Assessment of tumor hypoxia and perfusion in recurrent glioblastoma following bevacizumab failure using MRI and 18F-FMISO PET
| Autor: | Mark Muzi, Paul A Jerabek, David A. Reardon, Shiliang Huang, Peter T. Fox, Geoffrey D. Clarke, Patrick Y. Wen, Hyewon Hyun, Andrew Brenner, Kathleen M. Schmainda, Joel E. Michalek, Eudocia Q. Lee, John Floyd |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
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Oncology Biomarkers Pharmacological 030218 nuclear medicine & medical imaging chemistry.chemical_compound 0302 clinical medicine Cerebral Blood Volume Multidisciplinary Brain Neoplasms Hazard ratio Middle Aged Magnetic Resonance Imaging Progression-Free Survival Bevacizumab 030220 oncology & carcinogenesis Medicine Biomarker (medicine) Female medicine.symptom Perfusion medicine.drug Adult Cancer microenvironment medicine.medical_specialty Science Article Young Adult 03 medical and health sciences Internal medicine medicine Humans Misonidazole Aged Evofosfamide Tumor hypoxia business.industry Hypoxia (medical) Confidence interval CNS cancer chemistry Drug Resistance Neoplasm Positron-Emission Tomography Tumor Hypoxia Cancer imaging Neoplasm Recurrence Local Glioblastoma business |
| Zdroj: | Scientific Reports Scientific Reports, Vol 11, Iss 1, Pp 1-12 (2021) |
| ISSN: | 2045-2322 |
| Popis: | Tumoral hypoxia correlates with worse outcomes in glioblastoma (GBM). While bevacizumab is routinely used to treat recurrent GBM, it may exacerbate hypoxia. Evofosfamide is a hypoxia-targeting prodrug being tested for recurrent GBM. To characterize resistance to bevacizumab and identify those with recurrent GBM who may benefit from evofosfamide, we ascertained MRI features and hypoxia in patients with GBM progression receiving both agents. Thirty-three patients with recurrent GBM refractory to bevacizumab were enrolled. Patients underwent MR and 18F-FMISO PET imaging at baseline and 28 days. Tumor volumes were determined, MRI and 18F-FMISO PET-derived parameters calculated, and Spearman correlations between parameters assessed. Progression-free survival decreased significantly with hypoxic volume [hazard ratio (HR) = 1.67, 95% confidence interval (CI) 1.14 to 2.46, P = 0.009] and increased significantly with time to the maximum value of the residue (Tmax) (HR = 0.54, 95% CI 0.34 to 0.88, P = 0.01). Overall survival decreased significantly with hypoxic volume (HR = 1.71, 95% CI 1.12 to 12.61, p = 0.01), standardized relative cerebral blood volume (srCBV) (HR = 1.61, 95% CI 1.09 to 2.38, p = 0.02), and increased significantly with Tmax (HR = 0.31, 95% CI 0.15 to 0.62, p s = 0.77, P s = 0.75, P |
| Databáze: | OpenAIRE |
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