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Volume 7
OMICS Journal of Radiology
Radiology and Oncology 2018
July 16-17, 2018
Page 43
conference
series
.com
July 16-17, 2018 Dubai, UAE
Radiology and Oncology
2
nd
World Congress on
Notes:
Judging response to cancer therapy RECIST and Beyond
M
onitoring response after treatment of cancer is an integral component of oncology practice. Objective tumor shrinkage
has been widely regarded as a standard to judge response and is routinely used in everyday clinical practice to guide
clinical decision-making. Imaging studies play a critical role in quantifying tumor response. The World Health Organization
in 1979 laid down the WHO criteria for response assessment. The European organization for research and treatment of
cancer came up with Response Evaluation Criteria in Solid Tumors in the year 2000 (RECIST). The RECIST documentation
goes beyond lesion selection, measurement and assessment of response. It also makes specific recommendations on the
usage of imaging techniques. RECIST was modified in 2009 to RECIST 1.1 which is the current standard for objective
response assessment in most solid tumors. However, both WHO and RECIST criteria have relied upon size alone. It is
well-known that cancer response to treatment is not always by reduction in size alone. RECIST doesn't work very well
with Gastro Intestinal Stromal Tumors (GIST), mesotheliomas and Hepato Cellular Carcinoma (HCC) after locoregional
therapies such as TACE and ablative treatments. For this reason, modified RECIST criteria (mRECIST) for HCC and Choi
criteria for GIST have evolved. With many new anti-cancer drugs, particularly molecular targeted therapies, decrease in
metabolic activity precedes any reduction in size. Also, very often as in lymphomas a non-viable residual mass without any
viable tumor tissue may continue to be seen. As such PET-CT is being increasingly used today to monitor response. It is
a part of the new PERCIST criteria and is the standard tool in assessing response in lymphomas. With increasing use of
molecular targeted therapies and immunotherapy to treat many advanced cancers there is a fundamental change in the way
cancers may respond. Cancer specific and therapy specific response criteria have become relevant in an era of personalized
medicine. Paradoxically increase in size and even appearance of a new lesion may well be a part of the initial response in
immunotherapy. The evolution of response criteria, going beyond RECIST and evaluation of cancer and therapy specific
response is the primary objective of this study.
Biography
Arvind K Chaturvedi is currently the Chair of the Department of Radiology at the Rajiv Gandhi Cancer Institute & Research Centre, India. He has also served as
the Medical Director of the Institute from 2006 to 2010. He is directing Oncological Radiology Fellowship program and has the distinction of having trained many
international radiologists. He is a Member of Radiological Society of North America, European Society of Radiology, Breast Imaging Society of India and Indian
Radiological and Imaging Association.
arvindatdelhi@yahoo.comArvind K Chaturvedi
Rajiv Gandhi Cancer Institute & Research Centre, India
Arvind K Chaturvedi, OMICS J Radiol 2018, Volume 7
DOI: 10.4172/2167-7964-C1-020