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Tumor Pseudoprogression

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https://read.qxmd.com/read/30769193/the-roles-of-fdg-pet-ct-in-predicting-the-adverse-effects-of-chimeric-antigen-receptor-t-cell-therapy-treating-patients-with-non-hodgkin-lymphoma
#1
Jiasheng Wang, Yongxian Hu, Shuye Yang, Guoqin Wei, Xin Zhao, Wenjun Wu, Yanlei Zhang, Yafei Zhang, Donghe Chen, Zhao Wu, Lei Xiao, Alex Hongsheng Chang, He Huang, Kui Zhao
BACKGROUND: CD19-targeting chimeric antigen receptor (CAR) T cell therapy has shown great efficacy in patients with relapsed/refractory non-Hodgkin lymphoma (NHL), but has been associated with serious adverse effects such as cytokine release syndrome (CRS). It has been speculated that NHL baseline disease burden might affect clinical outcome and CRS, but such assumption has not been explored in detail. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG), as measured by FDG PET-CT, are quantitative indicators of baseline tumor burden...
February 12, 2019: Biology of Blood and Marrow Transplantation
https://read.qxmd.com/read/30734514/unusual-radiologic-manifestation-of-pseudoprogression-in-pulmonary-metastases-after-durvalumab-treatment-in-metastatic-bladder-urothelial-cancer
#2
Eun Young Kim, Inkeun Park, Young Saing Kim, Hee Kyung Ahn, Hee Young Lee, Jeong Ho Kim
Durvalumab is an immune checkpoint inhibitor that blocks PD-L1. Unlike cytotoxic chemotherapy or molecularly targeted agents, immune checkpoint inhibitors occasionally present distinct response patterns, including radiologic pseudoprogression (initial tumor enlargement with subsequent tumor regression) and immune-related adverse events in normal tissues. We report a case of unusual computed tomography (CT) findings of pseudoprogression of pulmonary metastases in a patient with metastatic bladder cancer after durvalumab treatment: multiple pulmonary metastases turned into ground-glass opacity on first follow-up CT; on second follow-up CT, and after sustained treatment of the PD-L1 inhibitor, the lesion was resolved...
February 7, 2019: Thoracic Cancer
https://read.qxmd.com/read/30718844/the-beginning-of-the-end-for-conventional-recist-novel-therapies-require-novel-imaging-approaches
#3
REVIEW
Mirjam Gerwing, Ken Herrmann, Anne Helfen, Christoph Schliemann, Wolfgang E Berdel, Michel Eisenblätter, Moritz Wildgruber
Owing to improvements in our understanding of the biological principles of tumour initiation and progression, a wide variety of novel targeted therapies have been developed. Developments in biomedical imaging, however, have not kept pace with these improvements and are still mainly designed to determine lesion size alone, which is reflected in the Response Evaluation Criteria in Solid Tumors (RECIST). Imaging approaches currently used for the evaluation of treatment responses in patients with solid tumours, therefore, often fail to detect successful responses to novel targeted agents and might even falsely suggest disease progression, a scenario known as pseudoprogression...
February 4, 2019: Nature Reviews. Clinical Oncology
https://read.qxmd.com/read/30694757/the-emerging-role-of-surgery-for-patients-with-advanced-melanoma-treated-with-immunotherapy
#4
Charles J Puza, Elizabeth Schell Bressler, Alicia M Terando, J Harrison Howard, Michael C Brown, Brent Hanks, April K S Salama, Georgia M Beasley
BACKGROUND: The emergence of immune checkpoint inhibitors (ICIs) has improved survival for patients with metastatic melanoma. The types of disease-response patterns to ICI therapy can be more complex relative to traditional chemotherapy and include mixed responses, pseudoprogression, and oligoprogression. The potential benefit of surgery after incomplete response to ICI therapy has not been explored. The purpose of this study was to explore outcomes of surgery after ICI therapy in patients with metastatic melanoma...
