Health Services, Other Medical and Health Sciences, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

IntroductionMeningioma is the most common primary intracranial tumour in adults. The majority are non-malignant, but a proportion behave more aggressively. Incidental/minimally symptomatic meningioma are often managed by serial imaging. Symptomatic meningioma, those that threaten neurovascular structures, or demonstrate radiological growth, are usually resected as first-line management strategy. For patients in poor clinical condition, or with inoperable, residual or recurrent disease, radiotherapy is often used as primary or adjuvant treatment. Effective pharmacotherapy treatments do not currently exist. There is heterogeneity in the outcomes measured and reported in meningioma clinical studies. Two 'Core Outcome Sets' (COS) will be developed: (COSMIC: Intervention) for use in meningioma clinical effectiveness trials and (COSMIC: Observation) for use in clinical studies of incidental/untreated meningioma.Methods and analysisTwo systematic literature reviews and trial registry searches will identify outcomes measured and reported in published and ongoing (1) meningioma clinical effectiveness trials, and (2) clinical studies of incidental/untreated meningioma. Outcomes include those that are clinician reported, patient reported, caregiver reported and based on objective tests (eg, neurocognitive tests), as well as measures of progression and survival. Outcomes will be deduplicated and categorised to generate two long lists. The two long lists will be prioritised through two, two-round, international, modified eDelphi surveys including patients with meningioma, healthcare professionals, researchers and those in caring/supporting roles. The two final COS will be ratified through two 1-day online consensus meetings, with representation from all stakeholder groups.Ethics and disseminationInstitutional review board (University of Liverpool) approval was obtained for the conduct of this study. Participant eConsent will be obtained prior to participation in the eDelphi surveys and consensus meetings. The two systematic literature reviews and two final COS will be published and freely available.Trial registration numberCOMET study ID 1508.

Published
2022

17. Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses

Author

Zeyen, Thomas, 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, and Schaub, Christina

Published
2023
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19. Imaging Characteristics of Meningiomas

Author

Galldiks, Norbert, Hattingen, Elke, Langen, Karl-Josef, Tonn, Jörg C., Crusio, Wim E., Series Editor, Dong, Haidong, Series Editor, Radeke, Heinfried H., Series Editor, Rezaei, Nima, Series Editor, Steinlein, Ortrud, Series Editor, Xiao, Junjie, Series Editor, Zadeh, Gelareh, editor, Goldbrunner, Roland, editor, Krischek, Boris, editor, and Nassiri, Farshad, editor

Published
2023
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21. A framework for standardised tissue sampling and processing during resection of diffuse intracranial glioma: joint recommendations from four RANO groups

Author

Aldape, Kenneth, Baehring, Joachim M., Bello, Lorenzo, Brat, Daniel J., Cahill, Daniel P., Chung, Caroline, Colman, Howard, Dietrich, Jorg, Drummond, Katharine, Esquenazi, Yoshua, Gerstner, Elizabeth R., Furtner, Julia, Garibotto, Valentina, Kaufmann, Timothy J., Komori, Takashi, Kotecha, Rupesh, Liau, Linda M., Lupo, Janine M., Minniti, Giuseppe, Narita, Yoshitaka, Niyazi, Maximilian, Perry, Arie, Preusser, Matthias, Rudà, Roberta, Sanai, Nader, Schmidt, Nils-Ole, Steinbach, Joachim P., Thust, Stefanie C., Tolboom, Nelleke, van der Hoorn, Anouk, van der Vaart, Thijs, Verger, Antoine, Vik-Mo, Einar Osland, Watts, Colin, Westphal, Manfred, Wesseling, Pieter, Young, Jacob S., Karschnia, Philipp, Smits, Marion, Reifenberger, Guido, Le Rhun, Emilie, Ellingson, Benjamin M, Galldiks, Norbert, Kim, Michelle M, Huse, Jason T, Schnell, Oliver, Harter, Patrick N, Mohme, Malte, von Baumgarten, Louisa, Albert, Nathalie L, Huang, Raymond Y, Mehta, Minesh P, van den Bent, Martin, Weller, Michael, Vogelbaum, Michael A, Chang, Susan M, Berger, Mitchel S, and Tonn, Joerg-Christian

Published
2023
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29. Joint EANM/SIOPE/RAPNO practice guidelines/SNMMI procedure standards for imaging of paediatric gliomas using PET with radiolabelled amino acids and [18F]FDG: version 1.0

