International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017)

Area of Science:

• Oncology
• Radiology
• Clinical Trials

Background:

• Increasing novel agents for lymphoma treatment necessitate updated clinical trial evaluation methods.
• Current lymphoma response criteria (Lugano) differ from solid tumor criteria (RECIST), complicating multi-tumor trial assessments.
• Advancements in genomic sequencing enable basket trials, requiring unified response assessment across malignancies.

Framework:

• Hypothesized that single-dimension measurements, like RECIST, could effectively assess lymphoma treatment response.
• Developed the RECIL 2017 criteria based on analysis of extensive imaging data from lymphoma patients.
• Introduced a provisional 'minor response' category for nuanced treatment evaluation.

Implementation:

• Analyzed 47,828 imaging measurements from 2983 adult and pediatric lymphoma patients across 10 multicenter trials.
• Validated the use of the sum of longest diameters for up to three target lesions to assess tumor burden.
• Clarified response assessment for unique imaging findings in patients on novel immunotherapies and targeted agents.

Implications:

• RECIL 2017 offers a standardized, potentially more efficient method for lymphoma response assessment in clinical trials.
• The criteria facilitate comparison across different tumor types and treatment modalities, including novel agents.
• Improved response assessment can accelerate drug development and optimize patient care in lymphoma treatment.