December 20, 2018: Journal of Surgical Research
https://read.qxmd.com/read/30684665/outcomes-following-proton-therapy-for-pediatric-low-grade-glioma
#5
Daniel J Indelicato, Ronny L Rotondo, Haruka Uezono, Eric S Sandler, Philipp R Aldana, Nathan J Ranalli, Alexandra D Beier, Christopher G Morris, Julie A Bradley
BACKGROUND/OBJECTIVES: Dosimetric studies show that proton therapy can reduce the low/intermediate radiation dose to uninvolved tissue in children with low-grade glioma (LGG). For this reason, LGG is the 4th most common pediatric tumor treated with proton therapy, yet clinical outcome data on efficacy and toxicity are limited. DESIGN/METHODS: We reviewed the medical records of 174 children (≤21 years old) with non-metastatic LGG enrolled on a prospective protocol and treated with proton therapy between 2007 and 2017 to assess clinical outcomes and toxicity, and analyze patient, tumor, and treatment-related variables...
January 23, 2019: International Journal of Radiation Oncology, Biology, Physics
https://read.qxmd.com/read/30666091/hyperprogression-after-anti-programmed-cell-death-ligand-1-therapy-in-a-patient-with-recurrent-metastatic-urothelial-bladder-carcinoma-following-first-line-cisplatin-based-chemotherapy-a-case-report
#6
Shiyu Mao, Junfeng Zhang, Yadong Guo, Ziwei Zhang, Yuan Wu, Wentao Zhang, Longsheng Wang, Jiang Geng, Yang Yan, Xudong Yao
Background: Immune checkpoint blockade targeting programmed cell death ligand-1 (PD-L1)/programmed death-1 (PD-1) signaling was approved recently for locally advanced and metastatic urothelial bladder carcinoma (UBC). Some patients experience a very rapid tumor progression, rather than clinical benefit, from anti-PD-L1/PD-1 therapy. Case presentation: A 58-year-old male diagnosed with non-muscle-invasive bladder cancer 3 years ago received transurethral resection of bladder tumor (TURBT) and intravesical chemotherapy...
2019: Drug Design, Development and Therapy
https://read.qxmd.com/read/30659892/longitudinal-mri-findings-in-patients-with-newly-diagnosed-glioblastoma-after-intraoperative-radiotherapy
#7
Alex Förster, Johannes Böhme, Máté E Maros, Stefanie Brehmer, Marcel Seiz-Rosenhagen, Daniel Hänggi, Frederik Wenz, Christoph Groden, Whitney B Pope, Frank A Giordano
BACKGROUND AND PURPOSE: Postradiation treatment effects (pseudoprogression/radionecrosis) may bias MRI-based tumor response evaluation. To understand these changes specifically after high doses of radiotherapy, we analyzed MRIs of patients enrolled in the INTRAGO study (NCT02104882), a phase I/II dose-escalation trial of intraoperative radiotherapy (20-40 Gy) in glioblastoma. METHODS: INTRAGO patients were evaluated and compared to control patients who received standard therapy with focus on contrast enhancement patterns/volume, T2 lesion volume, and mean rCBV...
January 16, 2019: Journal of Neuroradiology. Journal de Neuroradiologie
https://read.qxmd.com/read/30657859/novel-patterns-of-response-under-immunotherapy
#8
E Borcoman, Y Kanjanapan, S Champiat, S Kato, V Servois, R Kurzrock, S Goel, P Bedard, C Le Tourneau
Novel patterns of response and progression to immunotherapy have been reported that are not observed with conventional cytotoxic or targeted anti-cancer treatments. A major breakthrough with immunotherapy is potential to achieve durable responses in a subset of patients with advanced cancer that can be maintained several years even after stopping treatment. No standardized definition of durable response exists in the literature, and the optimal duration of treatment in case of durable response is not clearly established...
