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Diagnosis
Pulmonary Neoplasms
Evaluation of Treatment Response
irRC and irRECIST
irRC and irRECIST
Brett W. Carter, MD, CPPS
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KEY FACTS

  • Terminology

    • Key Concepts

      • Clinical Implications

        TERMINOLOGY

        • Abbreviations

          • Immune-Related Response Criteria (irRC)
          • Immune-Related Response Evaluation Criteria in Solid Tumors (irRECIST)

        • Rationale and Key Concepts

          • Conventional response criteria may not adequately assess activity of immunotherapeutic agents
            • Appearance of measurable change may take longer for immune therapies than for cytotoxic therapies
            • Response to immune therapies may occur after conventional progressive disease
            • Discontinuation of therapy may not be appropriate in some cases
              • Unless progressive disease confirmed
            • Allowance for “clinically insignificant” progressive disease is recommended
              • e.g., new small lesions in presence of other responsive lesions
            • Durable stable disease may represent antitumor effects

        IMAGING ANATOMY

        • Baseline

          CLINICAL IMPLICATIONS

          • Reassessment

            • Evaluation of Overall Response

              Selected References

              1. Nishino M et al: Developing a common language for tumor response to immunotherapy: immune-related response criteria using unidimensional measurements. Clin Cancer Res. 19(14):3936-43, 2013
              2. Wolchok JD et al: Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria. Clin Cancer Res. 15(23):7412-20, 2009
              Related Anatomy
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              Related Differential Diagnoses
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              References
              Tables

              Tables

              KEY FACTS

              • Terminology

                • Key Concepts

                  • Clinical Implications

                    TERMINOLOGY

                    • Abbreviations

                      • Immune-Related Response Criteria (irRC)
                      • Immune-Related Response Evaluation Criteria in Solid Tumors (irRECIST)

                    • Rationale and Key Concepts

                      • Conventional response criteria may not adequately assess activity of immunotherapeutic agents
                        • Appearance of measurable change may take longer for immune therapies than for cytotoxic therapies
                        • Response to immune therapies may occur after conventional progressive disease
                        • Discontinuation of therapy may not be appropriate in some cases
                          • Unless progressive disease confirmed
                        • Allowance for “clinically insignificant” progressive disease is recommended
                          • e.g., new small lesions in presence of other responsive lesions
                        • Durable stable disease may represent antitumor effects

                    IMAGING ANATOMY

                    • Baseline

                      CLINICAL IMPLICATIONS

                      • Reassessment

                        • Evaluation of Overall Response

                          Selected References

                          1. Nishino M et al: Developing a common language for tumor response to immunotherapy: immune-related response criteria using unidimensional measurements. Clin Cancer Res. 19(14):3936-43, 2013
                          2. Wolchok JD et al: Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria. Clin Cancer Res. 15(23):7412-20, 2009