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[New guidelines to evaluate the response to treatment in solid tumors]
1EORTC Data Center, avenue E.-Mounier no. 83, Bte 11, 1200 Bruxelles, Belgique.
Abstract:
Anticancer agents go through a process by which their antitumor activity, on the basis of the amount of tumor shrinkage they could generate, has been investigated. In the late 1970s, the International Union Against Cancer and the World Health Organization (WHO) introduced specific criteria for the codification of tumor response evaluation. In 1994, several organizations involved in clinical cancer research joined together to undertake the review of these response evaluation criteria on the basis of their experience and knowledge. After several years of intensive discussions, new guidelines are ready and will replace the previous WHO criteria. In parallel to this initiative, one of the participating groups developed a model by which response rates could be derived from unidimensional measurement of tumor lesions instead of the usual bidimensional approach. This new concept has been largely validated by the Response Evaluation Criteria in Solid Tumors (Recist) Group and integrated into the present guidelines. This special article provides some philosophic background to clarify the various purposes of response evaluation. It proposes a model by which a combined assessment of all existing lesions, characterized by target lesion (to be measured) and nontarget lesions, is used to extrapolate an overall response to treatment. Methods of assessing tumor lesions are better codified. All other aspects of response evaluation have been discussed, reviewed, and amended whenever suitable.
Insights
New anticancer drug response criteria, Response Evaluation Criteria in Solid Tumors (Recist), replace older World Health Organization (WHO) guidelines. These updated cancer treatment evaluation methods improve tumor shrinkage assessment for better drug efficacy analysis.
Area of Science:
- Oncology
- Clinical Trial Design
- Biostatistics
Context:
- Established World Health Organization (WHO) criteria for evaluating anticancer agent efficacy have been in use since the late 1970s.
- Clinical cancer research organizations convened to revise these criteria based on accumulated experience and knowledge.
- A new model for deriving response rates from unidimensional measurements was developed, contrasting with the traditional bidimensional approach.
Purpose:
- To introduce updated guidelines for evaluating tumor response to anticancer agents, replacing the previous WHO criteria.
- To provide a philosophic background for response evaluation and clarify its diverse purposes.
- To propose a refined model for assessing overall treatment response using both target and nontarget lesions.
Summary:
- New guidelines integrate the Response Evaluation Criteria in Solid Tumors (Recist) model, which utilizes unidimensional measurements for response rate derivation.
- The updated criteria offer a more codified approach to assessing tumor lesions, including target and nontarget lesions.
- These guidelines represent a significant revision, incorporating advancements in clinical cancer research and evaluation methodologies.
Impact:
- The revised criteria aim to standardize and improve the accuracy of antitumor activity assessment in clinical trials.
- Implementation of Recist guidelines is expected to enhance the comparability and reliability of cancer drug efficacy data.
- This evolution in response evaluation supports more informed decision-making in cancer drug development and clinical practice.