RESEARCH SUMMARY

New criteria to assess progression in glioma aims to speed discovery of new medicines

Study Title: RANO 2.0: Update to the Response Assessment in Neuro-Oncology Criteria for High- and Low-Grade Gliomas in Adults

Publication: Journal of Clinical Oncology

Dana-Farber Cancer Institute author: Patrick Y. Wen, MD

Summary: In order to accurately assess the efficacy of novel therapies for brain tumors it is necessary to have reliable criteria to determine response or progression. Response assessment in brain tumors is difficult because of the irregular shapes of the tumors and the fact that many therapies used to treat these tumors can also produce imaging changes that resemble tumor growth. Neuro-oncologists currently use guidelines, defined by the Response Assessment in Neuro-Oncology (RANO) working (RANO criteria) led by Dana-Farber, to determine response to therapies in glioma patients during clinical trials. Over time several sets of RANO criteria have been developed to evaluate novel therapies such as immunotherapies.

This paper recommends an update to the RANO criteria (RANO 2.0), based on the results of a study conducted by Dana-Farber which defines a single set of criteria for all glioma cases. RANO 2.0, proposed by Dana-Farber Cancer Institute neuro-oncologist Patrick Y. Wen, MD, Director of the Center for Neuro-Oncology, and an international team of neuro-oncologists and neuroradiologists in the RANO Working Group, should be used for both high- and low-grade gliomas and for all glioma trials, regardless of the type of therapy being investigated. There is guidance on distinguishing the effects of treatment with immunotherapy or radiochemotherapy from tumor progression and separate criteria for these treatment modalities are no longer needed.

Impact: Glioblastomas and other gliomas are the most common type of malignant primary brain tumor, yet few effective therapies are available. Over ten years ago, researchers created the RANO criteria to accelerate the discovery of new medicines by improving the reliability of clinical trial results and making it possible for investigators to compare the results of one trial to another. RANO 2.0 is an important update that provides one single set of criteria for investigators to use for clinical research in glioma. It will reduce confusion about which criteria to use in each trial and will also improve reliability and comparability of trial data, and hopefully help accelerate the development of more effective therapies for patients with brain tumors.