TY - JOUR
T1 - Assessment of response to therapy in hepatocellular carcinoma
AU - Patel, Tushar
AU - Harnois, Denise
N1 - Funding Information:
Declaration of interest: Preparation of this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R01DK069370. The content is solely the responsibility of the authors and does not necessarily represent the offi cial views of the National Institutes of Health. The authors report no conflicts of interest.
PY - 2014/5
Y1 - 2014/5
N2 - The appropriate use of conventional or potential treatments for hepatocellular carcinoma requires that benefit can be shown. Therefore, the accurate assessment of response is both critical and essential. Demonstration of benefit observed will be determined by the criteria used. However, the use of conventional criteria based on anatomical imaging to assess response and progression is inadequate. Limitations occur due to the unique nature, presentation, and course of hepatocellular cancer, any underlying concomitant disease, the multiplicity of treatment options, and the challenges in assessing viable tumor. Locoregional therapies or cytostatic therapies can have beneficial effects and induce tumor necrosis without appreciable changes in tumor size. In recognition of the inherent limitations in conventional imaging criteria, various modifications have been proposed. In this review, the goals of assessing tumor response in clinical practice and in clinical trials are outlined. The varying patterns of response to different therapeutic modalities such as locoregional therapy and molecularly targeted therapy are reviewed, and an approach to the assessment of response based on clinical, biochemical, morphological, and functional criteria has been outlined. The implications of current and proposed approaches of assessing response for clinical practice or design of clinical trials are reviewed.
AB - The appropriate use of conventional or potential treatments for hepatocellular carcinoma requires that benefit can be shown. Therefore, the accurate assessment of response is both critical and essential. Demonstration of benefit observed will be determined by the criteria used. However, the use of conventional criteria based on anatomical imaging to assess response and progression is inadequate. Limitations occur due to the unique nature, presentation, and course of hepatocellular cancer, any underlying concomitant disease, the multiplicity of treatment options, and the challenges in assessing viable tumor. Locoregional therapies or cytostatic therapies can have beneficial effects and induce tumor necrosis without appreciable changes in tumor size. In recognition of the inherent limitations in conventional imaging criteria, various modifications have been proposed. In this review, the goals of assessing tumor response in clinical practice and in clinical trials are outlined. The varying patterns of response to different therapeutic modalities such as locoregional therapy and molecularly targeted therapy are reviewed, and an approach to the assessment of response based on clinical, biochemical, morphological, and functional criteria has been outlined. The implications of current and proposed approaches of assessing response for clinical practice or design of clinical trials are reviewed.
KW - Clinical trials
KW - Imaging
KW - Liver cancer
KW - Magnetic resonance imaging
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U2 - 10.3109/07853890.2014.891355
DO - 10.3109/07853890.2014.891355
M3 - Review article
C2 - 24716738
AN - SCOPUS:84899810454
SN - 0785-3890
VL - 46
SP - 130
EP - 137
JO - Annals of Medicine
JF - Annals of Medicine
IS - 3
ER -