#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Comparison of RECIST 1.1 and iRECIST for Response Evaluation in Solid Tumours


Authors: Š. Houdek 1;  T. Büchler 2;  E. Kindlová 3
Authors‘ workplace: Radiodia gnostické oddělení, Nemocnice Na Homolce, Praha 1;  Onkologická klinika 1. LF UK a Thomayerova nemocnice, Praha 2;  Radioterapeutická a onkologická klinika 3. LF UK a FN Královské Vinohrady, Praha 3
Published in: Klin Onkol 2017; 30(Supplementum3): 32-39
Category: Review
doi: https://doi.org/10.14735/amko20173S32

Overview

Background:
Immunotherapy is a relatively new and developing modality in oncological treatment, which may significantly improve treatment results for some patients with malignant tumors. With the increasing number of clinical trials, the demand for a suitable tool to assess and compare treatment responses is growing. Currently, the most common response assessment system for solid tumors is RECIST (response Evaluation Criteria in Solid Tumors) version 1.1. However, in immuno-oncology, a small percentage of patients manifest a new response pattern termed pseudoprogression, in which, after the initial increase in tumor burden or after the discovery of new lesions, a response or at least a prolonged stabilization of the disease can occur. This patient group would be included in the progression category when using RECIST 1.1 and effective treatment would be discontinued. Therefore, iRECIST criteria were established to capture the phenomenon of pseudoprogression, the need for PD confirmation (according to RECIST 1.1) was introduced, and changes were made in the evaluation of new lesions.

Aim:
The present work introduces criteria for the evaluation of oncological responses in solid tumors using RECIST version 1.1 and iRECIST immunotherapy variant (including a brief overview of previous immune criteria). These criteria are compared in an immuno-oncological context and their potential pitfalls are discussed.

Conclusion:
iRECIST criteria were established by expert consensus; however, sufficient data for final validation has not yet been collected. As a result, RECIST 1.1 should be the primary assessment system in immuno-oncology. The use of iRECIST should be reserved for research purposes (testing and validation). Distinguishing pseudoprogression from true PD in patients treated with immunotherapy remains a major challenge in oncological imaging.

Key words:
RECIST – response criteria – immunotherapy – measurement – tumor burden

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
24. 9. 2017

Accepted:
3. 10. 2017


Sources

1. Seymour L, Bogaerts J, Peronne A et al. iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics. Lancet Oncology 2017; 18 (3): 143–152. doi: 10.1016/S1470-2045 (17) 30074-8.

2. Tirkes T, Hollar M, Tann M et al. Response Criteria in Oncologic Imaging: Review of Traditional and New Criteria. Radio Graphics 2013; 33 (5): 1323–1341. doi: 10.1148/ rg.335125214.

3. Kamta J, Chaar M, Ande A et al. Advancing Cancer Therapy with Present and Emerging Immuno-Oncology Approaches. Front Oncol 2017; 7: 64. doi: 10.3389/ fonc.207.00064.

4. Ferte CH, Marabelle A. IRECIST: A clarification of tumour response assessment in the immunotherapy era. Eur J Cancer 2017; 77: 165–167. doi: 10.1016/j.ejca.2017.02.015.

5. Okada H, Weller M, Huang R et al. Immunotherapy Response Assessment in neuro-oncology: a report of the RANO working group. Lancet Oncol 2015; 16 (15): 534–542. doi: 10.1016/S1470-2045 (15) 00088-1.

6. Wolchok JD, Hoos A, O’Day S et al. Guidelines for the Evaluation of Immune Therapy Activity in Solid Tumors: Immune-Related Response Criteria. Clin Cancer Rec 2009; 15 (23): 7417–7420. doi: 10.1158/1078-0432.CCR-09-1624.

7. Hodi FS, Butler M, Oble DA et al. Immunologic and clinical effects of antibody blockade of cytotoxic T lymphocyte-associated antigen 4 in previously vaccinated cancer patients. Proc Natl Acad Sci U S A 2008; 105 (8): 3005–3010. doi: 10.1073/pnas.0712237105.

8. Hodi FS, Oble DA, Drappatz J et al. CTLA-4 blockade with ipilimumab induces significant clinical benefit in a female with melanoma metastases to the CNS. Nat Clin Pract Oncol 2008; 5 (9): 557–561. doi: 10.1038/ncponc1183.

9. Mohammed FF, Schwartz ML, Lightstone A et al. Pseudoprogression of vestibular schwannomas after fractioned stereotactic radiation therapy. J Radiat Oncol 2013; 2 (1): 15–20. doi: 10.1007/s13566-012-0084-1.

10. Wiggenraad R, Bos P, Verbeek-de Kanter A et al. Pseudo-progression after stereotactic radiotherapy of brain metastasis: lesion analysis using MRI cine-loops. J Neurooncol 2014; 199 (2): 437–443. doi: 10.1007/s11060-014-1519-x.

11. Eisenhauer EA, Therasse P, Bogaerts J et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45 (2): 228–247. doi: 10.1016/j.ejca.2008.10.026.

12. Nishino M, Jagannathan JP, Ramaiya NH et al. Revised RECIST Guideline Version 1.1: What Oncologists Want to Know and What Radiologists Need to Know. AJR Roentgenol 2010; 195 (2): 281–289. doi: 10.2214/AJR.09.4110.

13. Hodi FS, Hwu WJ, Kefford R et al. Evaluation of Immune-Related Response Criteria and RECIST v1.1 in Patients With Advanced Melanoma Treated With Pembrolizumab. J Clin Oncol 2016; 34 (13), 1510–1517. doi: 10.1200/JCO.2015.64.0391.

14. Nishino M, Guo M, Jackman DM et al. CT tumor volume measurement in advanced non-small-cell lung cancer: Performance characteristics of an emerging clinical tool. Acad Radiol 2011; 18 (1): 54–62. doi: 10.1016/j.acra.2010.08.021.

15. Zhao B, James LP, Moskowitz CS et al. Evaluating variability in tumor measurements from same-day repeat CT scans of patients with non-small cell lung cancer. Radiology 2009; 252 (1): 263–272. doi: 10.1148/radiol.2522081593.

16. Erasmus JJ, Gladish GW, Broemeling L et al. Interobserver and intraobserver variability in measurement of non-small-cell carcinoma lung lesions: implications for assessment of tumor response. J Clin Oncol 2003; 21 (13): 2574–2582. doi: 10.1200/JCO.2003.01. 144.

17. Nishino M. Immune-related response evaluations during immune-checkpoint inhibitor therapy: establishing a “common language” for the new arena of cancer treatment. J Immunother Cancer 2016; 4: 30. doi: 10.1186/s40425-016-0134-0.

Labels
Paediatric clinical oncology Surgery Clinical oncology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#