Cure Alveolar Soft Part Sarcoma International (iCureASPS)

Revised RECIST Guideline Version
1.1: What Oncologists Want to
Know and What Radiologists Need
to Know



Terms to understand when radiololigist and doctors describe your treatment progress or lack there of--

TABLE 1: Evaluation of Target and Nontarget Lesions by Response Evaluation Criteria in Solid Tumors
(RECIST), Version 1.0
Response Assessment RECIST Guideline, Version 1.0

Evaluation of target lesions-


CR Disappearance of all target lesions

PR ≥ 30% decrease in the sum of the longest diameters of target lesions compared with baseline

PD ≥ 20% increase in the sum of the longest diameter of target lesions compared with the smallest-sum longest
diameter recorded or the appearance of one or more new lesions

SD Neither PR or PD

Evaluation of nontarget lesions

CR Disappearance of all nontarget lesions and normalization of tumor marker level

Incomplete response, SD Persistence of one or more nontarget lesions and/or the maintenance of tumor marker level above the normal limits

PD Appearance of one or more new lesions and/or unequivocal progression of existing nontarget lesions

Note—CR = complete response, PR = partial response, PD = progressive disease, SD = stable disease.


http://www.ajronline.org/doi/pdf/10.2214/AJR.09.4110

It is a good article although I do not know what is new here?
But still - if you have ONLY 10-15% increase in the size of the metastases it could be reported as SD (stable disease) in the report, so be aware of this and the situation that could arise - few consecutive SD reports can be a big progression if reviewed in a year - 10% every time with the scans once in 3 month translate into roughly 40% over the course of the year.

Hi Olga
I agree with the need to baseline and keep the initial reading as indeed the baseline as ASPS is an indolent sarcoma.
We need to remind our doctors routinely

However, the reporting from the oncologist radiologist( hopefully) if we are lucky, is new to me as we , as a family, haven't had to approach the issue of systemic treatment prognosis and stopping treatments as a result of progression per se other than temador.

However I was surprised of the imaging requirements of new mets and how an experienced radiologist has to be on board with the status quo on the criteria to report, as per the criteria, on PD = progressive disease using the scan without and with contrast readings..

The problem herein lies that we are a group of innumerable lung mets when scanned, huh..
The article reads targeting 10--
When most of us have more than 10 to begin with and in various vascular areas of the very active lung..

The article reads targeting 10--
"After identifying measurable and non-measurable
lesions according to the guideline,
target lesions are selected at baseline.
Target lesions include all measurable lesions—
up to five per organ and 10 total—
and are recorded and measured at baseline"
Wow.
Has anyone had their radiologist count the number of imaging lesions in their lungs and measure each and every one?

RECIST criteria are mandatory used for the clinical trials, so the numbers apply for that situation (as I understand) or to be qualified for the clinical trial when documented progressive disease is needed to get in. For the follow up purpose - as a surveillance or to determine the treatment response - it is not necessarily used. They usually count and measure the biggest metastases.