January 18, 2019: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://read.qxmd.com/read/30604393/contrast-enhancing-spots-as-a-new-pattern-of-late-onset-pseudoprogression-in-glioma-patients
#9
Martin Voss, Kea Franz, Joachim P Steinbach, Emmanouil Fokas, Marie-Thérèse Forster, Katharina Filipski, Elke Hattingen, Marlies Wagner, Stella Breuer
INTRODUCTION: Magnet resonance imaging (MRI) of gliomas is assessed by Response Assessment in Neuro-Oncology Criteria (RANO), which define new contrast-enhancing lesions as a sign for tumor recurrence. Pseudoprogression after radiotherapy may mimic tumor progression in MRI but is usually limited to the first months after irradiation. We noted a late onset pattern of new contrast-enhancing spots (NCES) appearing years after radiotherapy. METHODS: We prospectively collected 23 glioma patients with 26 NCES (three patients had two separate NCES events) between 2014 and 2016 in our weekly tumor board without further selection by diagnosis, molecular markers or pretreatment...
January 2, 2019: Journal of Neuro-oncology
https://read.qxmd.com/read/30562198/point-spread-function-reconstruction-for-integrated-18f-fet-pet-mri-in-patients-with-glioma-does-it-affect-suvs-and-respective-tumor-to-background-ratios
#10
Julian Manuel Michael Rogasch, Josefine Albers, Ferdinand L Steinkrüger, Mathias Lukas, Florian Wedel, Holger Amthauer, Christian Furth
PURPOSE: Semiquantitative F-FET PET assessment using the tumor's SUV or tumor-to-background ratios (TBRs) can separate gliomas from peritumoral tissue or progression from pseudoprogression. This study investigated if point spread function (PSF) reconstruction of F-FET PET data affects SUV-based dignity assessment. MATERIALS AND METHODS: This study is a retrospective analysis of 87 glioma patients (female, 36; male, 51; age, 48 [13-81] years) undergoing F-FET PET/MRI for staging (n = 17) or restaging (n = 70)...
December 17, 2018: Clinical Nuclear Medicine
https://read.qxmd.com/read/30561164/perfusion-mri-in-treatment-evaluation-of-glioblastomas-clinical-relevance-of-current-and-future-techniques
#11
Bart R J van Dijken, Peter Jan van Laar, Marion Smits, Jan Willem Dankbaar, Roelien H Enting, Anouk van der Hoorn
Treatment evaluation of patients with glioblastomas is important to aid in clinical decisions. Conventional MRI with contrast is currently the standard method, but unable to differentiate tumor progression from treatment-related effects. Pseudoprogression appears as new enhancement, and thus mimics tumor progression on conventional MRI. Contrarily, a decrease in enhancement or edema on conventional MRI during antiangiogenic treatment can be due to pseudoresponse and is not necessarily reflective of a favorable outcome...
January 2019: Journal of Magnetic Resonance Imaging: JMRI
https://read.qxmd.com/read/30523049/genome-wide-sequencing-of-cell-free-dna-identifies-copy-number-alterations-that-can-be-used-for-monitoring-response-to-immunotherapy-in-cancer-patients
#12
Taylor J Jensen, Aaron M Goodman, Shumei Kato, Christopher K Ellison, Gregory A Daniels, Lisa Kim, Prachi Nakashe, Erin McCarthy, Amin R Mazloom, Graham McLennan, Daniel S Grosu, Mathias Ehrich, Razelle Kurzrock
Inhibitors of the PD-1/PD-L1/CTLA4 immune checkpoint pathway have revolutionized cancer treatment. Indeed, some patients with advanced, refractory malignancies achieve durable responses; however, only a subset of patients benefit, necessitating new biomarkers to predict outcome. Interrogating cell-free DNA (cfDNA) isolated from plasma (liquid biopsy) provides a promising method for monitoring response. We describe the use of low-coverage, genome-wide sequencing of cfDNA, validated extensively for non-invasive prenatal testing (NIPT), to detect tumor-specific copy number alterations, and the development of a new metric--the genome instability number (GIN)--to monitor response to these drugs...