Author

Piccardo, Arnoldo, Albert, Nathalie L., Borgwardt, Lise, Fahey, Frederic H., Hargrave, Darren, Galldiks, Norbert, Jehanno, Nina, Kurch, Lars, Law, Ian, Lim, Ruth, Lopci, Egesta, Marner, Lisbeth, Morana, Giovanni, Young Poussaint, Tina, Seghers, Victor J., Shulkin, Barry L., Warren, Katherine E., Traub-Weidinger, Tatjana, and Zucchetta, Pietro

Published
2022
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30. Borderline Findings in O -(2-[18F]-Fluoroethyl)-l-Tyrosine PET of Patients with Suspected Glioma Relapse: Role in Clinical Practice.

Author

Langen, Karl-Josef, Stoffels, Gabriele, Filss, Christian P., Kocher, Martin, Lerche, Christoph, Sabel, Michael, Rapp, Marion, Noltemeier, Hosai, Werner, Jan-Michael, Ceccon, Garry, Wollring, Michael M., Rosen, Jurij, Steinbach, Joachim P., Hattingen, Elke, Weinzierl, Martin R., Stoffel, Michael, Clusmann, Hans, Shah, N. Jon, Mottaghy, Felix M., and Galldiks, Norbert

Published
2025
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31. Quantitative assessment of residual tumor is a strong and independent predictor of survival in methylated glioblastoma following radiochemotherapy with lomustine/temozolomide.

Author

Zeyen, Thomas, Böhm, Laura, Paech, Daniel, Schäfer, Niklas, Tzaridis, Theophilos, Duffy, Cathrina, Nitsch, Louisa, Schneider, Matthias, Potthoff, Anna-Laura, Schneider-Rothhaar, Javen Lennard, Steinbach, Joachim Peter, Hau, Peter, Kowalski, Thomas, Seidel, Clemens, Krex, Dietmar, Grauer, Oliver, Goldbrunner, Roland, Zeiner, Pia Susan, Tabatabai, Ghazaleh, and Galldiks, Norbert

Published
2025
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32. Correction to: Undetected pseudoprogressions in the CeTeG/NOA-09 trial: hints from postprogression survival and MRI analyses

Author

Zeyen, Thomas, 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, and Schaub, Christina

Published
2023
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36. PET imaging of gliomas: Status quo and quo vadis?

Author

Galldiks, Norbert, Lohmann, Philipp, Friedrich, Michel, Werner, Jan-Michael, Stetter, Isabelle, Wollring, Michael M, Ceccon, Garry, Stegmayr, Carina, Krause, Sandra, Fink, Gereon R, Law, Ian, Langen, Karl-Josef, and Tonn, Joerg-Christian

Published
2024
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38. MRI and18F-FET PET for Multimodal Treatment Monitoring in Patients with Brain Metastases: A Cost-Effectiveness Analysis

Author

Rosen, Jurij, primary, Werner, Jan-Michael, additional, Ceccon, Garry S., additional, Rosen, Elena K., additional, Wollring, Michael M., additional, Stetter, Isabelle, additional, Lohmann, Philipp, additional, Mottaghy, Felix M., additional, Fink, Gereon R., additional, Langen, Karl-Josef, additional, and Galldiks, Norbert, additional

Published
2024
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39. Liquid biopsy for improving diagnosis and monitoring of CNS lymphomas: a RANO review

Author

Nayak, Lakshmi, primary, Bettegowda, Chetan, additional, Scherer, Florian, additional, Galldiks, Norbert, additional, Ahluwalia, Manmeet, additional, Baraniskin, Alexander, additional, von Baumgarten, Louisa, additional, Bromberg, Jacoline E C, additional, Ferreri, Andrés J M, additional, Grommes, Christian, additional, Hoang-Xuan, Khê, additional, Kühn, Julia, additional, Rubenstein, James L, additional, Rudà, Roberta, additional, Weller, Michael, additional, Chang, Susan M, additional, van den Bent, Martin J, additional, Wen, Patrick Y, additional, and Soffietti, Riccardo, additional

Published
2024
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40. Meningioma:International Consortium on Meningiomas consensus review on scientific advances and treatment paradigms for clinicians, researchers, and patients

