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Published on: February 12, 2017
Tumor response assessment by the single-lesion measurement per organ in small cell lung cancer
Soong Goo Jung1, Jung Han Kim1, Hyeong Su Kim1
11Department of Internal Medicine.
Background:
The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 is an arbitrary one, being supported by no objective evidence. The optimal number of target lesions per organ still needs to be investigated. We compared tumor responses using the RECIST 1.1 (measuring two target lesions per organ) and modified RECIST 1.1 (measuring the single largest lesion in each organ) in patients with small cell lung cancer (SCLC).
Methods:
We reviewed medical records of patients with SCLC who received first-line treatment between January 2004 and December 2014 and compared tumor responses according to the two criteria using computed tomography.
Results:
There were a total of 34 patients who had at least two target lesions in any organ according to the RECIST 1.1 during the study period. The differences in the percentage changes of the sum of tumor measurements between RECIST 1.1 and modified RECIST 1.1 were all within 13%. Seven patients showed complete response and fourteen showed partial response according to the RECIST 1.1. The overall response rate was 61.8%. When assessing with the modified RECIST 1.1 instead of the RECIST 1.1, tumor responses showed perfect concordance between the two criteria (k=1.0).
Conclusions:
The modified RECIST 1.1 showed perfect agreement with the original RECIST 1.1 in the assessment of tumor response of SCLC. Our result suggests that it may be enough to measure the single largest target lesion per organ for evaluating tumor response.
Insights
Measuring the single largest target lesion per organ, a modified RECIST 1.1, accurately assesses small cell lung cancer (SCLC) tumor response. This simplified approach shows perfect agreement with the original RECIST 1.1 criteria.
Area of Science:
- Oncology
- Radiology
- Clinical Trial Design
Background:
- The standard Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 uses an arbitrary two target lesions per organ criterion.
- Objective evidence supporting the optimal number of target lesions per organ is lacking.
- The current study investigates alternative lesion measurement strategies for solid tumors.
Purpose of the Study:
- To compare tumor response assessment in small cell lung cancer (SCLC) using RECIST 1.1 and a modified RECIST 1.1.
- To evaluate the efficacy of measuring only the single largest lesion per organ versus two lesions.
- To determine if a simplified RECIST approach maintains accuracy in SCLC treatment response evaluation.
Main Methods:
- Retrospective review of medical records for SCLC patients receiving first-line treatment (January 2004 - December 2014).
- Comparison of tumor responses using standard RECIST 1.1 (two target lesions/organ) and modified RECIST 1.1 (single largest lesion/organ).
- Computed tomography (CT) scans were utilized for tumor response assessment.
Main Results:
- 34 SCLC patients had at least two target lesions per organ by RECIST 1.1.
- Differences in sum of tumor measurements between criteria were within 13%.
- Modified RECIST 1.1 demonstrated perfect concordance (k=1.0) with RECIST 1.1 for SCLC tumor response.
Conclusions:
- Modified RECIST 1.1, measuring the single largest lesion per organ, is a valid alternative for SCLC tumor response assessment.
- This simplified approach shows perfect agreement with the original RECIST 1.1.
- Measuring the single largest target lesion per organ may be sufficient for evaluating treatment response in SCLC.
