Prognostic Significance of 99mTc Hynic-rh-Annexin V Scintigraphy During Platinum-Based Chemotherapy in Advanced Lung Cancer

2007 ◽  
Vol 25 (18) ◽  
pp. 2534-2539 ◽  
Author(s):  
Marina Kartachova ◽  
Nico van Zandwijk ◽  
Sjaak Burgers ◽  
Harm van Tinteren ◽  
Marcel Verheij ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Progressive Disease ◽  
Tumor Response ◽  
Prognostic Significance ◽  
Evaluation Criteria ◽  
Annexin V ◽  
Advanced Lung Cancer ◽  
Response Evaluation ◽  
Platinum Based Chemotherapy ◽  
Induced Changes

Purpose The purpose of this study was to evaluate if sequential 99mTc Hynic-rh- annexin V scintigraphy (TAS) can predict outcome in patients with advanced lung cancer, shortly after the start of platinum-based chemotherapy. Patients and Methods In 16 consecutive chemotherapy-naive patients with advanced stage non–small-cell lung cancer scheduled for platinum-based chemotherapy, TAS was performed before and within 48 hours after the start of therapy. Chemotherapy-induced changes in tumor annexin V uptake, calculated as maximum count per pixel and expressed as percentage to baseline value, were compared with treatment response determined according to Response Evaluation Criteria in Solid Tumors. Results A significant correlation (r2 = 0.86; P = .0001) was found between annexin V metabolic changes and treatment outcome. All patients with notably increased annexin V tumor uptake showed complete or partial response. Less prominently increased or decreased uptake correlated with stable or progressive disease. Conclusion TAS is a promising test to predict tumor response in patients with advanced lung cancer early in the course of platinum-based chemotherapy.

Assessing solid tumor response with and without RECIST.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 504-504
Author(s):  
Aileen Deng ◽  
Benjamin E Leiby ◽  
Russell J. Schilder ◽  
William Kevin Kelly ◽  
Sandeep Deshmukh ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Progressive Disease ◽  
Tumor Response ◽  
Evaluation Criteria ◽  
Kappa Statistic ◽  
Response Assessment ◽  
Complete Response ◽  
Response Evaluation ◽  
Academic Center ◽  
Standard Report

504 Background: Response Evaluation Criteria in Solid Tumors (RECIST) has become widely accepted as gold standard for response evaluation in clinical trials. It remains underutilized in routine clinical practice. We compared tumor response assessment made with and without RECIST. Methods: This study included patients with solid tumors who underwent imaging from January 2013 to December 2014 at a single academic center. Tumor response was assessed by a radiologist using RECIST and by an oncologist (Onc) and resident (Res) without using RECIST (standard report). Tumor response was classified as progressive disease (PD), stable disease (SD), partial response (PR) and complete response (CR). Agreement in assessment between RECIST and standard report was determined by percent agreement and Kappa statistic. Results: 292 imaging studies were included. Concordance between RECIST and Onc-interpreted standard report is presented in Table 1. Overall agreement between RECIST and Onc-interpreted standard report was 56% (95% CI: 46-65%) and Kappa was 0.31 (95% CI: 0.19-0.44). Similar results were seen between RECIST and Res-interpreted standard report (Table 1). Overall agreement between RECIST and Res-interpreted report was 54% (95% CI: 44%-63%) and Kappa was 0.26 (95% CI: 0.13-0.40). Conclusions: Our study found variability in tumor response assessment between clinicians and radiologists. RECIST-classified PD was often interpreted as SD and vice versa, a distinction that affect treatment decisions. Our study highlights the need to standardize tumor response assessment. [Table: see text]

scholarly journals Imaging Assessment of Tumor Response in the Era of Immunotherapy

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1041
Author(s):  
Jun Nakata ◽  
Kayako Isohashi ◽  
Yoshihiro Oka ◽  
Hiroko Nakajima ◽  
Soyoko Morimoto ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Solid Tumors ◽  
False Positive ◽  
Progressive Disease ◽  
Tumor Response ◽  
Metabolic Response ◽  
Evaluation Criteria ◽  
Emission Tomography ◽  
Response Criteria ◽  
Positron Emission