Author

Wang, Justin Z, Landry, Alexander P, Raleigh, David R, Sahm, Felix, Walsh, Kyle M, Goldbrunner, Roland, Yefet, Leeor S, Tonn, Jörg C, Gui, Chloe, Ostrom, Quinn T, Barnholtz-Sloan, Jill, Perry, Arie, Ellenbogen, Yosef, Hanemann, C Oliver, Jungwirth, Gerhard, Jenkinson, Michael D, Tabatabai, Ghazaleh, Mathiesen, Tiit I, McDermott, Michael W, Tatagiba, Marcos, la Fougère, Christian, Maas, Sybren L N, Galldiks, Norbert, Albert, Nathalie L, Brastianos, Priscilla K, Ehret, Felix, Minniti, Giuseppe, Lamszus, Katrin, Ricklefs, Franz L, Schittenhelm, Jens, Drummond, Katharine J, Dunn, Ian F, Pathmanaban, Omar N, Cohen-Gadol, Aaron, Sulman, Erik P, Tabouret, Emeline, Le Rhun, Emelie, Mawrin, Christian, Moliterno, Jennifer, Weller, Michael, Bi, Wenya Linda, Gao, Andrew, Yip, Stephen, Niyazi, Maximilian, Wang, Justin Z, Landry, Alexander P, Raleigh, David R, Sahm, Felix, Walsh, Kyle M, Goldbrunner, Roland, Yefet, Leeor S, Tonn, Jörg C, Gui, Chloe, Ostrom, Quinn T, Barnholtz-Sloan, Jill, Perry, Arie, Ellenbogen, Yosef, Hanemann, C Oliver, Jungwirth, Gerhard, Jenkinson, Michael D, Tabatabai, Ghazaleh, Mathiesen, Tiit I, McDermott, Michael W, Tatagiba, Marcos, la Fougère, Christian, Maas, Sybren L N, Galldiks, Norbert, Albert, Nathalie L, Brastianos, Priscilla K, Ehret, Felix, Minniti, Giuseppe, Lamszus, Katrin, Ricklefs, Franz L, Schittenhelm, Jens, Drummond, Katharine J, Dunn, Ian F, Pathmanaban, Omar N, Cohen-Gadol, Aaron, Sulman, Erik P, Tabouret, Emeline, Le Rhun, Emelie, Mawrin, Christian, Moliterno, Jennifer, Weller, Michael, Bi, Wenya Linda, Gao, Andrew, Yip, Stephen, and Niyazi, Maximilian

Abstract

Meningiomas are the most common primary intracranial tumors in adults and are increasing in incidence due to the aging population and increased access to neuroimaging. While most exhibit nonmalignant behavior, a subset of meningiomas are biologically aggressive and are associated with treatment resistance, resulting in significant neurologic morbidity and even mortality. In recent years, meaningful advances in our understanding of the biology of these tumors have led to the incorporation of molecular biomarkers into their grading and prognostication. However, unlike other central nervous system (CNS) tumors, a unified molecular taxonomy for meningiomas has not yet been established and remains an overarching goal of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-Not Official World Health Organization (cIMPACT-NOW) working group. Additionally, clinical equipoise still remains on how specific meningioma cases and patient populations should be optimally managed. To address these existing gaps, members of the International Consortium on Meningiomas including field-leading experts, have prepared this comprehensive consensus narrative review directed toward clinicians, researchers, and patients. Included in this manuscript are detailed overviews of proposed molecular classifications, novel biomarkers, contemporary treatment strategies, trials on systemic therapies, health-related quality-of-life studies, and management strategies for unique meningioma patient populations. In each section, we discuss the current state of knowledge as well as ongoing clinical and research challenges to road map future directions for further investigation.

Published
2024

41. Joint EANM/EANO/RANO/SNMMI Practice Guideline/Procedure Standards for Diagnostics and Therapy (Theranostics) of Meningiomas Using Radiolabeled Somatostatin Receptor Ligands : Version 1.0

