免疫检查点抑制剂的真实反应评估：黑色素瘤和非小细胞肺癌患者的 iRECIST 和 RECIST 1.1 比较

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2024-09-18 DOI:10.1007/s00330-024-11060-4

Christian Nelles, Moritz Gräf, Pascale Bernard, Thorsten Persigehl, Nils Große Hokamp, David Zopfs, David Maintz, Nicole Kreuzberg, Jürgen Wolf, Paul J. Bröckelmann, Simon Lennartz

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引用次数: 0

摘要

目的比较用于黑色素瘤和非小细胞肺癌 (NSCLC) 患者免疫检查点抑制剂 (ICI) 治疗反应评估的实体瘤免疫反应评估标准 (iRECIST) 和实体瘤反应评估标准 (RECIST) 1.1。方法回顾性纳入了252例黑色素瘤和NSCLC患者，这些患者接受了CTLA-4抑制剂伊匹单抗或PD-1抑制剂尼妥珠单抗或pembrolizumab治疗，并接受了胸部和腹部的分期CT检查。根据 RECIST 1.1 和 iRECIST 指南对所有患者进行了治疗反应评估。比较了 RECIST 1.1 和 iRECIST 的反应模式以及总反应率 (ORR)、疾病控制率 (DCR) 和进展时间 (TTP)。结果在 143 例根据 RECIST 1.1 诊断为疾病进展 (PD) 的患者中，有 48 例（33.6%）未根据 iRECIST 获得疾病进展确认 (iCPD)，6 例在 RECIST 1.1 进展后接受治疗的患者在 iRECIST 的较晚时间点达到 PD，导致 iRECIST 和 RECIST 1.1 的 TTP 显著不同（分别为 618.3 ± 626.9 天 vs. 538.1 ± 617.9 天 (p <0.05)）。根据 RECIST 1.1，无应答者为 79 人，而使用 iRECIST 时为 60 人。RECIST1.1的ORR为28.5%，iRECIST为34.1%；RECIST1.1的相应DCR为67.4%，iRECIST为74.6%。结论iRECIST比RECIST1.1更适合捕捉黑色素瘤和NSCLC患者对ICI治疗的非典型反应模式，从而导致治疗反应评估的差异。iRECIST 更适合评估非小细胞肺癌和黑色素瘤患者对免疫检查点抑制剂的反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Real-world response assessment of immune checkpoint inhibition: comparing iRECIST and RECIST 1.1 in melanoma and non-small cell lung cancer patients

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Real-world response assessment of immune checkpoint inhibition: comparing iRECIST and RECIST 1.1 in melanoma and non-small cell lung cancer patients

Objectives

To compare immune response evaluation criteria in solid tumors (iRECIST) and response evaluation criteria in solid tumors (RECIST) 1.1 for response assessment of immune checkpoint inhibitor (ICI) therapy in a real-world setting in patients with melanoma and non-small cell lung cancer (NSCLC).

Methods

Two-hundred fifty-two patients with melanoma and NSCLC who received CTLA-4 inhibitor ipilimumab or PD-1 inhibitors nivolumab or pembrolizumab and who underwent staging CT of the chest and abdomen were retrospectively included. Treatment response evaluation according to the RECIST 1.1 and iRECIST guidelines was performed for all patients. Response patterns, as well as overall response rate (ORR), disease control rate (DCR), and time to progression (TTP), were compared between RECIST 1.1 and iRECIST.

Results

Out of 143 patients with progressive disease (PD) according to RECIST 1.1, 48 (33.6%) did not attain confirmation of progression (iCPD) as per iRECIST and six patients who were treated beyond RECIST 1.1 progression reached PD at a later point in time in iRECIST, resulting in a significant difference in TTP between iRECIST and RECIST 1.1 (618.3 ± 626.9 days vs. 538.1 ± 617.9 days, respectively (p < 0.05)). The number of non-responders as per RECIST 1.1 was 79, whereas it was 60 when using iRECIST. ORR was 28.5% for RECIST 1.1 and 34.1% for iRECIST, and corresponding DCR of 67.4% for RECIST 1.1 and 74.6% for iRECIST.

Conclusion

iRECIST was more suitable than RECIST 1.1 for capturing atypical response patterns to ICI therapy in patients with melanoma and NSCLC, resulting in differences in the assessment of treatment response.

Clinical relevance statement

Compared to RECIST 1.1, iRECIST may improve patient care and treatment decisions for patients with NSCLC or melanoma who are treated with immune checkpoint inhibitors in clinical routine.

Key Points

RECIST 1.1 may incorrectly assess atypical treatment patterns to immune checkpoint inhibitors.
iRECIST better captured atypical response patterns compared to RECIST 1.1.
iRECIST was more suitable for assessing response to immune checkpoint inhibitors in non-small cell lung carcinoma and melanoma.

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.