Universität zu Köln

Lennartz, Simon, Diederich, Stefan, Doehn, Christian, Gebauer, Bernhard, Gruenwald, Viktor, Notohamiprodjo, Mike, Sommer, Wieland, Schlemmer, Heinz-Peter and Persigehl, Thorsten (2020). Radiological Monitoring of Modern Immunotherapy: A Novel Challenge for Interdisciplinary Patient Care. Rofo-Fortschr. Gebiet Rontgenstrahlen Bildgeb. Verfahr., 192 (3). S. 235 - 245. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9010

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Abstract

Background Immunotherapy represents an effective therapeutic approach for many malignant diseases that were previously difficult to treat. However, since immunotherapy can lead to atypical therapy response patterns in the form of pseudo-progression or mixed responses and comprise an altered spectrum of adverse reactions, they present a new challenge for oncologic imaging. Detailed knowledge in this area is essential for oncologic clinical radiologists, since the radiological report is a cornerstone of response assessment, and increasingly influences therapy regimens and coverage by health insurances. Method This white paper is based on an expert meeting in Frankfurt am Main and subsequent discussions between the authors. Based on the iRECIST criteria, it is intended to provide orientation for a response assessment of oncologic patients undergoing immunotherapy that can be applied in the clinical routine. Results Radiological therapy monitoring outside clinical studies is subject to inherent limitations, but should be performed based on iRECIST criteria, according to the opinion of the expert panel. It should be taken into account that immunotherapies can in principle lead to pseudo-progression and autoimmunological side effects. Since radiological follow-up is currently the only method to accurately distinguish real progressive disease from pseudo-progression, clinically stable patients with disease progression under immunotherapy should undergo additional short-term follow-up imaging according to the suspected diagnosis. Biopsy should be used cautiously and predominately in curative settings. Conclusion For response assessment of immunotherapy in clinical studies, the new iRECIST criteria were published in 2017. Outside studies, the application of iRECIST criteria in the clinical routine is subject to several limitations. The recommendations implied in these criteria can, however, be used in conjunction with the current literature as a guideline in clinical practice and outside studies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Diederich, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Doehn, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebauer, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruenwald, Viktor UNSPECIFIED UNSPECIFIED UNSPECIFIED Notohamiprodjo, Mike UNSPECIFIED UNSPECIFIED UNSPECIFIED Sommer, Wieland UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlemmer, Heinz-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-343472
DOI:	10.1055/a-1015-6869
Journal or Publication Title:	Rofo-Fortschr. Gebiet Rontgenstrahlen Bildgeb. Verfahr.
Volume:	192
Number:	3
Page Range:	S. 235 - 245
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9010
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMMUNE-RELATED RESPONSE; CELL LUNG-CANCER; CLINICAL ACTIVITY; OPEN-LABEL; NIVOLUMAB; PSEUDOPROGRESSION; PEMBROLIZUMAB; CARCINOMA; RECURRENT; THERAPY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34347