Framework and prospects for the Latin-American
Neuro-Oncology Network - RedLANO
After completing two years of operation, the Latin-American Neuro-Oncology Network (Red Latino Americana de Neuro-Oncología – RedLANO) has produced encouraging achievements regarding the number of participating members, currently being more than 320. There has been 355% growth in new users’ participation and the official website (www.redlano.org) has received more than 119,000 visits since its setting up in 2010 (noticeable growth happening from September 2011 onwards). The RedLANO platform received 72,400 visits between December 2011 and May 2013, such traffic becoming concentrated after the publication of the preliminary programme for the next congress which will be held this year in Cartagena, Colombia. Compared to January 2011, the number of visits has increased by 180%, thereby suggesting an exponential growth throughout these last two years.
Most RedLANO users are from Colombia, Ecuador, Peru, Mexico, Costa Rica, Chile, Argentina, Bolivia, Spain, United States, Panama, Paraguay, Puerto Rico, Uruguay and Venezuela. Our community has managed to run two successful congresses and many regional meetings encouraging and promoting knowledge in neuro-oncology and its related areas. Since its establishment, and as a result of the joint work of many specialists, the news section has been strengthened by the introduction of the component Images in neuro-oncology and the interactive presentation of conferences; such segment currently having more than 60 readily addressed products and high-quality content which is being constantly renewed.
RedLANO has also promoted the formation of a monographic follow-up record for patients suffering from high-grade gliomas, currently including more than 220 patients. Preliminary results of 170 patients with a mean age of 56 years (17-84 range), males predominating (56%), were presented during ASCO meeting last year. 82% of the patients had glioblastomas (most being primary); 59% of them were treated by cytoreduction and a biopsy was performed on 23% of them. 77% of the patients completed the treatment schema proposed by Stupp et al., including a 58.2 Gy median radiation dose and an average of 5 ±3 temozolomide cycles (excluding concomitance). Pseudoprogression was found in 20% of the patients, median overall survival (OS) was 15.8 months (11.9-19.7 months 95%CI) and time to progression was 4.1 months (2.9-5.3 months 95%CI). Survival rate at one and two years was 69% and 31%, respectively, and retrospective analysis revealed that patients aged less than 50 years (p=0.0001) had a more prolonged OS as they had a better postoperative functional state (p=0.05) and a better stratification according to RPA classification (p=0.04). 71 patients (41%) were treated with second-line treatment at the time of progression (combos with bevacizumab, 32; temozolomide in dense or metronomic doses, 24; Carmustine 14; others 1), achieving 66% overall response by adding anti-angiogenic therapy and 76% clinical benefit1. The state of the O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation gene was evaluated in 93 patients, revealing a 15.8 month (9.0-22 95%CI) OS for the group of positive patients compared to 7.6 months (5.5-9-6 95%CI) for those who proved negative. The latter difference was statistically significant (p=0.001) (Ortiz LD, Cardona AF, Fadul C, et al. Clinical outcome of concomitant chemoradiotherapy followed by adjuvant temozolomide (TMZ) therapy for high-grade gliomas (HGG) in Colombia (RedLANO registry). J Clin Oncol 2011;29 (suppl):abstr 2092)
These achievements have shown RedLANO’s transition towards maturity, encouraging the organisation to continue promoting advances in neuro-oncology through research and education. It is hoped that neuro-oncology will be able to integrate more specialists in Latin-America during this year.
For further information, contact Andrés Felipe Cardona, MD, MSc, PhD. Telephone (+57)1-6190052, a_cardonaz @yahoo.com