Objective: This post-hoc analysis of the AtTEnd trial explored differences in the prognostic characteristics and in the efficacy of atezolizumab between Asians and non-Asians. Methods: The role of Asian race was evaluated on progression-free survival (PFS) using Cox-models and on time to appearance of new lesions using Fine and Gray models. Results: From October 2018 to February 2022, 549 patients were randomized, of whom, 20.4% were Asian. Asians showed a better prognostic profile in terms of age, body mass index, Eastern Cooperative Oncology Group performance status, disease status and previous treatments. The prognostic impact of Asian race on PFS was confirmed in the placebo arm (adjusted hazard ratio [HR]=0.41; 95% confidence interval [CI]=0.24–0.70). In proficient mismatch repair (pMMR) tumors, the HRs for PFS comparing atezolizumab versus placebo were 0.82 (95% CI=0.63–1.05) in non-Asians, and 1.42 (95% CI=0.80–2.50) in Asians. In the pMMR population randomized to atezolizumab, the subdistribution HRs comparing Asians to non-Asians were 0.68 (95% CI=0.43–1.09) for progression with new lesions and 1.21 (95% CI=0.73–2.03) for progression without new lesions. Asians showed a higher occurrence of severe adverse events in atezolizumab compared to placebo arm (Asians: 82.1% vs. 64.3%, p=0.036; non-Asian: 63.3% vs. 63.6%, p=0.949). Conclusion Race seems to affect the safety of the addition of atezolizumab and, in pMMR tumors, also its efficacy. In the atezolizumab arm, Asian patients seem to have a lower cumulative incidence of new lesions when primary tumor regrowth was considered a competing risk, and a higher cumulative incidence of primary tumor regrowth when new lesions appearance was the competing risk.

The common cerebral small vessel disease (CSVD) neuroimaging features visible on conventional structural magnetic resonance imaging include recent small subcortical infarcts, lacunes, white matter hyperintensities, perivascular spaces, microbleeds, and brain atrophy. The CSVD neuroimaging features have shared and distinct clinical consequences, and the automatic quantification methods for these features are increasingly used in research and clinical settings. This review article explores the recent progress in CSVD neuroimaging feature quantification and provides an overview of the clinical consequences of these CSVD features as well as the possibilities of using these features as endpoints in clinical trials. The added value of CSVD neuroimaging quantification is also discussed for researches focused on the mechanism of CSVD and the prognosis in subjects with CSVD.
Cerebral Small Vessel Diseases/diagnostic imaging* ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Prognosis

Background and Objective: Comparable data are sparse for infl ammatory demyelinating diseases of the central nervous system (CNS) in the Asia-Pacifi c region, and we aimed to establish a registry of patients with such diseases in the region. Methods: A network of neurologists in the Asia-Pacifi c Region was established to register patients with the targeted diseases. A standardized register form and relevant instructions in English, translated into the local language when needed, were prepared before the study start and used for data collection. Results: Eight study centres from different countries/areas participated in the study. In total, 857 patients with a validated diagnosis of different infl ammatory demyelinating diseases of the CNS were registered, 591 females and 266 males with a female-to-male ratio 2.2. The mean age at onset for all patients was 35.9 (SD: 12.9) years, signifi cantly younger (p = 0.010) for females (35.1 years, SD: 12.6 years) than for males (37.6 years, SD: 13.4 years). Conclusion: Patients with different infl ammatory demyelinating diseases of the CNS were in the fi rst time registered in a multi-centre study from eight countries/areas in the Asia-Pacifi c region. A platform and basis has been established for further study in the fi eld.