Evidence map›Paper›PMID 31728884›Full record

Trial reportJournal of neuro-oncology2020

Treatment-induced lesions in newly diagnosed glioblastoma patients undergoing chemoradiotherapy and heat-shock protein vaccine therapy.

Paula Alcaide-Leon, Tracy L Luks, Marisa Lafontaine, Janine M Lupo, Hideho Okada, Jennifer L Clarke, Javier E Villanueva-Meyer

Open access · greenAbstract readClinical Trial, Phase IIMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Immunotherapy in central nervous system tumors.International journal of surgery (London, England) · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Paula Alcaide-LeonDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA. paulaalcaideleon@hotmail.com.ORCID http://orcid.org/0000-0001-6146-7972
Tracy L LuksDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0003-0994-9960
Marisa LafontaineDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-2352-3299
Janine M LupoDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-0051-6387
Hideho OkadaDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0003-0076-9920
Jennifer L ClarkeDepartment of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-8054-7342
Javier E Villanueva-MeyerDepartment of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.ORCID http://orcid.org/0000-0002-5910-0757
University of California, San Francisco · USUniversity Health Network · CA

Funding

Project 4: Multi-modality Metabolic Imaging for Monitoring Molecular Sub-types of GliomaP01CA118816 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Susan M Chang, Janine Marie Lupo · 2007 to 2026
$44.7M
MR Metabolic Imaging of Response to Targeted Therapies in GBMR01CA154915 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NELSON, SARAH J., RONEN, SABRINA MIRIAM · 2011 to 2015
$2.7M
NCI NIH HHS P01 CA118816NCI NIH HHS R01 CA154915NIH HHS P01 CA118816
6 · The paper itself

Abstract

objectivesTreatment-induced lesions represent a great challenge in neuro-oncology. The aims of this study were (i) to characterize treatment induced lesions in glioblastoma patients treated with chemoradiotherapy and heat-shock protein (HSP) vaccine and (ii) to evaluate the diagnostic accuracy of diffusion weighted imaging for differentiation between treatment-induced lesions and tumor progression.

methodsTwenty-seven patients with newly diagnosed glioblastoma treated with HSP vaccine and chemoradiotherapy were included. Serial magnetic resonance imaging evaluation was performed to detect treatment-induced lesions and assess their growth. Quantitative analysis of the apparent diffusion coefficient (ADC) was performed to discriminate treatment-induced lesions from tumor progression. Mann-Whitney U-test and receiver operating characteristic (ROC) curves were used for analysis.

resultsThirty-three percent of patients developed treatment-induced lesions. Five treatment-related lesions appeared between end of radiotherapy and the first vaccine administration; 4 lesions within the first 4 months from vaccine initiation and 1 at 3.5 years. Three patients with pathology proven treatment-induced lesions showed a biphasic growth pattern progressed shortly after. ADC ratio between the peripheral enhancing rim and central necrosis showed an accuracy of 0.84 (95% CI 0.63-1) for differentiation between progression and treatment-induced lesions.

conclusionOur findings do not support the iRANO recommendation of a 6-month time window in which progressive disease should not be declared after immunotherapy initiation. A biphasic growth pattern of pathologically proven treatment-induced lesions was associated with a dismal prognosis. The presence of lower ADC values in the central necrotic portion of the lesions compared to the enhancing rim shows high specificity for detection of treatment-induced lesions.

Indexed as

AdultAgedBrain NeoplasmsChemoradiotherapyCombined Modality TherapyDiffusion Magnetic Resonance ImagingDisease ProgressionFemaleFollow-Up StudiesGlioblastomaHeat-Shock ProteinsHumansImmunotherapy, ActiveMaleMiddle AgedNecrosisHeat-Shock ProteinsChemoradiotherapyGlioblastomaHeat-shock proteinsImmunotherapyMagnetic resonance imaging

Identifiers

PMID31728884
PMCPMC6939141
OpenAlexW2984668848

What OpenQuestion holds

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Registered trials

None linked

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.