Rthp-18. liquid biopsy distinguishes recurrent gbm from radiation necrosis in peripharal blood of patients with gbm

Glioblastoma (GBM) is the most aggressive and lethal type of brain cancer with a median survival of less than two years even with aggressive treatment. Among the many challenges in treating patients with this devastating disease is the ability to differentiate radiation induced change, often termed "radiation necrosis" from true GBM recurrence (rGBM). Radiation necrosis (RN) and GBM are very difficult to distinguish using standard Magnetic Resonance Imaging (MRI), and RANO criterion. Only a brain biopsy, an invasive procedure, can conclusively differentiate them. Recent studies by our group and others have demonstrated the presence of Myeloid-Derived Suppressor Cells (MDSC) in GBM. Here, we demonstrate the utility of a MDSC biomarker, Vanin-2 (VNN2), combined with expression of traditional MHC Class II molecule HLA-DR on CD14+ monocytes in GBM patients. Our preliminary data indicate that VNN2 expression on monocytic (CD14+)-MDSC (Mo-MDSC), in conjunction with CD14+ HLA-DRneg/low staining, can be used to monitor, among CD14+ monocytes, the frequency of circulating HLA-DRneg/low cells and VNN2+ cells whose ratio allow us to create an index (the DR-VNN Index or DVI) that can differentiate with high sensitivity and specificity, patients with recurrent GBM from phenotypically similar (on MRI) non-recurrent radiation necrosis (RN). Receiver-Operator Characteristic (ROC) curve analyses demonstrate an excellent level of sensitivity and specificity for the DVI (AUC=0.833, 95% CI ...
Source: Neuro-Oncology - Category: Cancer & Oncology Authors: Tags: RADIATION THERAPY Source Type: research