Response Assessment in Neuro-Oncology (RANO): more than imaging criteria for malignant glioma

Area of Science:

• Neuro-oncology
• Clinical trial methodology
• Radiology

Background:

• Antiangiogenic therapies present challenges for assessing malignant glioma treatment response using standard imaging.
• The Macdonald criteria have limitations in accurately evaluating therapeutic efficacy in neuro-oncology.

Purpose of the Study:

• To critically evaluate the limitations of the Macdonald criteria for assessing treatment response in malignant glioma.
• To develop and implement new criteria for response assessment in neuro-oncological clinical trials and care.

Main Methods:

• Formation of a multidisciplinary investigator group (Response Assessment in Neuro-Oncology - RANO) starting in 2008.
• Critical review of response assessment across multiple tumor types and endpoint selection.
• Focus on improving outcome criteria for neuro-oncological trials.

Main Results:

• The RANO initiative has evolved over 7 years to address broader aspects of neuro-oncological trial design.
• Established principles and efforts of the RANO initiative are reviewed.
• Highlighted the collaborative, multidisciplinary nature of the RANO endeavor.

Conclusions:

• The RANO initiative provides improved criteria for assessing treatment response in malignant glioma.
• RANO enhances the design and conduct of clinical trials in neuro-oncology.
• The RANO framework supports better clinical decision-making and patient management.