Comparison of the RECIST and PERCIST criteria in solid tumors: a pooled analysis and review.

Seon Jeong Min,Jung Han Kim,Hyun Joo Jang

doi:10.18632/oncotarget.8425

Abstract

The PET Response Criteria in Solid Tumors (PERCIST) is a new method for the quantitative assessment of metabolic changes in solid tumors. The assessments of tumor response between the RECIST and PERCIST have shown considerable difference in several studies. This pooled study was conducted to compare tumor response according to the two criteria in patients with solid tumors. We surveyed MEDLINE, EMBASE and PUBMED for articles with terms of the RECIST or PERCIST from 2009 and January 2016. There were six articles comparing the RECIST and PERCIST. A total of 268 patients were recruited; 81 with colorectal cancer, 60 with lung cancer, 48 with esophageal cancer, 28 with breast cancer, 14 with basal cell carcinoma, 12 with stomach cancer, 10 with head and neck cancer, and 16 with other rare cancers. The agreement of tumor response between the RECIST and PERCIST was moderate (k = 0.590). Of 268 patients, 101 (37.7%) showed discordance in the tumor responses between two criteria. When adopting the PERCIST, tumor response was upgraded in 85 patients and downgraded in 16. The estimated overall response rates were significantly different between two criteria (35.1% by RECIST vs. 54.1% by PERCIST, P < 0.0001). In conclusion, this pooled analysis demonstrates that the concordance of tumor responses between the RECIST and PERCIST criteria is not excellent. The PERCIST might be more suitable for assessing tumor response than the RECIST criteria.

Highlights

To avoid continuing anti-cancer treatment with no efficacy, the accurate assessment of therapeutic response is essential
The estimated overall response rates were significantly different between two criteria (35.1% by Response Evaluation Criteria in Solid Tumors (RECIST) vs. 54.1% by Positron emission tomography (PET) Response Criteria in Solid Tumors (PERCIST), P < 0.0001)
The advantage of the PERCIST over the RECIST criteria need to be further evaluated. This pooled study was conducted to compare tumor response assessment according to the anatomic (RECIST) and metabolic (PERCIST) criteria in patients with malignant solid tumors

Summary

INTRODUCTION

To avoid continuing anti-cancer treatment with no efficacy, the accurate assessment of therapeutic response is essential. Targeted agents are usually more cytostatic than cytocidal, acting as signal transduction inhibitors They tend to induce necrosis and cystic change in solid tumors without necessarily producing tumor shrinkage [6]. FDG PET is increasingly performed to detect earlier tumor responses to anti-cancer therapies [7] It can allow the measurement of tumor response even in the absence of anatomic changes. The PET Response Criteria in Solid Tumors (PERCIST) was proposed as a new method for the quantitative assessment of metabolic changes in solid tumors [8]. The advantage of the PERCIST over the RECIST criteria need to be further evaluated This pooled study was conducted to compare tumor response assessment according to the anatomic (RECIST) and metabolic (PERCIST) criteria in patients with malignant solid tumors

RESULTS

DISCUSSION

Summary Colorectal cancer