December 6, 2018: Molecular Cancer Therapeutics
https://read.qxmd.com/read/30487391/the-emerging-role-of-amino-acid-pet-in-neuro-oncology
#13
REVIEW
Amer M Najjar, Jason M Johnson, Dawid Schellingerhout
Imaging plays a critical role in the management of the highly complex and widely diverse central nervous system (CNS) malignancies in providing an accurate diagnosis, treatment planning, response assessment, prognosis, and surveillance. Contrast-enhanced magnetic resonance imaging (MRI) is the primary modality for CNS disease management due to its high contrast resolution, reasonable spatial resolution, and relatively low cost and risk. However, defining tumor response to radiation treatment and chemotherapy by contrast-enhanced MRI is often difficult due to various factors that can influence contrast agent distribution and perfusion, such as edema, necrosis, vascular alterations, and inflammation, leading to pseudoprogression and pseudoresponse assessments...
November 28, 2018: Bioengineering
https://read.qxmd.com/read/30482243/atypical-response-with-bone-pseudoprogression-in-a-patient-receiving-nivolumab-for-advanced-cutaneous-squamous-cell-carcinoma
#14
Leandro J C Oliveira, Aline B L Gongora, Felipe G Barbosa, Carlos H Dos Anjos, Rodrigo R Munhoz
Currently, there is no established standard of care for patients with metastatic CSCC. Based on the mechanisms of CSCC carcinogenesis has been postulated that these tumors may be amenable to PD-1/PD-L1 blockade.This case illustrates a patient with CSCC with nodal involvement and pulmonary metastases, refractory to two lines of platinum-based regimens and salvage surgery, for whom treatment with nivolumab was recommended. His clinical course was marked by an atypical pattern of response, with initial reduction of soft tissue/visceral lesions, yet development of new bone findings, followed by overall improvement in subsequent scans and sustained disease control upon treatment continuation...
November 27, 2018: Journal for Immunotherapy of Cancer
https://read.qxmd.com/read/30468872/pseudoprogression-in-previously-treated-patients-with-non-small-cell-lung-cancer-who-received-nivolumab-monotherapy-a-multicenter-retrospective-cohort-study
#15
Daichi Fujimoto, Hiroshige Yoshioka, Yuki Kataoka, Takeshi Morimoto, Tae Hata, Young Hak Kim, Keisuke Tomii, Tadashi Ishida, Masataka Hirabayashi, Satoshi Hara, Manabu Ishitoko, Yasushi Fukuda, Moon Hee Hwang, Naoki Sakai, Motonari Fukui, Hitoshi Nakaji, Mitsunori Morita, Tadashi Mio, Takehiro Yasuda, Takakazu Sugita, Toyohiro Hirai
INTRODUCTION: Nivolumab is effective in the treatment of previously treated patients with advanced non-small cell lung cancer (NSCLC). However, its radiological evaluation is challenging because of atypical patterns of responses such as pseudoprogression. We examined the characteristics and outcomes of previously treated patients with NSCLC who were treated with nivolumab and who developed pseudoprogression. METHODS: We conducted a 15-center retrospective cohort study of previously treated patients with advanced NSCLC who received nivolumab monotherapy...