Author

Albert, Nathalie L; https://orcid.org/0000-0003-0953-7624, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Traub-Weidinger, Tatjana; https://orcid.org/0000-0003-1118-926X, Tolboom, Nelleke; https://orcid.org/0000-0002-8005-2833, Law, Ian; https://orcid.org/0000-0001-9644-7496, Palmer, Joshua D; https://orcid.org/0000-0003-3311-0129, Guedj, Eric, Furtner, Julia; https://orcid.org/0000-0001-8258-3681, Fraioli, Francesco, Huang, Raymond Y; https://orcid.org/0000-0001-7661-797X, Johnson, Derek R, Deroose, Christophe M; https://orcid.org/0000-0002-6080-1577, Herrmann, Ken; https://orcid.org/0000-0002-9662-7259, Vogelbaum, Michael A; https://orcid.org/0000-0002-9833-2374, Chang, Susan, Tonn, Joerg-Christian; https://orcid.org/0009-0004-1756-423X, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Wen, Patrick Y; https://orcid.org/0000-0002-0774-7700, van den Bent, Martin J; https://orcid.org/0000-0001-5710-5127, Verger, Antoine, Ivanidze, Jana, Galldiks, Norbert; https://orcid.org/0000-0002-2485-1796, Albert, Nathalie L; https://orcid.org/0000-0003-0953-7624, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Traub-Weidinger, Tatjana; https://orcid.org/0000-0003-1118-926X, Tolboom, Nelleke; https://orcid.org/0000-0002-8005-2833, Law, Ian; https://orcid.org/0000-0001-9644-7496, Palmer, Joshua D; https://orcid.org/0000-0003-3311-0129, Guedj, Eric, Furtner, Julia; https://orcid.org/0000-0001-8258-3681, Fraioli, Francesco, Huang, Raymond Y; https://orcid.org/0000-0001-7661-797X, Johnson, Derek R, Deroose, Christophe M; https://orcid.org/0000-0002-6080-1577, Herrmann, Ken; https://orcid.org/0000-0002-9662-7259, Vogelbaum, Michael A; https://orcid.org/0000-0002-9833-2374, Chang, Susan, Tonn, Joerg-Christian; https://orcid.org/0009-0004-1756-423X, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Wen, Patrick Y; https://orcid.org/0000-0002-0774-7700, van den Bent, Martin J; https://orcid.org/0000-0001-5710-5127, Verger, Antoine, Ivanidze, Jana, and Galldiks, Norbert; https://orcid.org/0000-0002-2485-1796

Abstract

Purpose To provide practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor (SSTR) ligands. Methods This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO). Results Positron emission tomography (PET) using somatostatin receptor (SSTR) ligands can detect meningioma tissue with high sensitivity and specificity and may provide clinically relevant information beyond that obtained from structural magnetic resonance imaging (MRI) or computed tomography (CT) imaging alone. SSTR-directed PET imaging can be particularly useful for differential diagnosis, delineation of meningioma extent, detection of osseous involvement, and the differentiation between posttherapeutic scar tissue and tumour recurrence. Moreover, SSTR-peptide receptor radionuclide therapy (PRRT) is an emerging investigational treatment approach for meningioma. Conclusion These practice guidelines will define procedure standards for the application of PET imaging in patients with meningiomas and related SSTR-targeted PRRTs in routine practice and clinical trials and will help to harmonize data acquisition and interpretation across centers, facilitate comparability of studies, and to collect larger databases. The current document provides additional information to the evidence-based recommendations from the PET/RANO Working Group regarding the utilization of PET imaging in meningiomas Galldiks (Neuro Oncol. 2017;19(12):1576–87). The information provided should be considered in the context of local conditions and regulations.

Published
2024

42. PET-based response assessment criteria for diffuse gliomas (PET RANO 1.0): a report of the RANO group

Author

MS Radiologie, Brain, Cancer, Albert, Nathalie L, Galldiks, Norbert, Ellingson, Benjamin M, van den Bent, Martin J, Chang, Susan M, Cicone, Francesco, de Groot, John, Koh, Eng-Siew, Law, Ian, Le Rhun, Emilie, Mair, Maximilian J, Minniti, Giuseppe, Rudà, Roberta, Scott, Andrew M, Short, Susan C, Smits, Marion, Suchorska, Bogdana, Tolboom, Nelleke, Traub-Weidinger, Tatjana, Tonn, Joerg-Christian, Verger, Antoine, Weller, Michael, Wen, Patrick Y, Preusser, Matthias, MS Radiologie, Brain, Cancer, Albert, Nathalie L, Galldiks, Norbert, Ellingson, Benjamin M, van den Bent, Martin J, Chang, Susan M, Cicone, Francesco, de Groot, John, Koh, Eng-Siew, Law, Ian, Le Rhun, Emilie, Mair, Maximilian J, Minniti, Giuseppe, Rudà, Roberta, Scott, Andrew M, Short, Susan C, Smits, Marion, Suchorska, Bogdana, Tolboom, Nelleke, Traub-Weidinger, Tatjana, Tonn, Joerg-Christian, Verger, Antoine, Weller, Michael, Wen, Patrick Y, and Preusser, Matthias

