Trial reportNeuro-oncology2018
Prognostic value of contrast enhancement and FLAIR for survival in newly diagnosed glioblastoma treated with and without bevacizumab: results from ACRIN 6686.
Trial report in Neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Patient-reported outcomes as prognostic indicators for overall survival and progression-free survival in brain tumor patients - a systematic review and meta-analysis of randomized clinical trials.Journal of neuro-oncology · 2026Pooled it
- Impact of radiation fractionation on pseudoprogression in older patients with glioblastoma: a retrospective cohort study.CNS oncology · 2025Article
- Survival risk stratification of 2021 WHO glioblastoma by MRI radiomics and biological exploration.BMC cancer · 2025Article
- RANO 2.0: Update to the Response Assessment in Neuro-Oncology Criteria for High- and Low-Grade Gliomas in Adults.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Pseudoprogression versus true progression in glioblastoma: what neurosurgeons need to know.Journal of neurosurgery · 2023Review
- Diagnostic Approaches to Adult-Type Diffuse Glial Tumors: Comparative Literature and Clinical Practice Study.Current oncology (Toronto, Ont.) · 2023Review
- Molecular and functional imaging in cancer-targeted therapy: current applications and future directions.Signal transduction and targeted therapy · 2023Review
- Prediction of IDH1 gene mutation by a nomogram based on multiparametric and multiregional MR images.Clinics (Sao Paulo, Brazil) · 2023Article
- Federated learning enables big data for rare cancer boundary detection.Nature communications · 2022Article
- MRI-based radiomics signature and clinical factor for predicting H3K27M mutation in pediatric high-grade gliomas located in the midline of the brain.European radiology · 2022Article
- Limited field adaptive radiotherapy for glioblastoma: changes in target volume and organ at risk doses.Radiation oncology journal · 2022Article
- Advanced Imaging Techniques for Newly Diagnosed and Recurrent Gliomas.Frontiers in neuroscience · 2022Review
- A Clinical PET Imaging Tracer ([Clinical cancer research : an official journal of the American Association for Cancer Research · 2021Article
- Transcription Factor ELF1 Activates MEIS1 Transcription and Then Regulates the GFI1/FBW7 Axis to Promote the Development of Glioma.Molecular therapy. Nucleic acids · 2021Article
- Value of dynamic contrast perfusion MRI to predict early response to bevacizumab in newly diagnosed glioblastoma: results from ACRIN 6686 multicenter trial.Neuro-oncology · 2021Article
- Dynamic Susceptibility Perfusion Imaging for Differentiating Progressive Disease from Pseudoprogression in Diffuse Glioma Molecular Subtypes.Journal of clinical medicine · 2021Article
- Assessment of Pre-operative Measurements of Tumor Size by MRI Methods as Survival Predictors in Wild Type IDH Glioblastoma.Frontiers in oncology · 2020Article
- A radiomics nomogram based on multiparametric MRI might stratify glioblastoma patients according to survival.European radiology · 2019Article
- Multi-parametric and multi-regional histogram analysis of MRI: modality integration reveals imaging phenotypes of glioblastoma.European radiology · 2019Article
- Non-Contrast-Enhancing Tumor: A New Frontier in Glioblastoma Research.AJNR. American journal of neuroradiology · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
Background: ACRIN 6686/RTOG 0825 was a phase III trial of conventional chemoradiation plus adjuvant temozolomide with bevacizumab or without (placebo) in newly diagnosed glioblastoma. This study investigated whether changes in contrast-enhancing and fluid attenuated inversion recovery (FLAIR)-hyperintense tumor assessed by central reading prognosticate overall survival (OS). Methods: Two hundred eighty-four patients (171 men; median age 57 y, range 19-79; 159 on bevacizumab) had MRI at post-op (baseline) and pre-cycle 4 of adjuvant temozolomide (22 wk post chemoradiation initiation). Four central readers measured bidimensional lesion enhancement (2D-T1) and FLAIR hyperintensity at both time points. Changes from baseline to pre-cycle 4 for both markers were dichotomized (increasing vs non-increasing). Cox proportional hazards model and Kaplan-Meier survival estimates were used for inference. Results: Adjusting for treatment, increasing 2D-T1 (n = 262, hazard ratio [HR] = 2.07, 95% CI: 1.48-2.91, P < 0.0001) and FLAIR (n = 273, HR = 1.75, 95% CI: 1.26-2.41, P = 0.0008) significantly predicted worse OS. Median OS (days) was significantly shorter for patients with increasing versus non-increasing 2D-T1 for both bevacizumab (443 vs 535, P = 0.004) and placebo (526 vs 887, P = 0.001). Median OS was significantly shorter for patients with increasing versus non-increasing FLAIR for placebo (595 vs 872, P = 0.001), and trended similarly for bevacizumab (499 vs 535, P = 0.0935). Adjusting for 2D-T1 and treatment, increasing FLAIR represented significantly higher risk for death (HR = 1.59 [1.11-2.26], P = 0.01). Conclusion: Increased 2D-T1 significantly predicts worse OS in both treatment groups, implying absence of a substantial proportion of pseudoprogression 22 weeks after initiation of standard therapy. FLAIR adds value beyond 2D-T1 in predicting OS, potentially addressing the pseudoresponse effect by substratifying bevacizumab-treated patients with non-increasing 2D-T1.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.