Dataset Information

Image-based metric of invasiveness predicts response to adjuvant temozolomide for primary glioblastoma.

ABSTRACT:

Background

Temozolomide (TMZ) has been the standard-of-care chemotherapy for glioblastoma (GBM) patients for more than a decade. Despite this long time in use, significant questions remain regarding how best to optimize TMZ therapy for individual patients. Understanding the relationship between TMZ response and factors such as number of adjuvant TMZ cycles, patient age, patient sex, and image-based tumor features, might help predict which GBM patients would benefit most from TMZ, particularly for those whose tumors lack O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation.

Methods and findings

Using a cohort of 90 newly-diagnosed GBM patients treated according to the standard of care, we examined the relationships between several patient and tumor characteristics and volumetric and survival outcomes during adjuvant chemotherapy. Volumetric changes in MR imaging abnormalities during adjuvant therapy were used to assess TMZ response. T1Gd volumetric response is associated with younger patient age, increased number of TMZ cycles, longer time to nadir volume, and decreased tumor invasiveness. Moreover, increased adjuvant TMZ cycles corresponded with improved volumetric response only among more nodular tumors, and this volumetric response was associated with improved survival outcomes. Finally, in a subcohort of patients with known MGMT methylation status, methylated tumors were more diffusely invasive than unmethylated tumors, suggesting the improved response in nodular tumors is not driven by a preponderance of MGMT methylated tumors.

Conclusions

Our finding that less diffusely invasive tumors are associated with greater volumetric response to TMZ suggests patients with these tumors may benefit from additional adjuvant TMZ cycles, even for those without MGMT methylation.

SUBMITTER: Massey SC

PROVIDER: S-EPMC7100932 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Publications

Image-based metric of invasiveness predicts response to adjuvant temozolomide for primary glioblastoma.

Massey Susan Christine SC White Haylye H Whitmire Paula P Doyle Tatum T Johnston Sandra K SK Singleton Kyle W KW Jackson Pamela R PR Hawkins-Daarud Andrea A Bendok Bernard R BR Porter Alyx B AB Vora Sujay S Sarkaria Jann N JN Hu Leland S LS Mrugala Maciej M MM Swanson Kristin R KR

PloS one 20200327 3

<h4>Background</h4>Temozolomide (TMZ) has been the standard-of-care chemotherapy for glioblastoma (GBM) patients for more than a decade. Despite this long time in use, significant questions remain regarding how best to optimize TMZ therapy for individual patients. Understanding the relationship between TMZ response and factors such as number of adjuvant TMZ cycles, patient age, patient sex, and image-based tumor features, might help predict which GBM patients would benefit most from TMZ, particu ...[more]

PMID: 32218600

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Dataset Information

Image-based metric of invasiveness predicts response to adjuvant temozolomide for primary glioblastoma.

Background

Methods and findings

Conclusions

Publications

Image-based metric of invasiveness predicts response to adjuvant temozolomide for primary glioblastoma.

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