November 20, 2018: Journal of Thoracic Oncology
https://read.qxmd.com/read/30385468/shape-features-of-the-lesion-habitat-to-differentiate-brain-tumor-progression-from-pseudoprogression-on-routine-multiparametric-mri-a-multisite-study
#16
M Ismail, V Hill, V Statsevych, R Huang, P Prasanna, R Correa, G Singh, K Bera, N Beig, R Thawani, A Madabhushi, M Aahluwalia, P Tiwari
BACKGROUND AND PURPOSE: Differentiating pseudoprogression, a radiation-induced treatment effect, from tumor progression on imaging is a substantial challenge in glioblastoma management. Unfortunately, guidelines set by the Response Assessment in Neuro-Oncology criteria are based solely on bidirectional diametric measurements of enhancement observed on T1WI and T2WI/FLAIR scans. We hypothesized that quantitative 3D shape features of the enhancing lesion on T1WI, and T2WI/FLAIR hyperintensities (together called the lesion habitat) can more comprehensively capture pathophysiologic differences across pseudoprogression and tumor recurrence, not appreciable on diametric measurements alone...
December 2018: AJNR. American Journal of Neuroradiology
https://read.qxmd.com/read/30370356/brain-metastases-with-poor-vascular-function-are-susceptible-to-pseudoprogression-after-stereotactic-radiation-surgery
#17
Ingrid Digernes, Endre Grøvik, Line B Nilsen, Cathrine Saxhaug, Oliver Geier, Edmund Reitan, Dag Ottar Sætre, Birger Breivik, Timothy Reese, Kari Dolven Jacobsen, Åslaug Helland, Kyrre Eeg Emblem
Purpose: This study aimed to investigate the hemodynamic status of cerebral metastases prior to and after stereotactic radiation surgery (SRS) and to identify the vascular characteristics that are associated with the development of pseudoprogression from radiation-induced damage with and without a radionecrotic component. Methods and materials: Twenty-four patients with 29 metastases from non-small cell lung cancer or malignant melanoma received SRS with dose of 15 Gy to 25 Gy...
October 2018: Advances in Radiation Oncology
https://read.qxmd.com/read/30367809/immune-recist-criteria-and-symptomatic-pseudoprogression-in-non-small-cell-lung-cancer-patients-treated-with-immunotherapy
#18
Martina Vrankar, Mojca Unk
Background Uncommon response during immunotherapy is a new challenging issue in oncology practice. Recently, new criteria for evaluation of response to immunotherapy immune response evaluation criteria in solid tumors (iRECIST) were accepted. According to iRECIST, worsening of performance status (PS) accompanied to pseudoprogression reflects most probably the true progression of the malignant disease. Methods A systematic review of the literature was made by using several electronic database with the following search criteria: symptomatic pseudoprogression, atypical response, immunotherapy and lung cancer...
October 18, 2018: Radiology and Oncology
https://read.qxmd.com/read/30366646/characteristics-and-outcomes-of-patients-with-recurrent-ovarian-cancer-undergoing-early-phase-immune-checkpoint-inhibitor-clinical-trials
#19
Emily Hinchcliff, David Hong, Hung Le, Gary Chisholm, Revathy Iyer, Aung Naing, Patrick Hwu, Amir Jazaeri
OBJECTIVE: To describe the clinical outcomes associated with the use of checkpoint inhibitor therapy in recurrent ovarian malignancy. METHODS: Women with recurrent ovarian cancer treated with an immune checkpoint inhibitor between 1/2012 and 8/2017 were included. RECIST criteria determined disease status, and immune related adverse events (irAE) were graded per trial protocols. Predictors of response, irAE, progression free survival (PFS) and overall survival (OS) were investigated...
October 23, 2018: Gynecologic Oncology
https://read.qxmd.com/read/30334063/-tumor-assessment-in-immune-checkpoint-inhibitor-therapy-tumor-response-progression-and-pseudoprogression
#20
REVIEW
S Foller, H Oppel-Heuchel, M-O Grimm
In contrast to chemotherapy, treatment with immune checkpoint inhibitors occasionally results in an unconventional pattern of response. Besides an early partial or complete response or tumor progression, a so-called pseudoprogression, a "mixed response" or late responses can also be observed. Treatment beyond radiographically defined progression may therefore be appropriate in selected cases. For these treatment decisions, the clinical evaluation of the patient (performance status, symptoms, etc...
November 2018: Der Urologe. Ausg. A
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