title: Tumour growth kinetics assessment: added value to RECIST in cancer patients treated with molecularly targeted agents.
abstract: BACKGROUND
  Treatment effect is categorised into four classes by RECIST based on the evolution of the size of target lesions and the occurrence of new lesions, irrespective of tumour growth kinetics before treatment. This study aimed at evaluating the added value of tumour growth kinetics assessment to RECIST in patients treated with molecularly targeted agents (MTAs).
  
  
  METHODS
  On-study imaging, along with pre-baseline imaging, of patients treated with MTA(s) in clinical trials at Institut Curie were centrally reviewed. The tumour growth ratio (TGr), defined as the ratio of the slope of tumour growth before treatment and the slope of tumour growth on treatment between the nadir and disease progression, was calculated for each patient.
  
  
  RESULTS
  A total of 50 patients included in 18 trials were eligible for the study. Among the 44 patients who withdrew from the study because of disease progression according to the investigators' assessment, 18 patients (41%) had a TGr <0.9. Among these 18 patients, 5 had disease progression according to RECIST 1.1 based on our retrospective reassessment of on-study imaging and occurrence of no new lesion during study treatment.
  
  
  CONCLUSIONS
  Our preliminary results suggest that a substantial proportion of patients treated with MTAs have discontinued treatment although being potentially benefitted from them.
authors.affiliation: Department of Medical Oncology, Institut Curie, 26, rue d'Ulm, 75248 Paris Cedex 05, France. Christophe.LeTourneau@curie.net
authors.forename: C
authors.initials: C
authors.lastname: Le Tourneau
authors.forename: V
authors.initials: V
authors.lastname: Servois
authors.forename: V
authors.initials: V
authors.lastname: Diéras
authors.forename: L
authors.initials: L
authors.lastname: Ollivier
authors.forename: P
authors.initials: P
authors.lastname: Tresca
authors.forename: X
authors.initials: X
authors.lastname: Paoletti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D049109:Cell Proliferation; D003952:Diagnostic Imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents