학술논문

Magnetic resonance imaging-derived parameters to predict response to regorafenib in recurrent glioblastoma.
Document Type
Article
Source
Neuroradiology. Oct2023, Vol. 65 Issue 10, p1439-1445. 7p.
Subject
*THERAPEUTIC use of antineoplastic agents
*BRAIN
*GLIOMAS
*CANCER relapse
*MAGNETIC resonance imaging
*PROTEIN-tyrosine kinase inhibitors
*CANCER patients
*COMPARATIVE studies
*TREATMENT effectiveness
*SURVIVAL analysis (Biometry)
*DESCRIPTIVE statistics
*TUMOR markers
*BLOOD volume
*PROGRESSION-free survival
*NEURORADIOLOGY
*OVERALL survival
Language
ISSN
0028-3940
Abstract
Purpose: Regorafenib is a multikinase inhibitor, approved as a preferred regimen for recurrent glioblastoma (rGB). Although its effects on prolonging survival could seem modest, it is still unclear whether a subset of patients, potentially identifiable by imaging biomarkers, might experience a more substantial positive effect. Our aim was to evaluate the potential value of magnetic resonance imaging-derived parameters as non-invasive biomarkers to predict response to regorafenib in patients with rGB. Methods: 20 patients with rGB underwent conventional and advanced MRI at diagnosis (before surgery), at recurrence and at first follow-up (3 months) during regorafenib. Maximum relative cerebral blood volume (rCBVmax) value, intra-tumoral susceptibility signals (ITSS), apparent diffusion coefficient (ADC) values, and contrast-enhancing tumor volumes were tested for correlation with response to treatment, progression-free survival (PFS), and overall survival (OS). Response at first follow-up was assessed according to Response Assessment in Neuro-Oncology (RANO) criteria. Results: 8/20 patients showed stable disease at first follow-up. rCBVmax values of the primary glioblastoma (before surgery) significantly correlated to treatment response; specifically, patients with stable disease displayed higher rCBVmax compared to progressive disease (p = 0.04, 2-group t test). Moreover, patients with stable disease showed longer PFS (p = 0.02, 2-group t test) and OS (p = 0.04, 2-group t test). ITSS, ADC values, and contrast-enhancing tumor volumes showed no correlation with treatment response, PFS nor OS. Conclusion: Our results suggest that rCBVmax of the glioblastoma at diagnosis could serve as a non-invasive biomarker of treatment response to regorafenib in patients with rGB. [ABSTRACT FROM AUTHOR]