Relative cerebral blood volume as response predictor in the treatment of recurrent glioblastoma with anti-angiogenic therapy

• Published in: Clinical neurology and neurosurgery Vol. 233; p. 107904
• Main Authors: Breda-Yepes, Michele, Rodríguez-Hernández, Luis A., Gómez-Figueroa, Enrique, Mondragón-Soto, Michel G., Arellano-Flores, Gerardo, Hernández-Hernández, Alan, Rodríguez-Rubio, Héctor A., Martínez, Pablo, Reyes-Moreno, Ignacio, Álvaro-Heredia, Juan A., Gutiérrez Aceves, Guillermo A., Villanueva-Castro, Eliezer, Sangrador-Deitos, Marcos V., Alonso-Vanegas, Mario, Guerrero-Juárez, Vicente, González-Aguilar, Alberto
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2023; Elsevier Limited
• Subjects: Angiogenesis; Antiangiogenics; Bevacizumab; Blood; Brain cancer; Brain tumors; Cerebral blood flow; Chemotherapy; Glioblastoma; Magnetic resonance imaging; Medical prognosis; Multivariate analysis; Neuroimaging; Neurology; Oncology; Relative cerebral blood volume and antiangiogenics; Statistical analysis; Tumors; Antiangiogenics; Relative cerebral blood volume and antiangiogenics; Glioblastoma; Bevacizumab
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2023.107904

Glioblastoma is one of the most common brain tumors in adult populations, usually carrying a poor prognosis. While several studies have researched the impact of anti-angiogenic therapies, especially anti-VEFG treatments in glioblastoma, few have attempted to assess its progress using imaging studies. We attempted to analyze whether relative cerebral blood volume (rCBV) from dynamic susceptibility-weighted contrast-enhanced MRI (DSC-MRI) could predict response in patients with glioblastoma undergoing Bevacizumab (BVZ) treatment. We performed a retrospective study evaluating patients with recurrent glioblastoma receiving anti-angiogenic therapy with BVZ between 2012 and 2017 in our institution. Patients were scheduled for routine MRIs at baseline and first-month follow-up visits. Studies were processed for DSC-MRI, cT1, and FLAIR images, from which relative cerebral blood volume measurements were obtained. We assessed patient response using the Response Assessment in Neuro-Oncology (RANO) working group criteria and overall survival. 40 patients were included in the study and were classified as Bevacizumab responders and non-responders. The average rCBV before treatment was 4.5 for both groups, and average rCBV was 2.5 for responders and 5.4 for non-responders. ROC curve set a cutoff point of 3.7 for rCBV predictive of response to BVZ. Cox Multivariate analysis only showed rCBV as a predictive factor of OS. A statistically significant difference was found in rCBV between patients who responded and those who did not respond to BVZ treatment. rCBV may be a low-cost and effective marker to assess response to Bevacizumab treatment in GBM. •rCBV is an indirect value of the cerebral blood volume using contrast material.•rCBV can identify patients who benefit from antiangiogenic therapy in a cost-effective way.•Pretreatment rCBV is a potential predicting imaging biomarker in BVZ-treated rGB.