Published
2024

43. Treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide

Author

ZL Neuro-Oncologie Medisch, Neurologen, Cancer, Brain, Flies, Christina Maria, Friedrich, Michel, Lohmann, Philipp, van Garderen, Karin Alida, Smits, Marion, Tonn, Joerg-Christian, Weller, Michael, Galldiks, Norbert, Snijders, Tom Jan, ZL Neuro-Oncologie Medisch, Neurologen, Cancer, Brain, Flies, Christina Maria, Friedrich, Michel, Lohmann, Philipp, van Garderen, Karin Alida, Smits, Marion, Tonn, Joerg-Christian, Weller, Michael, Galldiks, Norbert, and Snijders, Tom Jan

Published
2024

44. Liquid biopsy for improving diagnosis and monitoring of CNS lymphomas:A RANO review

Author

Nayak, Lakshmi, Bettegowda, Chetan, Scherer, Florian, Galldiks, Norbert, Ahluwalia, Manmeet, Baraniskin, Alexander, von Baumgarten, Louisa, Bromberg, Jacoline E.C., Ferreri, Andrés J.M., Grommes, Christian, Hoang-Xuan, Khê, Kühn, Julia, Rubenstein, James L., Rudà, Roberta, Weller, Michael, Chang, Susan M., van den Bent, Martin J., Wen, Patrick Y., Soffietti, Riccardo, Nayak, Lakshmi, Bettegowda, Chetan, Scherer, Florian, Galldiks, Norbert, Ahluwalia, Manmeet, Baraniskin, Alexander, von Baumgarten, Louisa, Bromberg, Jacoline E.C., Ferreri, Andrés J.M., Grommes, Christian, Hoang-Xuan, Khê, Kühn, Julia, Rubenstein, James L., Rudà, Roberta, Weller, Michael, Chang, Susan M., van den Bent, Martin J., Wen, Patrick Y., and Soffietti, Riccardo

Abstract

BACKGROUND: The utility of liquid biopsies is well documented in several extracranial and intracranial (brain/leptomeningeal metastases, gliomas) tumors. METHODS: The RANO (Response Assessment in Neuro-Oncology) group has set up a multidisciplinary Task Force to critically review the role of blood and cerebrospinal fluid (CSF)-liquid biopsy in CNS lymphomas, with a main focus on primary central nervous system lymphomas (PCNSL). RESULTS: Several clinical applications are suggested: diagnosis of PCNSL in critical settings (elderly or frail patients, deep locations, and steroid responsiveness), definition of minimal residual disease, early indication of tumor response or relapse following treatments, and prediction of outcome. CONCLUSIONS: Thus far, no clinically validated circulating biomarkers for managing both primary and secondary CNS lymphomas exist. There is need of standardization of biofluid collection, choice of analytes, and type of technique to perform the molecular analysis. The various assays should be evaluated through well-organized central testing within clinical trials.

Published
2024

45. Challenges, limitations, and pitfalls of PET and advanced MRI in patients with brain tumors:A report of the PET/RANO group

Author

Galldiks, Norbert, Kaufmann, Timothy J., Vollmuth, Philipp, Lohmann, Philipp, Smits, Marion, Veronesi, Michael C., Langen, Karl Josef, Rudà, Roberta, Albert, Nathalie L., Hattingen, Elke, Law, Ian, Hutterer, Markus, Soffietti, Riccardo, Vogelbaum, Michael A., Wen, Patrick Y., Weller, Michael, Tonn, Joerg Christian, Galldiks, Norbert, Kaufmann, Timothy J., Vollmuth, Philipp, Lohmann, Philipp, Smits, Marion, Veronesi, Michael C., Langen, Karl Josef, Rudà, Roberta, Albert, Nathalie L., Hattingen, Elke, Law, Ian, Hutterer, Markus, Soffietti, Riccardo, Vogelbaum, Michael A., Wen, Patrick Y., Weller, Michael, and Tonn, Joerg Christian

