Ontology highlight
ABSTRACT: Background
Determining failure to anti-angiogenic therapy in recurrent glioblastoma (GBM) (rGBM) remains a challenge. The purpose of the study was to assess treatment response to bevacizumab-based therapy in patients with rGBM using MR spectroscopy (MRS).Methods
We performed longitudinal MRI/MRS in 33 patients with rGBM to investigate whether changes in N-acetylaspartate (NAA)/Choline (Cho) and Lactate (Lac)/NAA from baseline to subsequent time points after treatment can predict early failures to bevacizumab-based therapies.Results
After stratifying based on 9-month survival, longer-term survivors had increased NAA/Cho and decreased Lac/NAA levels compared to shorter-term survivors. ROC analyses for intratumoral NAA/Cho correlated with survival at 1 day, 2 weeks, 8 weeks, and 16 weeks. Intratumoral Lac/NAA ROC analyses were predictive of survival at all time points tested. At the 8-week time point, 88% of patients with decreased NAA/Cho did not survive 9 months; furthermore, 90% of individuals with an increased Lac/NAA from baseline did not survive at 9 months. No other metabolic ratios tested significantly predicted survival.Conclusions
Changes in metabolic levels of tumoral NAA/Cho and Lac/NAA can serve as early biomarkers for predicting treatment failure to anti-angiogenic therapy as soon as 1 day after bevacizumab-based therapy. The addition of MRS to conventional MR methods can provide better insight into how anti-angiogenic therapy affects tumor microenvironment and predict patient outcomes.
SUBMITTER: Talati P
PROVIDER: S-EPMC8193903 | biostudies-literature | 2021 Jan-Dec
REPOSITORIES: biostudies-literature
Talati Pratik P El-Abtah Mohamed M Kim Daniel D Dietrich Jorg J Fu Melanie M Wenke Michael M He Julian J Natheir Sharif N SN Vangel Mark M Rapalino Otto O Vaynrub Anna A Arrillaga-Romany Isabel I Forst Deborah A DA Yen Yi-Fen YF Andronesi Ovidiu O Kalpathy-Cramer Jayashree J Rosen Bruce B Batchelor Tracy T TT Gonzalez R Gilberto RG Gerstner Elizabeth R ER Ratai Eva-Maria EM
Neuro-oncology advances 20210101 1
<h4>Background</h4>Determining failure to anti-angiogenic therapy in recurrent glioblastoma (GBM) (rGBM) remains a challenge. The purpose of the study was to assess treatment response to bevacizumab-based therapy in patients with rGBM using MR spectroscopy (MRS).<h4>Methods</h4>We performed longitudinal MRI/MRS in 33 patients with rGBM to investigate whether changes in N-acetylaspartate (NAA)/Choline (Cho) and Lactate (Lac)/NAA from baseline to subsequent time points after treatment can predict ...[more]