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Updated response assessment criteria for high-grade glioma: beyond the MacDonald criteria
Mayur Sharma1, Rupa Gopalan Juthani1, Michael A Vogelbaum2
1Department of Neurological Surgery, Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA.
Abstract:
High-grade glioma continues to be a challenging disease with few effective treatment options and a poor prognosis, necessitating intensive research into alternate therapies. The Response Assessment in Neuro-Oncology (RANO) committee was formed to create a robust endpoint assessment criteria in Neuro-Oncology in order to streamline the assessment of new therapies in a uniform fashion. The aim of this committee is to create standardized guidelines to assess clinical and imaging response in the treatment of brain tumors, which can then be applied in clinical trials. Since the first RANO report was published in 2010, its criteria have been widely adopted and utilized in clinical trials worldwide. Standardized application of the RANO response assessment criteria in clinical trials will result in the generation of strong clinical data, which can subsequently be pooled and analyzed to attain a more accurate assessment of treatment efficacy. In this review, we summarize the current RANO guidelines in patients with high-grade glioma, highlighting the key clinical and imaging criteria used for RANO evaluation and introducing the role of newer imaging and biomarkers.
Insights
High-grade glioma treatment requires better assessment. The Response Assessment in Neuro-Oncology (RANO) guidelines provide standardized criteria for evaluating new therapies in clinical trials.
Area of Science:
- Neuro-Oncology
- Clinical Trial Methodology
Background:
- High-grade glioma presents significant treatment challenges and a poor prognosis.
- The Response Assessment in Neuro-Oncology (RANO) committee was established to address the need for standardized assessment criteria.
Purpose of the Study:
- To summarize current RANO guidelines for high-grade glioma evaluation.
- To highlight key clinical and imaging criteria used in RANO assessments.
- To introduce emerging imaging techniques and biomarkers in neuro-oncology.
Main Methods:
- Review of established RANO guidelines published since 2010.
- Analysis of clinical and imaging response assessment criteria.
- Discussion of the integration of novel imaging modalities and biomarkers.
Main Results:
- RANO criteria have been widely adopted globally for neuro-oncology clinical trials.
- Standardized RANO application enhances the generation of robust clinical data.
- Consistent data facilitates more accurate assessment of treatment efficacy.
Conclusions:
- The RANO guidelines are crucial for uniform evaluation of novel therapies in high-grade glioma.
- Adherence to RANO criteria improves the reliability and comparability of clinical trial outcomes.
- Future research should incorporate advanced imaging and biomarkers within the RANO framework.
