Assessing Radiological Response to Immunotherapy in Lung Cancer: An Evolving Arena

Kathrine S Rallis; Shania Makker; Aruni Ghose; Michail Sideris

doi:10.21873/cdp.10278

Assessing Radiological Response to Immunotherapy in Lung Cancer: An Evolving Arena

Cancer Diagn Progn. 2024 Jan 3;4(1):1-8. doi: 10.21873/cdp.10278. eCollection 2024 Jan-Feb.

Authors

Kathrine S Rallis^{1

2}, Shania Makker^{1

3}, Aruni Ghose^{4

5

6}, Michail Sideris^{7

8}

Affiliations

¹ Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.
² Barts Cancer Institute, Queen Mary University of London, London, U.K.
³ University College London Cancer Institute, London, U.K.
⁴ Department of Medical Oncology, Barts Cancer Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, U.K.
⁵ Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Northwood, U.K.
⁶ Department of Medical Oncology, Medway NHS Foundation Trust, Immuno-Oncology Clinical Network, Kent, U.K.
⁷ Wolfson Institute of Population Health, Cancer Research UK Barts Centre, Queen Mary University of London, London, U.K.
⁸ Department of Gynaecological Oncology, Barts Health NHS Trust, Royal London Hospital, London, U.K.

Abstract

In the past decade, immune checkpoint inhibitors (ICIs) have entered the treatment landscape of non-small-cell lung cancer, signalling a paradigm shift within the field characterized by significant survival benefits for patients with advanced and metastatic disease, and especially those with non-targetable genetic oncogenic driver mutations. However, the shift towards immune-based treatments has created new challenges in oncology. Atypical immunotherapy response patterns, including pseudo-progression and hyperprogressive disease, as well as immune-related adverse events have generated the need for new methods to predict patient response to treatment. Hence, new versions of the traditional Response Evaluation Criteria for Solid Tumors (RECIST) have emerged to help characterise with better accuracy radiological findings concerning patient response classification to immunotherapy. This review discusses response evaluation criteria relevant to unique radiological findings observed in patients treated with immunotherapy for non-small-cell lung cancer.

Keywords: ICI; Immunotherapy; NSCLC; RECIST; Response Evaluation Criteria for Solid Tumors; immune checkpoint inhibitors; nonsmall-cell lung cancer; review.

Publication types

Review