Abstract
The implementation of immunotherapy has radically changed the treatment of oncological patients. Currently, immunotherapy is indicated in the treatment of patients with head and neck tumors, melanoma, lung cancer, bladder tumors, colon cancer, cervical cancer, breast cancer, Merkel cell carcinoma, liver cancer, leukemia and lymphomas. However, its efficacy is restricted to a limited number of cases. The challenge is, therefore, to identify which subset of patients would benefit from immunotherapy. To this end, the establishment of immunotherapy response criteria and predictive and prognostic biomarkers is of paramount interest. In this report, a group of experts of the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Medical Radiology (SERAM), and Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM) provide an up-to-date review and a consensus guide on these issues.
Highlights
The implementation of immunotherapy has radically changed the treatment of oncological patients
Immunotherapy was maintained a nd18F-FDG positron emission tomography (PET)/computerized tomography (CT) performed in August 2016 (c) showed a metabolic reduction of lung lesion (SUVmax of 2.4) and lymph nodes (SUVmax of 2.6), consistent with partial response
Novel patterns of response and progression to immunotherapy, which may be more frequent in immunotherapy than in chemotherapy or targeted therapies, should be known
Summary
Novel patterns of response and progression to immunotherapy, which may be more frequent in immunotherapy than in chemotherapy or targeted therapies, should be known. The most common adverse event is dermatologic toxicity, but immune-related toxicity could affect any organ and cause different clinical and radiological manifestations that might mimic tumor progression (Table 1) [28]. These adverse events must be identified to initiate immunosuppression treatment. A nodular pattern of organized pneumonia or sarcoidosis/sarcoid reaction could be confounded with disease progression To differentiate these adverse events from progression, it is important to ascertain whether there is only thoracic progression and to compare the initial tumor radiological characteristics with the current tumor manifestations [30].
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