Radiologische Responsebeurteilung moderner Immuntherapien mithilfe von iRECIST

Clinical/methodical issueModern immunotherapies in oncology show tumor response patterns differing from conventional chemotherapies including initial pseudo-progression.Standard radiological methodsResponse evaluation criteria in solid tumors (RECIST 1.1) represent the currently most used response c...

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Bibliographic Details
Main Authors: Persigehl, Thorsten (Author) , Pöppel, Thorsten Dirk (Author) , Sedlaczek, Oliver (Author)
Format: Article (Journal)
Language:German
Published: 15 August 2017
In: Der Radiologe
Year: 2017, Volume: 57, Issue: 10, Pages: 826-833
ISSN:1432-2102
DOI:10.1007/s00117-017-0289-9
Online Access:Verlag, Volltext: http://dx.doi.org/10.1007/s00117-017-0289-9
Verlag, Volltext: https://link.springer.com/article/10.1007/s00117-017-0289-9
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Author Notes:T. Persigehl, T.D. Poeppel, O. Sedlaczek
Description
Summary:Clinical/methodical issueModern immunotherapies in oncology show tumor response patterns differing from conventional chemotherapies including initial pseudo-progression.Standard radiological methodsResponse evaluation criteria in solid tumors (RECIST 1.1) represent the currently most used response criteria for conventional chemotherapy of solid tumors. However, atypical response patterns of immunotherapies are not correctly classified using RECIST 1.1 so that the effectiveness is also incorrectly interpreted.Methodical innovationsIn order to correctly interpret these atypical response patterns, special immune-related response criteria in solid tumors (iRECIST) have been published. In contrast to RECIST 1.1 according to iRECIST an initially unconfirmed progressive disease (iUPD) requires confirmation (iCPD) in clinically stable patients by subsequent control imaging after 4-8 weeks. New lesions are separately assessed within iRECIST.PerformanceThe iRECIST procedure allows a standardized objective assessment of a possible pseudo-progression which can occur in up to 10% of cases depending on the immunomodulating drug and tumor entity.AchievementsIn principle, iRECIST was developed only for usage in trials testing modern immunotherapeutics.Practical recommendationsThe iRECIST procedure might also be helpful as an additional objective response criterium for clinical treatment decisions, taking the limitations into account.
Item Description:Gesehen am 24.07.2018
Physical Description:Online Resource
ISSN:1432-2102
DOI:10.1007/s00117-017-0289-9