Assessment of tumor response during treatment is one of the most important purposes of imaging. Before the appearance of immunotherapy, response evaluation criteria in solid tumors (RECIST) and positron emission tomography response criteria in solid tumors (PERCIST) were, respectively, the established morphologic and metabolic response criteria, and cessation of treatment was recommended when progressive disease was detected according to these criteria. However, various types of immunotherapy have been developed over the past 20 years, which show novel false positive findings on images, as well as distinct response patterns from conventional therapies. Antitumor immune response itself causes 18F-fluorodeoxyglucose (FDG) uptake in tumor sites, known as “flare phenomenon”, so that positron emission tomography using FDG can no longer accurately identify remaining tumors. Furthermore, tumors often initially increase, followed by stability or decrease resulting from immunotherapy, which is called “pseudoprogression”, so that progressive disease cannot be confirmed by computed tomography or magnetic resonance imaging at a single time point. As a result, neither RECIST nor PERCIST can accurately predict the response to immunotherapy, and therefore several new response criteria fixed for immunotherapy have been proposed. However, these criteria are still controversial, and also require months for response confirmation. The establishment of optimal response criteria and the development of new imaging technologies other than FDG are therefore urgently needed. In this review, we summarize the false positive images and the revision of response criteria for each immunotherapy, in order to avoid discontinuation of a truly effective immunotherapy.

The evolving landscape of criteria for evaluating tumor response in the era of cancer immunotherapy: From Karnofsky to iRECIST

2018 ◽  
Vol 104 (2) ◽  
pp. 88-95 ◽  
Author(s):  
Alessandro Inno ◽  
Giuseppe Lo Russo ◽  
Matteo Salgarello ◽  
Giulia Corrao ◽  
Raffaella Casolino ◽  
...  
Keyword(s):  
Tumor Response ◽  
Objective Response ◽  
Evaluation Criteria ◽  
Therapy Response ◽  
Clinical Activity ◽  
Special Focus ◽  
Response Evaluation ◽  
Recist 1.1 ◽  
New Anticancer Drugs ◽  
Response Evaluation Criteria

The objective response is an important endpoint to evaluate clinical activity of new anticancer drugs. Standardized criteria for evaluating response are needed for comparing results of different trials and represent the basis for advances in cancer therapy. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 are the most used in clinical practice and in clinical trials; however, they are not able to capture atypical responses seen with immunotherapy drugs. We describe the evolution of response criteria with a special focus on the immune-related criteria.

Impact of revised lymph node measurement rules in the new RECIST version 1.1 on the tumor response evaluation in patients with advanced lung cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7567-7567
Author(s):  
M. Endo ◽  
H. Watanabe ◽  
S. Yamamoto ◽  
N. Yamamoto ◽  
Y. Ohe ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Tumour Response ◽  
Major Change ◽  
Response Assessment ◽  
Advanced Lung Cancer ◽  
Kappa Statistics ◽  
Short Axis ◽  
Response Evaluation ◽  
Tumor Response Evaluation

7567 Background: The new RECIST ver. 1.1 was published in a special edition of the European Journal of Cancer in the first quarter of 2009 (EJC 2009;45:228). The major change involves the rules for lymph node measurement, which is to measure SHORT axis in stead of the longest diameter of lymph node. To be considered pathologically enlarged and measurable, a size of lymph node must be at least 15mm in short axis when assessed by CT scan. Lymph nodes that are at least 10mm but less than 15mm in short axis may be pathologic and can be considered as non-measurable/non-target lesions (not measured). The purpose of our study was to evaluate the response assessment using RECIST ver. 1.1. in comparison with that using ver. 1.0 in patients with advanced lung cancer. Methods: Two radiologists independently reviewed the objective tumour response of 305 patients (pts) with advanced lung cancer who had primary lesion and lymph node metastases as target lesions measured more than 10 mm in the longest diameter. According to ver. 1.1, only the short axis will be measured both at baseline and at follow-up. The response rates were calculated according to both the versions of RECIST. The tumor responses were divided into four categories (CR, PR, SD, PD), following proportion of agreement and estimation of kappa statistics between two the criteria as agreement measure. Results: The best overall responses as assessed by RECIST ver. 1.0 and ver. 1.1 are shown in the table. Out of the 108 pts with PR by ver.1.0, 8.3 % were downgraded to SD and 1.0 % was categorized as PD by ver.1.1. On the other hand, out of the 190 pts with SD by ver.1.0, 6.3 % were upgraded to PR and 8.9 % were downgraded to PD by ver.1.1. The proportion of agreement was 86.2 % (263/305, 95% CI: 75.8 - 96.6) and the kappa coefficient was 0.734 (95% CI: 0.662 - 0.806). Conclusions: No significant impact was observed for the revised lymph node measurement rules in the new RECIST ver. 1.1 on the response evaluation in pts with advanced lung cancer registered in this analysis. [Table: see text] [Table: see text]

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