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Radio-pathomic maps of glioblastoma identify phenotypes of non-enhancing tumor infiltration associated with bevacizumab treatment response.
Bobholz, Samuel A; Hoefs, Alisha; Hamburger, Jordyn; Lowman, Allison K; Winiarz, Aleksandra; Duenweg, Savannah R; Kyereme, Fitzgerald; Connelly, Jennifer; Coss, Dylan; Krucoff, Max; Banerjee, Anjishnu; LaViolette, Peter S.
Afiliación
  • Bobholz SA; Medical College of Wisconsin.
  • Hoefs A; Medical College of Wisconsin.
  • Hamburger J; Medical College of Wisconsin.
  • Lowman AK; Medical College of Wisconsin.
  • Winiarz A; Medical College of Wisconsin.
  • Duenweg SR; Medical College of Wisconsin.
  • Kyereme F; Medical College of Wisconsin.
  • Connelly J; Medical College of Wisconsin.
  • Coss D; Medical College of Wisconsin.
  • Krucoff M; Medical College of Wisconsin.
  • Banerjee A; Medical College of Wisconsin.
  • LaViolette PS; Medical College of Wisconsin.
Res Sq ; 2024 Jan 08.
Article en En | MEDLINE | ID: mdl-38260400
ABSTRACT

Background:

Autopsy-based radio-pathomic maps of glioma pathology have shown substantial promise inidentifying areas of non-enhancing tumor presence, which may be able to differentiate subsets of patients that respond favorably to treatments such as bevacizumab that have shown mixed efficacy evidence. We tested the hypthesis that phenotypes of non-enhancing tumor fronts can distinguish between glioblastoma patients that will respond favorably to bevacizumab and will visually capture treatment response.

Methods:

T1, T1C, FLAIR, and ADC images were used to generate radio-pathomic maps of tumor characteristics for 79 pre-treatment patients with a primary GBM or high-grade IDH1-mutant astrocytoma for this study. Novel phenotyping (hypercellular, hypocellular, hybrid, or well-circumscribed front) of the non-enhancing tumor front was performed on each case. Kaplan Meier analyses were then used to assess differences in survival and bevacizumab efficacy between phenotypes. Phenotype compartment segmentations generated longitudinally for a subset of 26 patients over the course of bevacizumab treatment, where a mixed effect model was used to detect longitudinal changes.

Results:

Well-Circumscribed patients showed significant/trending increases in survival compared to Hypercellular Front (HR = 2.0, p = 0.05), Hypocellular Front (HR = 2.02, p = 0.03), and Hybrid Front tumors (HR = 1.75, p = 0.09). Only patients with hypocellular or hybrid fronts showed significant survival benefits from bevacizumab treatment (HR = 2.35, p = 0.02; and HR = 2.45, p = 0.03, respectively). Hypocellular volumes decreased by an average 50.52 mm3 per day of bevacizumab treatment (p = 0.002).

Conclusion:

Patients with a hypocellular tumor front identified by radio-pathomic maps showed improved treatment efficacy when treated with bevacizumab, and reducing hypocellular volumes over the course of treatment may indicate treatment response.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Res Sq Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Res Sq Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos