Subbiah Vivek, Chuang Hubert H, Gambhire Dhiraj, Kairemo Kalevi
Departments of Investigational Cancer Therapeutics, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Diagnostics (Basel). 2017 Feb 15;7(1):10. doi: 10.3390/diagnostics7010010.
In this era of precision oncology, there has been an exponential growth in the armamentarium of genomically targeted therapies and immunotherapies. Evaluating early responses to precision therapy is essential for "go" versus "no go" decisions for these molecularly targeted drugs and agents that arm the immune system. Many different response assessment criteria exist for use in solid tumors and lymphomas. We reviewed the literature using the Medline/PubMed database for keywords "response assessment" and various known response assessment criteria published up to 2016. In this article we review the commonly used response assessment criteria. We present a decision tree to facilitate selection of appropriate criteria. We also suggest methods for standardization of various response assessment criteria. The relevant response assessment criteria were further studied for rational of development, key features, proposed use and acceptance by various entities. We also discuss early response evaluation and provide specific case studies of early response to targeted therapy. With high-throughput, advanced computing programs and digital data-mining it is now possible to acquire vast amount of high quality imaging data opening up a new field of "omics in radiology"-radiomics that complements genomics for personalized medicine. Radiomics is rapidly evolving and is still in the research arena. This cutting-edge technology is poised to move soon to the mainstream clinical arena. Novel agents with new mechanisms of action require advanced molecular imaging as imaging biomarkers. There is an urgent need for development of standardized early response assessment criteria for evaluation of response to precision therapy.
在这个精准肿瘤学时代，基因组靶向治疗和免疫治疗的手段呈指数级增长。评估对精准治疗的早期反应对于这些武装免疫系统的分子靶向药物和制剂的“继续”或“停止”决策至关重要。实体瘤和淋巴瘤有许多不同的反应评估标准可供使用。我们使用Medline/PubMed数据库，以“反应评估”以及截至2016年发表的各种已知反应评估标准为关键词检索文献。在本文中，我们回顾了常用的反应评估标准。我们提出了一个决策树以方便选择合适的标准。我们还建议了各种反应评估标准的标准化方法。对相关反应评估标准的制定原理、关键特征、建议用途及各实体的接受情况进行了进一步研究。我们还讨论了早期反应评估，并提供了靶向治疗早期反应的具体案例研究。借助高通量、先进的计算程序和数字数据挖掘，现在有可能获取大量高质量的影像数据，从而开辟了一个“放射组学”的新领域——它是“放射学中的组学”，可补充基因组学用于个性化医疗。放射组学正在迅速发展，仍处于研究阶段。这项前沿技术很快将进入主流临床领域。具有新作用机制的新型药物需要先进的分子影像作为影像生物标志物。迫切需要制定标准化的早期反应评估标准来评估对精准治疗的反应。
