Heugenhauser Johanna, Galijasevic Malik, Mangesius Stephanie, Goebel Georg, Buchroithner Johanna, Erhart Friedrich, Pichler Josef, Widhalm Georg, Stockhammer Günther, Iglseder Sarah, Freyschlag Christian F, Oberndorfer Stefan, Bordihn Karin, von Campe Gord, Czech Thomas, Surböck Birgit, Urbanic Purkart Tadeja, Marosi Christine, Felzmann Thomas, Nowosielski Martha
Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Cancers (Basel). 2022 Mar 20;14(6):1579. doi: 10.3390/cancers14061579.
Introduction: In this post hoc analysis we compared various response-assessment criteria in newly diagnosed glioblastoma (GB) patients treated with tumor lysate-charged autologous dendritic cells (Audencel) and determined the differences in prediction of progression-free survival (PFS) and overall survival (OS). Methods: 76 patients enrolled in a multicenter phase II trial receiving standard of care (SOC, n = 40) or SOC + Audencel vaccine (n = 36) were included. MRI scans were evaluated using MacDonald, RANO, Vol-RANO, mRANO, Vol-mRANO and iRANO criteria. Tumor volumes (T1 contrast-enhancing as well as T2/FLAIR volumes) were calculated by semiautomatic segmentation. The Kruskal-Wallis-test was used to detect differences in PFS among the assessment criteria; for correlation analysis the Spearman test was used. Results: There was a significant difference in median PFS between mRANO (8.6 months) and Vol-mRANO (8.6 months) compared to MacDonald (4.0 months), RANO (4.2 months) and Vol-RANO (5.4 months). For the vaccination arm, median PFS by iRANO was 6.2 months. There was no difference in PFS between SOC and SOC + Audencel. The best correlation between PFS/OS was detected for mRANO (r = 0.65) and Vol-mRANO (r = 0.69, each p < 0.001). A total of 16/76 patients developed a pure T2/FLAIR progressing disease, and 4/36 patients treated with Audencel developed pseudoprogression. Conclusion: When comparing different response-assessment criteria in GB patients treated with dendritic cell-based immunotherapy, the best correlation between PFS and OS was observed for mRANO and Vol-mRANO. Interestingly, iRANO was not superior for predicting OS in patients treated with Audencel.
在这项事后分析中，我们比较了接受肿瘤裂解物负载的自体树突状细胞（Audencel）治疗的新诊断胶质母细胞瘤（GB）患者的各种反应评估标准，并确定了无进展生存期（PFS）和总生存期（OS）预测方面的差异。方法：纳入76例参加多中心II期试验的患者，这些患者接受标准治疗（SOC，n = 40）或SOC + Audencel疫苗（n = 36）。使用MacDonald、RANO、Vol-RANO、mRANO、Vol-mRANO和iRANO标准对MRI扫描进行评估。通过半自动分割计算肿瘤体积（T1增强以及T2/FLAIR体积）。使用Kruskal-Wallis检验检测评估标准之间PFS的差异；相关性分析使用Spearman检验。结果：与MacDonald（4.0个月）、RANO（4.2个月）和Vol-RANO（5.4个月）相比，mRANO（8.6个月）和Vol-mRANO（8.6个月）的中位PFS存在显著差异。对于疫苗接种组，iRANO的中位PFS为6.2个月。SOC和SOC + Audencel之间的PFS没有差异。mRANO（r = 0.65）和Vol-mRANO（r = 0.69，均p < 0.001）在PFS/OS之间具有最佳相关性。共有16/76例患者发生单纯T2/FLAIR进展性疾病，4/36例接受Audencel治疗的患者发生假性进展。结论：在比较接受基于树突状细胞免疫治疗的GB患者的不同反应评估标准时，mRANO和Vol-mRANO在PFS和OS之间观察到最佳相关性。有趣的是，iRANO在预测接受Audencel治疗患者的OS方面并不优越。
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