Table 11. Assessment of Tumor Response.
| RECIST v1.1 | mRECIST | iRECIST | ||
|---|---|---|---|---|
| Target lesion response | ||||
| CR | Disappearance of all target lesions | Disappearance of any intratumoral arterial enhancement in all target lesions | ||
| PR | At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum of the diameters of target lesions | At least a 30% decrease in the sum of the diameters of viable (enhancement in the arterial phase) target lesions, taking as reference the baseline sum of the diameters of target lesions | ||
| SD | Any cases that do not qualify for either PR or PD | Any cases that do not qualify for either PR or PD | ||
| PD | An increase of at least 20% in the sum of the diameters of target lesions, taking as reference the smallest sum of the diameters of target lesions recorded since treatment started | An increase of at least 20% in the sum of the diameters of viable (enhancing) target lesions, taking as reference the smallest sum of the diameters of viable (enhancing) target lesions recorded since treatment started | iUPD: ≥ 20% increase of the sum of the longest diameters compared to nadir (minimum 5 mm) or progression of non-target lesions or new lesion; confirmation of progression recommended minimum 4 weeks after the first iUPD assessment iCPD: increased size of target or non-target lesions; increase in the sum of new target lesions > 5 mm; progression of new non-target lesions; appearance of another; new lesion | |
| Non-target lesion response | ||||
| CR | Disappearance of all non-target lesions | Disappearance of any intratumoral arterial enhancement in all non-target lesions | ||
| IR/SD | Persistence of one or more non-target lesions | Persistence of intratumoral arterial enhancement in one or more non-target lesions | ||
| PD | Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions | Appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions | ||
| mRECIST recommendations | ||||
| Pleural effusion and ascites | Cytopathologic confirmation of the neoplastic nature of any effusion that appears or worsens during treatment is required to declare PD. | |||
| Porta hepatis lymph node | Lymph nodes detected at the porta hepatis can be considered malignant if the lymph node short axis is at least 2 cm. | |||
| Portal vein invasion | Malignant portal vein invasion should be considered as a non-measurable lesion and thus included in the non-target lesion group. | |||
| New lesion | A new lesion can be classified as HCC if its longest diameter is at least 1 cm and the enhancement pattern is typical for HCC. A lesion with atypical radiological pattern can be diagnosed as HCC by evidence of at least 1 cm interval growth. | |||
| Target lesion | Non-target lesion | New lesion | Overall response | |
| CR | CR | No | CR | |
| CR | IR/SD | No | PR | |
| PR | Non-PD | No | PR | |
| SD | Non-PD | No | SD | |
| PD | Any | Yes or no | PD | |
| Any | PD | Yes or no | PD | |
| Any | Any | Yes | PD | |
Adapted from European Association For The Study Of The Liver and European Organisation For Research And Treatment Of Cancer [114], Lencioni and Llovet [990], and Tazdait et al. [1007]. RECIST v1.1 = Response Evaluation Criteria in Solid Tumors version 1.1, mRECIST = modified Response Evaluation Criteria in Solid Tumors, CR = complete response, PR = partial response, SD = stable disease, PD = progressive disease, iUPD = immune unconfirmed progressive disease, iCPD = immune confirmed progressive disease, IR = incomplete response, HCC = hepatocellular carcinoma