| Author/Editor | Vrankar, Martina; Unk, Mojca | |
| Title | Immune RECIST criteria and symptomatic pseudoprogression in non-small cell lung cancer patients treated with immunotherapy | |
| Type | članek | |
| Vol. and No. | Letnik 52, št. 4 | |
| Publication year | 2018 | |
| Volume | str. 365-369 | |
| ISSN | 1318-2099 - Radiology and oncology | |
| Language | eng | |
| Abstract | Uncommon responses during immunotherapy is a new challenging issue in oncology practice. Recently, new criteria for evaluation of response to immunotherapy immune response evaluation criteria solid tumors (iRECIST) were accepted. According to iRECIST, worsening of performance status (PS) accompanied to pseudoprogression reflects most probably the true progression of the malignant disease. Methods. A systematic review of the literature was made by using several electronic database with the following search criteria: symptomatic pseudoprogression, atypical response, immunotherapy and lung cancer. Results. In the literature, we identified five reports of seven patients treated with immunotherapy that met the inclusion criteria. We also report our experience of patient with pseudoprogression and almost complete response after one dose of immunotherapy. Conclusions. As seen from our review, iRECIST criteria might be insufficient in distinguishing true progression from pseudoprogression in some patients with advanced NSCLC treated with immunotherapy. More precise assessment methods are urgently needed.Nenavadni odzivi med zdravljenjem z imunoterapijo so nov izziv v vsakdanji onkološki praksi. Sprejeta so bila nova merila za oceno odziva na imunoterapijo, t.i. kriteriji iRECIST. Po teh kriterijih poslabšanje stanja zmogljivosti bolnika, pri katerem ugotavljamo pseudoprogres, predstavlja resnično napredovanje maligne bolezni. Metode. Opravili smo sistematični pregled literature z uporabo več elektronskih podatkovnih baz z naslednjimi iskalnimi kriteriji: simptomatski pseudoprogres, atipični odziv, imunoterapija in pljučni rak. Rezultati. V literaturi smo našli pet poročil o sedmih bolnikih z rakom pljuč, ki so jih zdravili z imunoterapijo in so izpolnjevali merila za vključitev v analizo. V članku smo predstavili tudi izkušnjo bolnice s pseudoprogresom po le enem odmerku imunoterapije, ki smo jo zdravili na Onkološkem inštitutu v Ljubljani. Zaključki. Po pregledu literature in na podlagi našega primera ugotavljamo, da kriteriji iRECIST za odgovor na imunoterapijo pri nekaterih bolnikih z nedrobnoceličnim rakom pljuč ne zadoščajo za razlikovanje pravega napredovanja rakave bolezni od pseudoprogresa. Nujno potrebujemo natančnejše metode za ocenjevanje odgovora na zdravljenje z imunoterapijo. | |
| Keywords | simptomatski psevdoprogres atipičen odgovor imunoterapija rak pljuč symptomatic pseudoprogression atypical response immunotherapy lung cancer |