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 These were adapted from the older Macdonald criteria, but have since been superseded by they RANO criteria (2010) .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 :

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)