Response assessment criteria for brain metastases: proposal from the RANO group

Nancy U Lin; Eudocia Q Lee; Hidefumi Aoyama; Igor J Barani; Daniel P Barboriak; Brigitta G Baumert; Martin Bendszus; Paul D Brown; D Ross Camidge; Susan M Chang; Janet Dancey; Elisabeth G E de Vries; Laurie E Gaspar; Gordon J Harris; F Stephen Hodi; Steven N Kalkanis; Mark E Linskey; David R Macdonald; Kim Margolin; Minesh P Mehta; David Schiff; Riccardo Soffietti; John H Suh; Martin J van den Bent; Michael A Vogelbaum; Patrick Y Wen; Response Assessment in Neuro-Oncology (RANO) group

doi:10.1016/S1470-2045(15)70057-4

Response assessment criteria for brain metastases: proposal from the RANO group

Lancet Oncol. 2015 Jun;16(6):e270-8. doi: 10.1016/S1470-2045(15)70057-4. Epub 2015 May 27.

Authors

Nancy U Lin¹, Eudocia Q Lee², Hidefumi Aoyama³, Igor J Barani⁴, Daniel P Barboriak⁵, Brigitta G Baumert⁶, Martin Bendszus⁷, Paul D Brown⁸, D Ross Camidge⁹, Susan M Chang¹⁰, Janet Dancey¹¹, Elisabeth G E de Vries¹², Laurie E Gaspar¹³, Gordon J Harris¹⁴, F Stephen Hodi¹⁵, Steven N Kalkanis¹⁶, Mark E Linskey¹⁷, David R Macdonald¹⁸, Kim Margolin¹⁹, Minesh P Mehta²⁰, David Schiff²¹, Riccardo Soffietti²², John H Suh²³, Martin J van den Bent²⁴, Michael A Vogelbaum²⁵, Patrick Y Wen²; Response Assessment in Neuro-Oncology (RANO) group

Affiliations

¹ Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Electronic address: nlin@partners.org.
² Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
³ Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan.
⁴ Department of Radiation Oncology, University of California, San Francisco, CA, USA.
⁵ Department of Radiology, Duke University Medical Center, Durham, NC, USA.
⁶ Department of Radiation-Oncology, MediClin Robert Janker Clinic & University of Bonn Medical Centre, Cooperation Unit Neuro-oncology, Bonn, Germany.
⁷ Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.
⁸ Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁹ Division of Medical Oncology, School of Medicine, University of Colorado Denver, Denver, CO, USA.
¹⁰ Department of Neurosurgery, University of California, San Francisco, CA, USA.
¹¹ NCIC Clinical Trials Group, Ontario Institute for Cancer Research, Queen's University, Kingston, ON, Canada.
¹² Department of Medical Oncology, University Medical Center Groningen, University of Groningen, RB Groningen, Netherlands.
¹³ Department of Radiation Oncology, The Anschutz Medical Campus, University of Colorado Denver, Aurora, CO, USA.
¹⁴ MGH 3D Imaging Lab, Massachusetts General Hospital, Boston, MA, USA.
¹⁵ Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
¹⁶ Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA.
¹⁷ Department of Neurological Surgery, University of California, San Francisco, CA, USA; UC Irvine Medical Center, Orange, CA, USA.
¹⁸ Department of Oncology, London Regional Cancer Program, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
¹⁹ Division of Oncology, Stanford University, Stanford, CA, USA.
²⁰ Maryland Proton Treatment Center, University of Maryland School of Medicine, Baltimore, MA, USA.
²¹ Division of Neuro-Oncology, University of Virginia, Charlottesville, VA, USA.
²² Department of Neurology/Neuro-Oncology, University of Turin, Turin, Italy.
²³ Department of Radiation Oncology/T28, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA.
²⁴ Neuro-Oncology Unit, Daniel den Hoed Cancer Center, Erasmus University Medical Center, Rotterdam, Netherlands.
²⁵ Department of Neurosurgery/ND40, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA.

PMID: 26065612
DOI: 10.1016/S1470-2045(15)70057-4

Abstract

CNS metastases are the most common cause of malignant brain tumours in adults. Historically, patients with brain metastases have been excluded from most clinical trials, but their inclusion is now becoming more common. The medical literature is difficult to interpret because of substantial variation in the response and progression criteria used across clinical trials. The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) working group is an international, multidisciplinary effort to develop standard response and progression criteria for use in clinical trials of treatment for brain metastases. Previous efforts have focused on aspects of trial design, such as patient population, variations in existing response and progression criteria, and challenges when incorporating neurological, neuro-cognitive, and quality-of-life endpoints into trials of patients with brain metastases. Here, we present our recommendations for standard response and progression criteria for the assessment of brain metastases in clinical trials. The proposed criteria will hopefully facilitate the development of novel approaches to this difficult problem by providing more uniformity in the assessment of CNS metastases across trials.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Brain Neoplasms / epidemiology*
Brain Neoplasms / pathology
Brain Neoplasms / secondary
Central Nervous System / pathology*
Clinical Trials as Topic
Glioma / epidemiology*
Glioma / pathology
Glioma / secondary
Humans
Magnetic Resonance Imaging