PMID- 32967939
OWN - NLM
STAT- MEDLINE
DCOM- 20220110
LR  - 20220110
IS  - 1557-3265 (Electronic)
IS  - 1078-0432 (Linking)
VI  - 27
IP  - 1
DP  - 2021 Jan 1
TI  - MRI and (18)FET-PET Predict Survival Benefit from Bevacizumab Plus Radiotherapy 
      in Patients with Isocitrate Dehydrogenase Wild-type Glioblastoma: Results from 
      the Randomized ARTE Trial.
PG  - 179-188
LID - 10.1158/1078-0432.CCR-20-2096 [doi]
AB  - PURPOSE: To explore a prognostic or predictive role of MRI and 
      O-(2-(18)F-fluoroethyl)-L-tyrosine ((18)FET) PET parameters for outcome in the 
      randomized multicenter trial ARTE that compared bevacizumab plus radiotherapy 
      with radiotherpay alone in elderly patients with glioblastoma. PATIENTS AND 
      METHODS: Patients with isocitrate dehydrogenase wild-type glioblastoma ages 65 
      years or older were included in this post hoc analysis. Tumor volumetric and 
      apparent diffusion coefficient (ADC) analyses of serial MRI scans from 67 
      patients and serial (18)FET-PET tumor-to-brain intensity ratios (TBRs) from 31 
      patients were analyzed blinded for treatment arm and outcome. Multivariate Cox 
      regression analysis was done to account for established prognostic factors and 
      treatment arm. RESULTS: Overall survival benefit from bevacizumab plus 
      radiotherapy compared with radiotherapy alone was observed for larger 
      pretreatment MRI contrast-enhancing tumor [HR per cm(3) 0.94; 95% confidence 
      interval (CI), 0.89-0.99] and for higher ADC (HR 0.18; CI, 0.05-0.66). Higher 
      (18)FET-TBR on pretreatment PET scans was associated with inferior overall 
      survival in both arms. Response assessed by standard MRI-based Response 
      Assessment in Neuro-Oncology criteria was associated with overall survival in the 
      bevacizumab plus radiotherapy arm by trend only (P = 0.09). High (18)FET-TBR of 
      noncontrast-enhancing tumor portions during bevacizumab therapy was associated 
      with inferior overall survival on multivariate analysis (HR 5.97; CI, 1.16-30.8). 
      CONCLUSIONS: Large pretreatment contrast-enhancing tumor mass and higher ADCs 
      identify patients who may experience a survival benefit from bevacizumab plus 
      radiotherapy. Persistent (18)FET-PET signal of no longer contrast-enhancing tumor 
      after concomitant bevacizumab plus radiotherapy suggests pseudoresponse and 
      predicts poor outcome.
CI  - (c)2020 American Association for Cancer Research.
FAU - Wirsching, Hans-Georg
AU  - Wirsching HG
AD  - Department of Neurology, University Hospital and University of Zurich, Zurich, 
      Switzerland. hans-georg.wirsching@usz.ch.
FAU - Roelcke, Ulrich
AU  - Roelcke U
AD  - Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland.
FAU - Weller, Jonathan
AU  - Weller J
AD  - Department of Neurology, University Hospital and University of Zurich, Zurich, 
      Switzerland.
FAU - Hundsberger, Thomas
AU  - Hundsberger T
AUID- ORCID: 0000-0002-4419-2767
AD  - Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
FAU - Hottinger, Andreas F
AU  - Hottinger AF
AD  - Departments of Clinical Neurosciences and Medical Oncology, University Hospital 
      Lausanne, Lausanne, Switzerland.
FAU - von Moos, Roger
AU  - von Moos R
AD  - Department of Medical Oncology, Cantonal Hospital Graubuenden, Chur, Switzerland.
FAU - Caparrotti, Francesca
AU  - Caparrotti F
AD  - Department of Radiation Oncology, University Hospital Geneva, Geneva, 
      Switzerland.
FAU - Conen, Katrin
AU  - Conen K
AD  - Department of Medical Oncology, University Hospital Basel, Basel, Switzerland.
FAU - Remonda, Luca
AU  - Remonda L
AD  - Department of Neuroradiology, Cantonal Hospital Aarau, Aarau, Switzerland.
FAU - Roth, Patrick
AU  - Roth P
AD  - Department of Neurology, University Hospital and University of Zurich, Zurich, 
      Switzerland.
FAU - Ochsenbein, Adrian
AU  - Ochsenbein A
AD  - Department of Medical Oncology, Inselspital, Berne University Hospital, 
      University of Berne, Berne, Switzerland.
FAU - Tabatabai, Ghazaleh
AU  - Tabatabai G
AD  - Department of Neurology, University Hospital and University of Zurich, Zurich, 
      Switzerland.
FAU - Weller, Michael
AU  - Weller M
AD  - Department of Neurology, University Hospital and University of Zurich, Zurich, 
      Switzerland.
LA  - eng
SI  - ClinicalTrials.gov/NCT01443676
PT  - Clinical Trial, Phase II
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20200923
PL  - United States
TA  - Clin Cancer Res
JT  - Clinical cancer research : an official journal of the American Association for 
      Cancer Research
JID - 9502500
RN  - 0 (Radiopharmaceuticals)
RN  - 1326R5J1IA ((18F)fluoroethyltyrosine)
RN  - 2S9ZZM9Q9V (Bevacizumab)
RN  - 42HK56048U (Tyrosine)
RN  - EC 1.1.1.41 (Isocitrate Dehydrogenase)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bevacizumab/*therapeutic use
MH  - Brain/*diagnostic imaging/pathology
MH  - Brain Neoplasms/diagnosis/genetics/mortality/*therapy
MH  - Chemoradiotherapy/methods/*statistics & numerical data
MH  - Female
MH  - Glioblastoma/diagnosis/genetics/mortality/*therapy
MH  - Humans
MH  - Isocitrate Dehydrogenase/genetics
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Positron-Emission Tomography/methods
MH  - Progression-Free Survival
MH  - Radiopharmaceuticals/administration & dosage
MH  - Tyrosine/administration & dosage/analogs & derivatives
EDAT- 2020/09/25 06:00
MHDA- 2022/01/11 06:00
CRDT- 2020/09/24 05:27
PHST- 2020/05/29 00:00 [received]
PHST- 2020/08/09 00:00 [revised]
PHST- 2020/09/17 00:00 [accepted]
PHST- 2020/09/25 06:00 [pubmed]
PHST- 2022/01/11 06:00 [medline]
PHST- 2020/09/24 05:27 [entrez]
AID - 1078-0432.CCR-20-2096 [pii]
AID - 10.1158/1078-0432.CCR-20-2096 [doi]
PST - ppublish
SO  - Clin Cancer Res. 2021 Jan 1;27(1):179-188. doi: 10.1158/1078-0432.CCR-20-2096. 
      Epub 2020 Sep 23.