'Primary Index Lesion' Useful Treatment Response Biomarker
Using existing guidelines to measure response in lesion helps predict liver cancer outcomes
TUESDAY, March 16 (HealthDay News) -- In patients treated with locoregional chemotherapy or radiotherapy for hepatocellular carcinoma, assessment of changes to the largest tumor targeted in the first round of treatment, the "primary index lesion," is a useful biomarker of response to treatment when existing guidelines are applied, according to a study in the March 17 issue of the Journal of the American Medical Association.
Ahsun Riaz, M.D., of Northwestern Memorial Hospital in Chicago, and colleagues write that three sets of treatment response guidelines are commonly used to assess response to therapy for hepatocellular carcinoma -- Response Evaluation Criteria in Solid Tumors (RECIST), World Health Organization (WHO), and European Association for Study of the Liver (EASL) -- but that there is no universally accepted standard. They conducted a study of 245 hepatocellular carcinoma patients who underwent chemoembolization or radioembolization, and reviewed 1,065 scans to look at the primary index lesion. They analyzed the extent to which the three sets of guidelines concurred in terms of assessment of treatment response in this lesion.
In all, 113 patients died and 96 had disease progression, the researchers note. There was a high degree of concurrence in classification of treatment response between the WHO and RECIST guidelines, the investigators found. However, both sets of guidelines had a low correlation with the EASL guidelines.
"Application of these methods to measure response in a primary index lesion resulted in statistically significant correlations with disease progression and survival," the authors write. "This may potentially lead to simplification, reproducibility, and standardization of imaging assessment guidelines in locoregional therapies."
Two authors reported financial relationships with MDS Nordion.