AVAglio criteria for glioblastoma

The AVAglio criteria were developed to assess response to first-line treatment of glioblastoma, treated with radiotherapy and temozolomide with or without bevacizumab . These were adapted from the older Macdonald criteria, but have since been superseded by they RANO criteria (2010) .

The AVAglio criteria, roughly similarly to other systems, divides response into 4 types of response based on imaging (MRI) and clinical features :

  • complete response
  • partial response
  • stable disease
  • progression
  • Measurement

    The AVAglio criteria were, at least in part, developed to address the issues faced when measuring some lesions on Macdonald criteria including T2 non-enhancing components.

    Criteria

    Complete response
    • imaging features
      • disappearance of all enhancing disease (measurable and non-measurable)
      • sustained for at least 4 weeks
      • no worsening of non-index lesions
      • no new lesions
    • clinical features
      • no corticosteroids (physiological replacement doses allowed)
      • clinically stable or improved neurological symptoms
    Partial response
    • imaging features
      • 50% or more decrease of all measurable enhancing lesions
      • sustained for at least 4 weeks
      • no progression of non-index lesions
      • no new lesions
    • clinical features
      • stable or reduced corticosteroids 
      • clinically stable or improved neurologic symptoms
    Stable disease
    • imaging features
      • does not qualify for complete response, partial response or progression
    • clinical features
      • clinically stable or improved neurologic symptoms
      • NB: steroid dose alone does not affect "stable disease"
    Progression
    • imaging features
      • 25% of more increase in index lesions
      • unequivocal progression of existing non-index lesions
      • any new lesions
    • clinical features
      • clinical neurologic deterioration (only if steroid dose stable or increased)