Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad scope and implementation-A progress report

Martin J van den Bent¹, Michael A Vogelbaum², Tim Cloughesy³, Norbert Galldiks^{4

5

6}, Nathalie L Albert⁷, Joerg-Christian Tonn^{8

9}, Edward Avila¹⁰, Jason Fangusaro¹¹, David Mirsky¹², Arjun Sahgal¹³, Ricardo Soffietti¹⁴, Philipp Karschnia^{15

8

9}, Minesh Mehta¹⁶, Michelle M Kim¹⁷, Florien Boele^{18

19}, Jason T Huse²⁰, Lakshmi Nayak²¹, Mary Jane Lim-Fat²², Emilie le Rhun²³, Annick Desjardins²⁴, Eudocia Q Lee²¹, Ugonma Chukwueke²¹, Johan A F Koekkoek²⁵, Tito Mendoza²⁶, Ashlee R Loughan²⁷, Joshua A Budhu¹⁰, Spyridon Bakas^{28

29}, Raymond Y Huang³⁰, Javier E Villanueva-Meyer^{31

32}, Jose Pablo Leone³³, Hideho Okada^{34

31}, David A Reardon²¹, Wenya L Bi³⁵, Patrick Y Wen²¹, Susan M Chang³⁶

Affiliations

¹ The Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
² Department of NeuroOncology, Moffitt Cancer Center, Tampa, Florida, USA.
³ Department of Neurology, UCLA, California, USA.
⁴ Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.
⁵ Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany.
⁶ Department of Neurology, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany.
⁷ Department of Nuclear Medicine, LMU University Hospital of Munich, Munich, Germany.
⁸ German Cancer Consortium (DKTK), Partner site Munich, Germany.
⁹ Department. of Neurosurgery, University Hospital of Munich (LMU), Munich, Germany.
¹⁰ Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, USA.
¹¹ Children's Healthcare of Atlanta, Emory University, and the Aflac Cancer Center, Atlanta, Georgia, USA.
¹² Department of Radiology, Pediatric Section, University of Colorado School of Medicine, Children's Hospital Colorado, Colorado, USA.
¹³ Sunnybrook Odette Cancer Center, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Division of Neuro-Oncology, Department of Neuroscience "Rita Levi Montalcini," University of Turin, Turin, Italy.
¹⁵ Department of Neurosurgery, University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany.
¹⁶ Miami Cancer Institute at Baptist Health of South Florida & Florida International University Department of Radiation Oncology, Miami, Florida, USA.
¹⁷ Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.
¹⁸ Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
¹⁹ Leeds Institute of Medical Research at St James's, St James's University Hospital, University of Leeds, Leeds, UK.
²⁰ Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
²¹ Center for Neuro-Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts, USA.
²² Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
²³ Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.
²⁴ The Preston Robert Tisch Brain Tumor Center at Duke, Department of Neurosurgery, Duke University, Durham, North Carolina, USA.
²⁵ Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
²⁶ Office of Patient-Centered Outcomes Research, Center for Cancer Research, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA.
²⁷ Department of Neurology, Division of Neuro-Oncology, Virginia Commonwealth University, Richmond, Virginia, USA.
²⁸ Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.
²⁹ Division of Computational Pathology, Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
³⁰ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³¹ Neurological Surgery at University of California, San Francisco, California, USA.
³² Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
³³ Department of Medical Oncology, Brigham and Women's Hospital Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
³⁴ Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA.
³⁵ Department of Neurosurgery Department of Neurosurgery, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
³⁶ Division of NeuroOncology, Department of Neurological Surgery, University of California San Francisco (UCSF), San Francisco, California, USA.

PMID: 40317212
PMCID: PMC12526114 (available on 2026-05-03)
DOI: 10.1093/neuonc/noaf118

Review

Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad scope and implementation-A progress report

Martin J van den Bent et al. Neuro Oncol. 2025.

. 2025 Oct 14;27(9):2209-2224.

doi: 10.1093/neuonc/noaf118.

