Measurability and selection of target lesions at baseline |
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Measurable/target lesions:
unidimensional measurement
All target lesions: LD only: size with conventional techniques ≥20 mm, with spiral CT ≥10 mm
Maximum number of target lesions: 5 per organ up to 10 total [more than 1 organ])
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Measurable/target lesions:
unidimensional measurement
Tumor lesions: LD only: size with conventional techniques ≥ 20 mm, with spiral CT ≥10 mm; nodes: short axis ≥ 15 mm
Malignant lymph nodes: >15 mm in short axis
Cystic lesions thought to represent metastases can be considered measurable if they meet size criteria.
Lesions in a previously irradiated area can be considered measurable if progression is demonstrated and they meet size criteria.
Maximum number of target lesions: 2 per organ up to 5 total [more than 1 organ])
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Selection of nontarget lesions |
Nontarget lesions: lesions < 1 cm, cystic lesions, bone lesions without soft tissue component, pleural and pericardial effusions, ascites, leptomeningeal disease, lesions in an irradiated area. |
Nontarget lesions: Lymph nodes: 10 to 15 mm nodes. Non-lymph nodes: lesions < 1 cm, bone lesions without soft tissue component, pleural and pericardial effusions, ascites, leptomeningeal disease. |
Objective response |
Target lesions (change in sum of LD): CR, disappearance of all target lesions, confirmed at ≥4 wk; PR, ≥30% decrease from baseline, confirmed at 4 wk; PD, ≥20% increase over smallest sum observed (nadir) or appearance of new lesions; SD, neither PR nor PD criteria met
Nontarget lesions: CR, disappearance of all nontarget lesions and normalization of tumor markers, confirmed at ≥4 wk; PD, unequivocal progression of nontarget lesions or appearance of new lesions; non-PD, persistence of one or more nontarget lesions or tumor markers above normal limits
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Target lesions (change in sum of LDs): CR, disappearance of all target lesions, confirmed at ≥4 wk; PR, ≥30% decrease from baseline, confirmed at 4 wk; PD, ≥20% increase over smallest sum observed (nadir) and overall 5-mm net increase or appearance of new lesions; SD, neither PR nor PD criteria met
Nontarget lesions: CR, disappearance of all nontarget lesions and normalization of tumor markers, confirmed at ≥4 wk; PD, unequivocal progression of nontarget lesions or appearance of new lesions; non-PD: persistence of one or more nontarget lesions or tumor markers above normal limits; PD must be “unequivocal” in nontarget lesions (e.g., 75% increase in volume); PD can also be new “positive PET” scan with confirmed anatomic progression. Stable positive PET is not PD if it corresponds to anatomic non-PD
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Overall Response |
Best response is recorded in measurable disease from treatment start to disease progression or recurrence
Non-PD in nontarget lesions will reduce CR in target lesions to overall PR
Unequivocal new lesions are PD regardless of response in target and nontarget lesions
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Best response is recorded in measurable disease from treatment start to disease progression or recurrence
Non-PD in nontarget lesions will reduce CR in target lesions to overall PR
Unequivocal new lesions are PD regardless of response in target and nontarget lesions
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