International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017)

Abstract

In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new “basket” clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.

Adolescent and young adult Hodgkin lymphoma: Raising the bar through collaborative science and multidisciplinary care

“…Incidence rates in non-Hispanic white 15-to 19-year-olds are between 3.4 and 3.7/100,000 versus 1.9-2.2/100,000 in non-Hispanic black patients. 4 This difference converges by [35][36][37][38][39] years. Population-based analyses suggest that place of birth is associated with HL incidence in Hispanic and Asian/Pacific Islanders from 20 to 39 years; those born in the United States have higher rates of HL compared to their foreign-born counterparts.…”

“…Thus, despite multiple secondary analyses, debates about optimal up‐front chemotherapy or appropriate use of RT in AYAs with HL remain unresolved. New efforts to harmonize response criteria and risk stratification are underway, which will allow direct comparison of outcomes across future trials . The recent NCI Trials Planning Consensus included a call for AYA‐specific clinical trials .…”

Interim PET/CT based on visual and semiquantitative analysis predicts survival in patients with diffuse large B‐cell lymphoma

“…In fact, a combination of changes in tumor size on CT and changes in SUVmax has been explored and may predict progression‐free survival (PFS) better than either test alone in Hodgkin's lymphoma . Furthermore, the Lugano criteria were challenged more recently . The change in tumor burden became a very important element in the International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017) .…”

“…19,20 Furthermore, the Lugano criteria were challenged more recently. 21,22 The change in tumor burden became a very important element in the International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017). 21 In the RECIL 2017 criteria, partial response (PR) is defined as a reduction in the sum of longest diameters (SLD) of targets by ≥30% but with a positive PET (DS 4-5).…”

“…21,22 The change in tumor burden became a very important element in the International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017). 21 In the RECIL 2017 criteria, partial response (PR) is defined as a reduction in the sum of longest diameters (SLD) of targets by ≥30% but with a positive PET (DS 4-5). Furthermore, stable disease (SD) and progressive disease (PD) are defined based on changes in SLD, irrespective of PET scan results.…”