Authors

Affiliations

¹ The Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
² Department of NeuroOncology, Moffitt Cancer Center, Tampa, Florida, USA.
³ Department of Neurology, UCLA, California, USA.
⁴ Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.
⁵ Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany.
⁶ Department of Neurology, Medical Faculty and University Hospital of Cologne, University of Cologne, Cologne, Germany.
⁷ Department of Nuclear Medicine, LMU University Hospital of Munich, Munich, Germany.
⁸ German Cancer Consortium (DKTK), Partner site Munich, Germany.
⁹ Department. of Neurosurgery, University Hospital of Munich (LMU), Munich, Germany.
¹⁰ Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, USA.
¹¹ Children's Healthcare of Atlanta, Emory University, and the Aflac Cancer Center, Atlanta, Georgia, USA.
¹² Department of Radiology, Pediatric Section, University of Colorado School of Medicine, Children's Hospital Colorado, Colorado, USA.
¹³ Sunnybrook Odette Cancer Center, University of Toronto, Toronto, Ontario, Canada.
¹⁴ Division of Neuro-Oncology, Department of Neuroscience "Rita Levi Montalcini," University of Turin, Turin, Italy.
¹⁵ Department of Neurosurgery, University Hospital Erlangen, Friedrich-Alexander University, Erlangen, Germany.
¹⁶ Miami Cancer Institute at Baptist Health of South Florida & Florida International University Department of Radiation Oncology, Miami, Florida, USA.
¹⁷ Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.
¹⁸ Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
¹⁹ Leeds Institute of Medical Research at St James's, St James's University Hospital, University of Leeds, Leeds, UK.
²⁰ Departments of Pathology and Translational Molecular Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
²¹ Center for Neuro-Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, Massachusetts, USA.
²² Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
²³ Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.
²⁴ The Preston Robert Tisch Brain Tumor Center at Duke, Department of Neurosurgery, Duke University, Durham, North Carolina, USA.
²⁵ Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
²⁶ Office of Patient-Centered Outcomes Research, Center for Cancer Research, National Cancer Institute, National Institute of Health, Bethesda, Maryland, USA.
²⁷ Department of Neurology, Division of Neuro-Oncology, Virginia Commonwealth University, Richmond, Virginia, USA.
²⁸ Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.
²⁹ Division of Computational Pathology, Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
³⁰ Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
³¹ Neurological Surgery at University of California, San Francisco, California, USA.
³² Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.
³³ Department of Medical Oncology, Brigham and Women's Hospital Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA.
³⁴ Parker Institute for Cancer Immunotherapy, San Francisco, CA, USA.
³⁵ Department of Neurosurgery Department of Neurosurgery, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
³⁶ Division of NeuroOncology, Department of Neurological Surgery, University of California San Francisco (UCSF), San Francisco, California, USA.

PMID: 40317212
PMCID: PMC12526114 (available on 2026-05-03)
DOI: 10.1093/neuonc/noaf118

Abstract

Since its first activities in 2008 and 2009, the Response Assessment in NeuroOncology (RANO) group has given guidance on response assessment, trial design, and trial procedures to improve and standardize the way clinical trials in neurooncological studies are performed. To achieve its objectives, a variety of working groups have been initiated that cover many aspects of clinical trial design and outcome assessment in patients with tumors affecting the Central Nervous System. The RANO working groups are built on expertise without a formal structure, which makes rapid responses to new developments possible. RANO is aiming at evidence-based guidelines and recommendations, but in the absence of evidence will provide consensus-based guidance achieved by inviting recognized international experts. In its 15 years of existence, more than 60 RANO papers have been published mostly in high-ranking journals, and its recommendations have been accepted by regulators and industry as guiding principles. RANO organizes two meetings per year, one in conjunction with the annual American Society for Clinical Oncology (ASCO) meeting, and one during the annual Society for Neuro-Oncology meeting. These meetings are open, as are the working groups of RANO. New initiatives are welcomed.

Keywords: RANO; brain metastases; outcome criteria; primary brain tumors.

© The Author(s) 2025. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad scope and implementation-A progress report

Affiliations

Response Assessment in Neuro-Oncology (RANO) 2009-2025: Broad scope and implementation-A progress report

Authors

Affiliations

Abstract

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Medical