Response evaluation for immunotherapy through semi-automatic software based on RECIST 1.1, irRC, and iRECIST criteria: comparison with subjective assessment. (July 2020)

• Record Type: Journal Article
• Authors: Lai, Ying-Chieh; Chang, Wen-Cheng; Chen, Chun-Bing; Wang, Chi-Liang; Lin, Yu-Fen; Ho, Ming-Mo; Cheng, Chi-Yuan; Huang, Pei-Wei; Hsu, Chao-Wei; Lin, Gigin
• Is Part Of: Acta radiologica. Volume 61:Number 7(2020)
• Page Start: 983
• Page End: 991
• Publication Date: 2020-07
• Subjects: Immunotherapy -- pseudoprogression -- response evaluation criteria in solid tumors (RECIST) -- immune-related response criteria (irRC) -- semi-automatic software; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185119887588
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Pseudoprogression is difficult to diagnose in patients undergoing immunotherapy. Subjective response assessment is still common in clinical practice. Purpose: To evaluate the differences between response evaluation criteria in solid tumors version 1.1 (RECIST 1.1), immune-related response criteria (irRC), and modified RECIST 1.1 for immunotherapy (iRECIST) through semi-automatic software, and to compare iRECIST-based response evaluation with subjective assessment. Material and Methods: The best overall response of each patient based on RECIST 1.1, irRC, and iRECIST was determined on CT scans through semi-automatic software and the differences between the criteria were evaluated. Criteria-based response evaluation through semi-automatic software was compared with subjective assessment on radiology report by correlating the best overall response to overall survival. Results: A total of 21 patients were included (five patients with melanoma, 12 patients with non-small-cell lung cancer, and four patients with hepatocellular carcinoma). Two patients with progressive disease by RECIST 1.1 but non-progressive disease by irRC and iRECIST eventually experienced tumor response and had favorable outcomes, indicating pseudoprogression. The survival difference between patients with non-progressive disease and progressive disease was better stratified through iRECIST-based response evaluation ( P = 0.078) than that through subjective assessment ( P = 0.501). Conclusion: Pseudoprogression in immunotherapy may be captured through semi-automatic software utilizing irRC or iRECIST criteria. iRECIST-based response evaluation may provide a better survival stratification compared with subjective assessment.