Abstract
Response criteria for paediatric high-grade glioma vary historically and across different cooperative groups. The Response Assessment in Neuro-Oncology working group developed response criteria for adult high-grade glioma, but these were not created to meet the unique challenges in children with the disease. The Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group, consisting of an international panel of paediatric and adult neuro-oncologists, clinicians, radiologists, radiation oncologists, and neurosurgeons, was established to address issues and unique challenges in assessing response in children with CNS tumours. We established a subcommittee to develop response assessment criteria for paediatric high-grade glioma. Current practice and literature were reviewed to identify major challenges in assessing the response of paediatric high-grade gliomas to various treatments. For areas in which scientific investigation was scarce, consensus was reached through an iterative process. RAPNO response assessment recommendations include the use of MRI of the brain and the spine, assessment of clinical status, and the use of corticosteroids or antiangiogenics. Imaging standards for brain and spine are defined. Compared with the recommendations for the management of adult high-grade glioma, for paediatrics there is inclusion of diffusion-weighted imaging and a higher reliance on T2-weighted fluid-attenuated inversion recovery. Consensus recommendations and response definitions have been established and, similar to other RAPNO recommendations, prospective validation in clinical trials is warranted.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e317-e329 |
| Journal | The Lancet Oncology |
| Volume | 21 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 2020 |
Funding
TYP reports grants from Pediatric Brain Tumor Consortium Neuroimaging Center, outside the submitted work. EF reports grants from Celgene, outside the submitted work. PYW reports research funding support from Agios, AstraZeneca, Beigene, Eli Lily, Roche-Genentech, Kazia, MediciNova, Merck, Novartis, Oncoceutics, Sanofi-Aventis, Vascular Biogenics, and VBI Vaccines, outside the submitted work, is on the advisory boards for Agios, AstraZeneca, Bayer, Blue Earth Diagnostics, Immunomic Therapeutics, Karyopharm, Kiyatec, Puma, Taiho, Vascular Biogenics, Deciphera, VBI Vaccines, and Tocagen, and is a speaker for Merck and Prime Oncology. IJD reports non-financial support from Apexigen, grants from Bristol-Myers Squibb and Novartis, personal fees from Celgene, and grants, personal fees, and non-financial support from Roche-Genentech, outside the submitted work. PSM reports grants from F Hoffmann-La Roche, outside the submitted work, and is co-chair of the European Society for Paediatric Oncology Brain Tumor Imaging Group. TJ reports grants from F Hoffman-La Roche, during the conduct of the submitted work. All other authors declare no competing interests. PSM is a member of the UK National Institute of Health Research Nottingham Biomedical Research Centre.
ASJC Scopus subject areas
- Oncology
