Radiological assessment of tumor response remains a challenge in patients treated with immune checkpoint inhibitors. In metastatic melanoma, for example, a spectrum of imaging response patterns to immunotherapies have been recognized and associated with clinical benefit.
In metastatic renal cell carcinoma (mRCC), less than half of patients treated with immune checkpoint inhibitors achieve objective responses, but some of the responses have been durable. In this series, five different imaging patterns of response and progression are described mRCC patients treated with anti-PD-1/PD-L1 agents: 1) early and complete response, 2) pseudo-progression, 3) disease stability before ultimate response, 4) mixed response with new lesions, and 5) early progression/primary refractory disease. The implications of the different imaging patterns of response on prognosis are discussed and highlight the need for individualized patient assessment with the use of novel immune-targeted agents.
Cancer immunology research. 2015 Nov 20 [Epub ahead of print]
Guillermo De Velasco, Katherine M Krajewski, Laurence Albiges, Mark M Awad, Joaquim Bellmunt, F Stephen Hodi, Toni K Choueiri
Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School. , Imaging, Dana-Farber Cancer Institute. , Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School. , Cancer Center, Massachusetts General Hospital. , Medical Oncology, Dana-Farber Cancer Center. , Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital. , Medical Oncology, Dana-Farber Cancer Center