[Evaluation of tumour response to treatment with targeted therapies: standard or targeted criteria?].
Evaluation of tumour response is a major concern. International criteria (WHO and Recist) have been promulgated and are overall well accepted. However, several authors drew the attention on different limitations. Some are more obvious in patients receiving a targeted therapy. The largest experience has been accumulated in patients with GIST, treated with imatinib. It became apparent that tumour size was not an early predictor of tumour response, while structural and perfusion modifications were readily observed. Meanwhile, modern imaging techniques like US, CT and MRI improved in functional and perfusion analysis, putting efforts on the vascular and interstitial compartments of the tumour that could be explored after tracer injection. Although interesting, these developments have not gone through all steps of validation and standardization that are required before large scale diffusion. In the future, it is more than likely that international criteria like WHO and RECIST will persist, though adapted and improved, and will continue to apply to most of the tumours, while functional and/or metabolic data will be provided as complementary information in specific tumours and/or in specific targeted therapies.
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Yves
Y
Service de radiologie, Hôpital de Bicêtre, 74 rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre. yves.menu@bct.ap-hop-paris.fr
D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards*; D016903:Drug Monitoring / Q000592:standards; D005060:Europe; D006801:Humans; D007390:International Agencies / Q000592:standards*; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D012015:Reference Standards; D016896:Treatment Outcome; D047368:Tumor Burden; D014944:World Health Organization