1. 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
- Author
-
Jodi Goldman, Akifumi Hagiwara, Jingwen Yao, Catalina Raymond, Christian Ong, Rojin Bakhti, Elizabeth Kwon, Maguy Farhat, Carlo Torres, Lily G. Erickson, Brandon J. Curl, Maggie Lee, Whitney B. Pope, Noriko Salamon, Phioanh L. Nghiemphu, Matthew Ji, Blaine S. Eldred, Linda M. Liau, Albert Lai, Timothy F. Cloughesy, Caroline Chung, and Benjamin M. Ellingson
- Subjects
Cancer Research ,Oncology and Carcinogenesis ,glioblastoma ,Neurosciences ,rCBV ,Brain Disorders ,Brain Cancer ,dynamic susceptibility contrast perfusion MRI ,Rare Diseases ,Oncology ,Clinical Research ,MGMT methylation ,chemoradiation ,neoplasms ,Cancer - Abstract
Background and PurposeWhile 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.Methods1,153 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 ResultsA 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 (pConclusionsThis 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.
- Published
- 2022