Evaluation
Laboratory tests (complete blood counts and basic metabolic panel) were
obtained weekly, a physical examination was performed at every clinical
visit with the medical oncologist, and contrast-enhanced brain MRI was
performed every 4 weeks.
Neuroradiologic response following treatment was determined by response
assessment in neuro-oncology (RANO) criteria
(23). Complete response (CR) was defined
as the disappearance of all contrast-enhancing tumor or non-enhancing
tumor, as defined on MRI FLAIR sequence, on consecutive MRIs at least 1
month apart, with the patient off corticosteroids. Partial response (PR)
was defined as a >50% reduction in the size of tumor
derived by the sum of cross-sectional radii measured by the contrast
enhanced MRI and the MRI FLAIR sequence on consecutive MRI scans at
least 1 month apart, with a stable or decreased corticosteroid dose.
Progressive disease (PD) was defined as a greater than 25% increase in
the size of tumor on either the contrast enhanced MR or FLAIR tumor, or
presence of new lesions. Stable disease (SD) was defined as all other
situations and required a confirmation MRI one month after documenting
best response. Patients were continued on ICI until documentation of PD
or unacceptable adverse effects (AE) at which time patients either
discontinued ICI, had bevacizumab added to their regimen, or were
offered alternative therapy.
PFS and OS were defined as the time from the first day of treatment with
ICI until progression of disease or death, or at date of last follow-up.
AE were retrospectively determined for all patients and tabulated using
Common Terminology Criteria for Adverse Events version 5.0.