Open AccessImmune response evaluation criteria in solid tumors for assessment of atypical responses after immunotherapy
Author(s) -
Davide Ippolito,
Cesare Maino,
Maria Ragusi,
Marco Porta,
Davide Gandola,
Cammillo Talei Franzesi,
Teresa Giandola,
Sandro Sironi
Publication year - 2021
Publication title -
world journal of clinical oncology
Language(s) - English
Resource type - Journals
ISSN - 2218-4333
DOI - 10.5306/wjco.v12.i5.323
Subject(s) - medicine , immunotherapy , immune system , solid tumor , response evaluation criteria in solid tumors , immunology , oncology , chemotherapy , cancer , progressive disease
In 2017, immune response evaluation criteria in solid tumors (iRECIST) were introduced to validate radiologic and clinical interpretations and to better analyze tumor's response to immunotherapy, considering the different time of following and response, between this new therapy compared to the standard one. However, even if the iRECIST are worldwide accepted, to date, different aspects should be better underlined and well reported, especially in clinical practice. Clinical experience has demonstrated that in a non-negligible percentage of patients, it is challenging to determine the correct category of response (stable disease, progression disease, partial or complete response), and consequently, to define which is the best management for those patients. Approaching radiological response in patients who underwent immunotherapy, a new uncommon kind of target lesions behavior was found. This phenomenon is mainly due to the different mechanisms of action of immunotherapeutic drug. Therefore, new groups of response have been described in clinical practice, defined as "atypical responses," and categorized into three new groups: pseudoprogression, hyperprogression, and dissociated response. This review summarizes and reports these patterns, helping clinicians and radiologists get used to atypical responses, in order to identify patients that respond best to treatment.