Hillman Cancer Center - Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Adv Exp Med Biol. 2020;1244:309-324. doi: 10.1007/978-3-030-41008-7_18.
Immune therapeutics are revolutionizing cancer treatments. In tandem, new and confounding imaging characteristics have appeared that are distinct from those typically seen with conventional cytotoxic therapies. In fact, only 10% of patients on immunotherapy may show tumor shrinkage, typical of positive responses on conventional therapy. Conversely, those on immune therapies may initially demonstrate a delayed response, transient enlargement followed by tumor shrinkage, stable size, or the appearance of new lesions. New imaging response criteria, such as the immune-related Response Evaluation Criteria in Solid Tumors (irRECIST) and immune-related Response Criteria (irRC), are being implemented in many trials. However, FDA approval of emerging therapies, including immunotherapies, still relies on the current RECIST criteria. In this chapter, we review the traditional and new imaging response criteria for evaluation of solid tumors and briefly touch on some of the more commonly associated immunotherapy-induced adverse events.
免疫疗法正在彻底改变癌症治疗。与此同时，新的、令人困惑的成像特征也出现了，与传统细胞毒性疗法通常所见的特征明显不同。事实上，只有 10%的免疫治疗患者可能出现肿瘤缩小，这是传统疗法阳性反应的典型表现。相反，那些接受免疫治疗的患者最初可能表现出延迟反应，短暂增大后肿瘤缩小，肿瘤大小稳定，或出现新的病灶。新的成像反应标准，如实体瘤免疫相关反应评估标准（irRECIST）和免疫相关反应标准（irRC），正在许多试验中实施。然而，新兴疗法（包括免疫疗法）的 FDA 批准仍然依赖于当前的 RECIST 标准。在这一章中，我们回顾了用于评估实体瘤的传统和新的成像反应标准，并简要介绍了一些更常见的与免疫疗法相关的不良反应。