Abstract

Brain tumor diagnostics have significantly evolved with the use of positron emission tomography (PET) and advanced magnetic resonance imaging (MRI) techniques. In addition to anatomical MRI, these modalities may provide valuable information for several clinical applications such as differential diagnosis, delineation of tumor extent, prognostication, differentiation between tumor relapse and treatment-related changes, and the evaluation of response to anticancer therapy. In particular, joint recommendations of the Response Assessment in Neuro-Oncology (RANO) Group, the European Association of Neuro-oncology, and major European and American Nuclear Medicine societies highlighted that the additional clinical value of radiolabeled amino acids compared to anatomical MRI alone is outstanding and that its widespread clinical use should be supported. For advanced MRI and its steadily increasing use in clinical practice, the Standardization Subcommittee of the Jumpstarting Brain Tumor Drug Development Coalition provided more recently an updated acquisition protocol for the widely used dynamic susceptibility contrast perfusion MRI. Besides amino acid PET and perfusion MRI, other PET tracers and advanced MRI techniques (e.g. MR spectroscopy) are of considerable clinical interest and are increasingly integrated into everyday clinical practice. Nevertheless, these modalities have shortcomings which should be considered in clinical routine. This comprehensive review provides an overview of potential challenges, limitations, and pitfalls associated with PET imaging and advanced MRI techniques in patients with gliomas or brain metastases. Despite these issues, PET imaging and advanced MRI techniques continue to play an indispensable role in brain tumor management. Acknowledging and mitigating these challenges through interdisciplinary collaboration, standardized protocols, and continuous innovation will further enhance the utility of these modalities in guiding optimal patient

Published
2024

46. Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor ligands:version 1.0

Author

Albert, Nathalie L., Preusser, Matthias, Traub-Weidinger, Tatjana, Tolboom, Nelleke, Law, Ian, Palmer, Joshua D., Guedj, Eric, Furtner, Julia, Fraioli, Fracesco, Huang, Raymond Y., Johnson, Derek R., Deroose, Christophe M., Hermann, Ken, Vogelbaum, Michael, Chang, Susan, Tonn, Joerg-Christian, Weller, Michael, Wen, Patrick Y., van den Bent, Martin J., Verger, Antoine, Ivanidze, Jana, Galldiks, Norbert, Albert, Nathalie L., Preusser, Matthias, Traub-Weidinger, Tatjana, Tolboom, Nelleke, Law, Ian, Palmer, Joshua D., Guedj, Eric, Furtner, Julia, Fraioli, Fracesco, Huang, Raymond Y., Johnson, Derek R., Deroose, Christophe M., Hermann, Ken, Vogelbaum, Michael, Chang, Susan, Tonn, Joerg-Christian, Weller, Michael, Wen, Patrick Y., van den Bent, Martin J., Verger, Antoine, Ivanidze, Jana, and Galldiks, Norbert

Abstract

Purpose To provide practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor (SSTR) ligands.Methods This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO).Results Positron emission tomography (PET) using somatostatin receptor (SSTR) ligands can detect meningioma tissue with high sensitivity and specificity and may provide clinically relevant information beyond that obtained from structural magnetic resonance imaging (MRI) or computed tomography (CT) imaging alone. SSTR-directed PET imaging can be particularly useful for differential diagnosis, delineation of meningioma extent, detection of osseous involvement, and the differentiation between posttherapeutic scar tissue and tumour recurrence. Moreover, SSTR-peptide receptor radionuclide therapy (PRRT) is an emerging investigational treatment approach for meningioma.Conclusion These practice guidelines will define procedure standards for the application of PET imaging in patients with meningiomas and related SSTR-targeted PRRTs in routine practice and clinical trials and will help to harmonize data acquisition and interpretation across centers, facilitate comparability of studies, and to collect larger databases. The current document provides additional information to the evidence-based recommendations from the PET/RANO Working Group regarding the utilization of PET imaging in meningiomas Galldiks (Neuro Oncol. 2017;19(12):1576-87). The information provided should be considered in the context of local conditions and regulations.

Published
2024

47. Translating the theranostic concept to neuro-oncology: disrupting barriers

Author

MS Radiologie, Brain, Cancer, Albert, Nathalie L., Le Rhun, Emilie, Minniti, Giuseppe, Mair, Maximilian J., Galldiks, Norbert, Tolboom, Nelleke, Jakola, Asgeir S., Niyazi, Maximilian, Smits, Marion, Verger, Antoine, Cicone, Francesco, Weller, Michael, Preusser, Matthias, European Organisation for Research and Treatment of Cancer Brain Tumor Group, MS Radiologie, Brain, Cancer, Albert, Nathalie L., Le Rhun, Emilie, Minniti, Giuseppe, Mair, Maximilian J., Galldiks, Norbert, Tolboom, Nelleke, Jakola, Asgeir S., Niyazi, Maximilian, Smits, Marion, Verger, Antoine, Cicone, Francesco, Weller, Michael, Preusser, Matthias, and European Organisation for Research and Treatment of Cancer Brain Tumor Group

