The beginning of the end for conventional RECIST - novel therapies require novel imaging approaches

Area of Science:

• Oncology
• Biomedical Imaging
• Translational Medicine

Background:

• Advances in understanding tumor biology have led to novel targeted therapies.
• Current biomedical imaging, primarily RECIST, focuses on lesion size and lags behind therapeutic advancements.
• Existing imaging methods may misinterpret treatment effects, leading to inaccurate assessments like pseudoprogression.

Purpose of the Study:

• To review current biomedical imaging approaches for monitoring treatment response in patients with solid tumors receiving novel targeted therapies.
• To highlight promising future imaging strategies that could enhance clinical practice.
• To address the limitations of current imaging criteria (RECIST) in evaluating novel targeted agents.

Main Methods:

• Review of current biomedical imaging techniques used in clinical practice.
• Discussion of preclinical and pilot clinical trial data for novel imaging approaches.
• Analysis of imaging strategies targeting specific hallmarks of cancer.

Main Results:

• Current imaging often fails to detect early treatment success with targeted therapies.
• Pseudoprogression is a common challenge, where imaging suggests progression despite effective treatment.
• Several promising imaging approaches targeting tumor biology show potential but are not yet widely implemented.

Conclusions:

• There is a critical need for advanced imaging techniques to accurately assess responses to novel targeted therapies.
• Future imaging modalities hold the potential to improve early detection of treatment efficacy and optimize patient management.
• Bridging the gap between therapeutic innovation and imaging capabilities is essential for effective cancer treatment.