Table 1.
Summary of the RANO criteria
| Response | Criteria |
|---|---|
| Complete response | Disappearance of all enhancing measurable and nonmeasurable disease sustained for a minimum of 4 weeks |
| Stable or improved FLAIR/T2 lesions | |
| No new lesions | |
| Clinical status is stable or improved | |
| Patients cannot be receiving corticosteroids (physiologic replacement doses are acceptable) | |
| Partial response | 50% or greater decrease (compared with baseline) in the sum of products of perpendicular diameters of all measurable enhancing lesions sustained for a minimum of 4 weeks |
| No progression of nonmeasurable disease | |
| No new lesions | |
| Stable or improved FLAIR/T2 lesions | |
| Clinical status is stable or improved | |
| The corticosteroid dosage at the time of the scan should be no greater than the dosage at the time of the baseline scan | |
| Stable disease | Patient does not qualify for complete response, partial response, or progression |
| Stable FLAIR/T2 lesions on a corticosteroid dose no greater than at baseline | |
| Clinical status is stable | |
| Progression | Defined by any of the following: |
| 25% or greater increase in sum of the products of perpendicular diameters of all measurable enhancing lesions compared with the smallest tumor measurement obtained either at baseline or best response following the initiation of therapy, while on a stable or increasing dose of corticosteroids. | |
| Significant increase in FLAIR/T2 lesions compared with baseline or best response following initiation of therapy, not caused by comorbid events (eg, radiation therapy, ischemic injury, seizures, postoperative changes, or other treatment effects), while on a stable or increasing dose of corticosteroids | |
| Presence of new lesions | |
| Clinical deterioration not attributable to other causes apart from the tumor (eg, seizures, medication side effects, complications of therapy, cerebrovascular events, infection) or decreases in corticosteroid dose | |
| Failure to return for evaluation due to death or deteriorating condition | |
| Clear progression of nonmeasurable disease |
FLAIR fluid-attenuated inversion recovery, RANO Response Assessment in Neuro-Oncology. (Adapted from Wen et al. [2])