Évaluation de la réponse thérapeutique en imagerie morphologique des tumeurs solides (RECIST) : historique, application et adaptation des critères aux thérapies innovantes

Abstract

The evaluation of therapeutic response in morphological imaging of solid tumors is based primarily on the RECIST criteria (Response Evaluation Criteria in Solid Tumours) established in 2000 and revised in 2009 to version RECIST 1.1. These criteria enable the efficacy of anti-cancer treatments to be analyzed on the basis of the measurement of tumor lesions by computed tomography (CT) or magnetic resonance imaging (MRI). The choice of target and non-target lesions is crucial for establishing a baseline examination prior to treatment, in order to monitor disease progression. Results are classified into 4 categories: partial response, complete response, stable disease and progressive disease. With the emergence of immunotherapy, adaptations to the criteria were necessary, leading to the creation of iRECIST in 2017, which takes into account the phenomenon of pseudoprogression. In addition, other limitations of the RECIST 1.1 criteria have been identified, notably their inability to assess functional changes in tumors, leading to the development of alternative criteria such as mRECIST and CHOI for specific types of cancer. These developments underline the importance of accurate and appropriate treatment evaluation in oncology.