Year: 2014
Type: article
Abstract: Bevacizumab's effects on contrast enhancement in high-grade glioma have created new challenges in determining tumor progression, eventuating in the adoption of the new RANO criteria. Moreover, animal models demonstrate that bevacizumab predisposes to development of a more invasive tumor phenotype characterized by T2/FLAIR signal abnormality distant from the original site of tumor. The frequency of this occurrence in human glioblastoma and its relationship to antiangiogenic treatment have been debated. The retrospective study of Nowosielski et al characterized patterns of progression in 83 glioblastoma patients receiving bevacizumab for recurrent disease. The patient population was fairly typical. Tumor progression was separated into four categories based upon MRI patterns. Patients who had an initial favorable response to bevacizumab but later progressed with more contrast enhancement were characterized as “cT1 flare-ups”. A 2nd group, “primary non-responders”, were defined as patients who failed to demonstrate reduced contrast enhancement on initial post-bevacizumab imaging. The final two groups showed post-bevacizumab reduction in contrast enhancement but had T2 progression. The “T2-diffuse” group manifested progressively expanding T2 signal abnormality exceeding anatomic boundaries of T1 hypointensity with associated mass effect, while the “T2-circumscribed” patients had bulky T2 progression with sharp borders corresponding to the T1-hypointense signal.
Source: Neuro-Oncology
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4253581234