Author(s): Georgina Hopkinson, Dr Jonathan Taylor, Dr Peter Metherall, Dr Edward Johnston, Judith Sugden, Dr Christina Messiou

Hospital: The Royal Marsden Hospital NHS Foundation Trust, Sheffield Teaching Hospitals NHS Foundation Trust

Reference: RAD Magazine, 48, 564, 25-26

Excerpt: 

The assessment of change in tumour burden is a crucial step for the evaluation of the activity and efficacy of novel cancer therapies in solid tumours. Clinical trials require imaging to be evaluated according to specific evaluation criteria to determine disease status. The most employed is Response Evaluation Criteria in Solid Tumours (RECIST v1.1). However, more recently, adaptations for use in immunotherapy trials such as iRECIST, mRECIST for mesothelioma and others are proposed.

The patient is scanned, usually with CT of the chest, abdomen and pelvis, before the treatment begins as a baseline. They are rescanned at regular intervals with the same imaging to allow comparison of disease burden. Prompt discontinuation of an ineffective trial medication is essential to allow the patient to remain well enough to be eligible for an alternative option. Some anti-cancer therapies have significant side effects, and the cost implications of administering an ineffective treatment are also a consideration.