Published
2024

48. Treatment-associated imaging changes in newly diagnosed MGMT promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide

Author

Flies, Christina Maria, Friedrich, Michel, Lohmann, Philipp, van Garderen, Karin Alida, Smits, Marion, Tonn, Joerg-Christian, Weller, Michael, Galldiks, Norbert, Snijders, Tom Jan, Flies, Christina Maria, Friedrich, Michel, Lohmann, Philipp, van Garderen, Karin Alida, Smits, Marion, Tonn, Joerg-Christian, Weller, Michael, Galldiks, Norbert, and Snijders, Tom Jan

Abstract

Background Radiological progression may originate from progressive disease (PD) or pseudoprogression/treatment-associated changes. We assessed radiological progression in O6-methylguanine-DNA methyltransferase (MGMT) promoter-methylated glioblastoma treated with standard-of-care chemoradiotherapy with or without the integrin inhibitor cilengitide according to the modified response assessment in neuro-oncology (RANO) criteria of 2017.Methods Patients with >= 3 follow-up MRIs were included. Preliminary PD was defined as a >= 25% increase of the sum of products of perpendicular diameters (SPD) of a new or increasing lesion compared to baseline. PD required a second >= 25% increase of the SPD. Treatment-associated changes require stable or regressing disease after preliminary PD.Results Of the 424 evaluable patients, 221 patients (52%) were randomized into the cilengitide and 203 patients (48%) into the control arm. After chemoradiation with or without cilengitide, preliminary PD occurred in 274 patients (65%) during available follow-up, and 88 of these patients (32%) had treatment-associated changes, whereas 67 patients (25%) had PD. The remaining 119 patients (43%) had no further follow-up after preliminary PD. Treatment-associated changes were more common in the cilengitide arm than in the standard-of-care arm (24% vs. 17%; relative risk, 1.3; 95% CI, 1.004-1.795; P = .047). Treatment-associated changes occurred mainly during the first 6 months after RT (54% after 3 months vs. 13% after 6 months).Conclusions With the modified RANO criteria, the rate of treatment-associated changes was low compared to previous studies in MGMT promoter-methylated glioblastoma. This rate was higher after cilengitide compared to standard-of-care treatment. Confirmatory scans, as recommended in the modified RANO criteria, were not always available reflecting current clinical practice.

Published
2024

49. Gender balance and suitable positive actions to promote gender equality among healthcare professionals in neuro-oncology: The EANO positive action initiative

Author

Le Rhun, Emilie; https://orcid.org/0000-0002-9408-3278, Boele, Florien; https://orcid.org/0000-0003-0409-7949, Minniti, Giuseppe; https://orcid.org/0000-0003-1239-1603, Galldiks, Norbert; https://orcid.org/0000-0002-2485-1796, Taphoorn, Martin; https://orcid.org/0000-0001-9949-4722, Piil, Karin; https://orcid.org/0000-0001-7972-4674, Rudà, Roberta, Niclou, Simone P; https://orcid.org/0000-0002-3417-9534, Geurts, Marjolein; https://orcid.org/0000-0003-2369-0035, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Short, Susan C, Dirven, Linda; https://orcid.org/0000-0001-9157-9895, Le Rhun, Emilie; https://orcid.org/0000-0002-9408-3278, Boele, Florien; https://orcid.org/0000-0003-0409-7949, Minniti, Giuseppe; https://orcid.org/0000-0003-1239-1603, Galldiks, Norbert; https://orcid.org/0000-0002-2485-1796, Taphoorn, Martin; https://orcid.org/0000-0001-9949-4722, Piil, Karin; https://orcid.org/0000-0001-7972-4674, Rudà, Roberta, Niclou, Simone P; https://orcid.org/0000-0002-3417-9534, Geurts, Marjolein; https://orcid.org/0000-0003-2369-0035, Preusser, Matthias; https://orcid.org/0000-0003-3541-2315, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Short, Susan C, and Dirven, Linda; https://orcid.org/0000-0001-9157-9895

