Oncology 1 Unit, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy.
Department of Surgery, Oncology and Gastroenterology, University of Padua., Padua, Italy.
Tumori. 2023 Dec;109(6):562-569. doi: 10.1177/03008916231188157. Epub 2023 Jul 28.
Evaluation of tumor response according only to dimensional criteria may underestimate treatment benefit in patients treated for metastatic renal cell carcinoma (RCC). In this study we evaluated the role of lesion enhancement modifications and Choi criteria in patients affected by renal cell carcinoma treated with immunotherapy.
We collected data of 60 consecutive patients (with a total of 154 measurable lesions) treated with immunotherapy (nivolumab or ipilimumab plus nivolumab) at a single Institution. We evaluated tumour response using both RECIST1.1 criteria and Choi criteria at the first radiological assessment; we subsequently associated response with progression free survival and overall survival.
Choi criteria found a higher rate of objective response compared to RECIST criteria (38.3% vs 18.3%). An objective response according to both criteria was associated with longer progression free survival and overall survival. Response rate for Choi did not vary according to lesion site.
Choi criteria seemed to be able to predict clinical benefit in a higher proportion of patients with renal cell carcinoma treated with immunotherapy than RECIST criteria. Partial response according to RECIST was confirmed as a predictor of longer progression-free survival and overall survival.
仅根据肿瘤尺寸标准评估肿瘤反应可能会低估转移性肾细胞癌(RCC)患者的治疗获益。在这项研究中,我们评估了病变强化改变和 Choi 标准在接受免疫治疗的肾细胞癌患者中的作用。
我们在一家机构中收集了 60 例连续患者(共 154 个可测量病变)的免疫治疗(nivolumab 或 ipilimumab 加 nivolumab)数据。我们在第一次影像学评估时同时使用 RECIST1.1 标准和 Choi 标准评估肿瘤反应;随后,我们将反应与无进展生存期和总生存期相关联。
与 RECIST 标准相比,Choi 标准发现客观反应的发生率更高(38.3%比 18.3%)。根据这两个标准的客观反应与更长的无进展生存期和总生存期相关。根据 Choi 标准,反应率与病变部位无关。
Choi 标准似乎能够比 RECIST 标准在更高比例的接受免疫治疗的肾细胞癌患者中预测临床获益。RECIST 标准的部分反应被确认为无进展生存期和总生存期延长的预测因素。