Abstract

Background The proportion of women among healthcare and biomedical research professionals in neuro-oncology is growing. With changes in cultural expectations and work-life balance considerations, more men aspire to nonfull-time jobs, yet, leadership positions remain dominated by men. Methods The European Association of Neuro-Oncology (EANO) disparity committee carried out a digital survey to explore gender balance and actions suitable to promote gender equality. The survey was distributed among EANO members in 2021, with responses analyzed descriptively. Results In total, 262 participants completed the survey (141 women, 53.8%; median age 43). Respondents were neurosurgeons (68, 26.0%); neurologists (67, 25.6%), medical oncologists (43, 16.4%), or other healthcare or research professionals; 208 participants (79.4%) worked full-time. Positive action to enforce the role of women in neuro-oncology was deemed necessary by 180 participants (68.7%), but only 28 participants (10.7%) agreed that women only should be promoted until gender balance is reached. A majority of respondents (162, 61.8%) felt that women with an equivalent CV should be prioritized over men to reach gender balance. If in the future the balance favored women at higher positions, 112 respondents (42.7%) agreed to apply positive action for men. The top indicators considered relevant to measure gender balance were: salary for similar positions (183/228, 80.3%), paid overtime (176/228, 77.2%), number of permanent positions (164/228, 71.9%), protected time for research (161/227, 70.9%), and training opportunities (157/227, 69.2%). Conclusions Specific indicators may help to measure and promote gender balance and should be considered for implementation among healthcare professionals in neuro-oncology.

Published
2024

50. Treatment-associated imaging changes in newly diagnosed $MGMT$ promoter-methylated glioblastoma undergoing chemoradiation with or without cilengitide

Author

Flies, Christina Maria; https://orcid.org/0000-0002-9160-4058, Friedrich, Michel, Lohmann, Philipp; https://orcid.org/0000-0002-5360-046X, van Garderen, Karin Alida, Smits, Marion; https://orcid.org/0000-0001-5563-2871, Tonn, Joerg-Christian; https://orcid.org/0009-0004-1756-423X, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Galldiks, Norbert; https://orcid.org/0000-0002-2485-1796, Snijders, Tom Jan; https://orcid.org/0000-0003-0857-081X, Flies, Christina Maria; https://orcid.org/0000-0002-9160-4058, Friedrich, Michel, Lohmann, Philipp; https://orcid.org/0000-0002-5360-046X, van Garderen, Karin Alida, Smits, Marion; https://orcid.org/0000-0001-5563-2871, Tonn, Joerg-Christian; https://orcid.org/0009-0004-1756-423X, Weller, Michael; https://orcid.org/0000-0002-1748-174X, Galldiks, Norbert; https://orcid.org/0000-0002-2485-1796, and Snijders, Tom Jan; https://orcid.org/0000-0003-0857-081X

Abstract

Background: Radiological progression may originate from progressive disease (PD) or pseudoprogression/treatment-associated changes. We assessed radiological progression in O6-methylguanine-DNA methyltransferase (MGMT) promoter-methylated glioblastoma treated with standard-of-care chemoradiotherapy with or without the integrin inhibitor cilengitide according to the modified response assessment in neuro-oncology (RANO) criteria of 2017. Methods: Patients with ≥ 3 follow-up MRIs were included. Preliminary PD was defined as a ≥ 25% increase of the sum of products of perpendicular diameters (SPD) of a new or increasing lesion compared to baseline. PD required a second ≥25% increase of the SPD. Treatment-associated changes require stable or regressing disease after preliminary PD. Results: Of the 424 evaluable patients, 221 patients (52%) were randomized into the cilengitide and 203 patients (48%) into the control arm. After chemoradiation with or without cilengitide, preliminary PD occurred in 274 patients (65%) during available follow-up, and 88 of these patients (32%) had treatment-associated changes, whereas 67 patients (25%) had PD. The remaining 119 patients (43%) had no further follow-up after preliminary PD. Treatment-associated changes were more common in the cilengitide arm than in the standard-of-care arm (24% vs. 17%; relative risk, 1.3; 95% CI, 1.004–1.795; P = .047). Treatment-associated changes occurred mainly during the first 6 months after RT (54% after 3 months vs. 13% after 6 months). Conclusions: With the modified RANO criteria, the rate of treatment-associated changes was low compared to previous studies in MGMT promoter-methylated glioblastoma. This rate was higher after cilengitide compared to standard-of-care treatment. Confirmatory scans, as recommended in the modified RANO criteria, were not always available reflecting current clinical practice.

Published
2024

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