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International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017).

Identifieur interne : 000995 ( PubMed/Corpus ); précédent : 000994; suivant : 000996

International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017).

Auteurs : A. Younes ; P. Hilden ; B. Coiffier ; A. Hagenbeek ; G. Salles ; W. Wilson ; J F Seymour ; K. Kelly ; J. Gribben ; M. Pfreunschuh ; F. Morschhauser ; H. Schoder ; A D Zelenetz ; J. Rademaker ; R. Advani ; N. Valente ; C. Fortpied ; T E Witzig ; L H Sehn ; A. Engert ; R I Fisher ; P-L Zinzani ; M. Federico ; M. Hutchings ; C. Bollard ; M. Trneny ; Y A Elsayed ; K. Tobinai ; J S Abramson ; N. Fowler ; A. Goy ; M. Smith ; S. Ansell ; J. Kuruvilla ; M. Dreyling ; C. Thieblemont ; R F Little ; I. Aurer ; M H J. Van Oers ; K. Takeshita ; A. Gopal ; S. Rule ; S. De Vos ; I. Kloos ; M S Kaminski ; M. Meignan ; L H Schwartz ; J P Leonard ; S J Schuster ; V E Seshan

Source :

RBID : pubmed:28379322

Abstract

In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.

DOI: 10.1093/annonc/mdx097
PubMed: 28379322

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pubmed:28379322

Le document en format XML

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<name sortKey="Wilson, W" sort="Wilson, W" uniqKey="Wilson W" first="W" last="Wilson">W. Wilson</name>
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<name sortKey="Seymour, J F" sort="Seymour, J F" uniqKey="Seymour J" first="J F" last="Seymour">J F Seymour</name>
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<name sortKey="Kelly, K" sort="Kelly, K" uniqKey="Kelly K" first="K" last="Kelly">K. Kelly</name>
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<name sortKey="Gribben, J" sort="Gribben, J" uniqKey="Gribben J" first="J" last="Gribben">J. Gribben</name>
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<name sortKey="Pfreunschuh, M" sort="Pfreunschuh, M" uniqKey="Pfreunschuh M" first="M" last="Pfreunschuh">M. Pfreunschuh</name>
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<name sortKey="Morschhauser, F" sort="Morschhauser, F" uniqKey="Morschhauser F" first="F" last="Morschhauser">F. Morschhauser</name>
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<nlm:affiliation>Department of Hematology, Université de Lille 2, Lille, France.</nlm:affiliation>
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<name sortKey="Schoder, H" sort="Schoder, H" uniqKey="Schoder H" first="H" last="Schoder">H. Schoder</name>
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<nlm:affiliation>Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York.</nlm:affiliation>
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<name sortKey="Zelenetz, A D" sort="Zelenetz, A D" uniqKey="Zelenetz A" first="A D" last="Zelenetz">A D Zelenetz</name>
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<name sortKey="Rademaker, J" sort="Rademaker, J" uniqKey="Rademaker J" first="J" last="Rademaker">J. Rademaker</name>
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<nlm:affiliation>Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York.</nlm:affiliation>
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<name sortKey="Advani, R" sort="Advani, R" uniqKey="Advani R" first="R" last="Advani">R. Advani</name>
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<nlm:affiliation>Department of Oncology, Stanford University, Stanford.</nlm:affiliation>
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<name sortKey="Valente, N" sort="Valente, N" uniqKey="Valente N" first="N" last="Valente">N. Valente</name>
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<nlm:affiliation>Genentech, San Francisco, USA.</nlm:affiliation>
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<name sortKey="Fortpied, C" sort="Fortpied, C" uniqKey="Fortpied C" first="C" last="Fortpied">C. Fortpied</name>
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<name sortKey="Witzig, T E" sort="Witzig, T E" uniqKey="Witzig T" first="T E" last="Witzig">T E Witzig</name>
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<nlm:affiliation>Mayo Clinic, Rochester, USA.</nlm:affiliation>
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<name sortKey="Sehn, L H" sort="Sehn, L H" uniqKey="Sehn L" first="L H" last="Sehn">L H Sehn</name>
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<nlm:affiliation>British Columbia Cancer Agency, Vancouver, Canada.</nlm:affiliation>
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<name sortKey="Engert, A" sort="Engert, A" uniqKey="Engert A" first="A" last="Engert">A. Engert</name>
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<nlm:affiliation>Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany.</nlm:affiliation>
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<name sortKey="Fisher, R I" sort="Fisher, R I" uniqKey="Fisher R" first="R I" last="Fisher">R I Fisher</name>
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<nlm:affiliation>Fox Chase Cancer Center, Philadelphia, USA.</nlm:affiliation>
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<name sortKey="Zinzani, P L" sort="Zinzani, P L" uniqKey="Zinzani P" first="P-L" last="Zinzani">P-L Zinzani</name>
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<nlm:affiliation>Department of Hematology, University of Bologna, Bologna.</nlm:affiliation>
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<author>
<name sortKey="Federico, M" sort="Federico, M" uniqKey="Federico M" first="M" last="Federico">M. Federico</name>
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<nlm:affiliation>Department of Diagnostic Medicine, University of Modena, Modena, Italy.</nlm:affiliation>
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<author>
<name sortKey="Hutchings, M" sort="Hutchings, M" uniqKey="Hutchings M" first="M" last="Hutchings">M. Hutchings</name>
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<nlm:affiliation>Department of Hematology, University of Copenhagen, Denmark.</nlm:affiliation>
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<name sortKey="Bollard, C" sort="Bollard, C" uniqKey="Bollard C" first="C" last="Bollard">C. Bollard</name>
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<nlm:affiliation>Children's National Health System, Washington, USA.</nlm:affiliation>
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<name sortKey="Trneny, M" sort="Trneny, M" uniqKey="Trneny M" first="M" last="Trneny">M. Trneny</name>
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<nlm:affiliation>Lymphoma and Stem Cell Transplantation Program, Charles University, Prague, Czech Republic.</nlm:affiliation>
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<name sortKey="Elsayed, Y A" sort="Elsayed, Y A" uniqKey="Elsayed Y" first="Y A" last="Elsayed">Y A Elsayed</name>
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<nlm:affiliation>Janssen Research & Development, Spring House, USA.</nlm:affiliation>
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<name sortKey="Tobinai, K" sort="Tobinai, K" uniqKey="Tobinai K" first="K" last="Tobinai">K. Tobinai</name>
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<nlm:affiliation>Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.</nlm:affiliation>
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<name sortKey="Abramson, J S" sort="Abramson, J S" uniqKey="Abramson J" first="J S" last="Abramson">J S Abramson</name>
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<nlm:affiliation>Massachusetts General Hospital, Center for Lymphoma, Boston.</nlm:affiliation>
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<author>
<name sortKey="Fowler, N" sort="Fowler, N" uniqKey="Fowler N" first="N" last="Fowler">N. Fowler</name>
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<nlm:affiliation>U.T. M.D.Anderson Cancer Center, Houston.</nlm:affiliation>
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<author>
<name sortKey="Goy, A" sort="Goy, A" uniqKey="Goy A" first="A" last="Goy">A. Goy</name>
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<nlm:affiliation>John Theurer Cancer Center, Hackensack University Medical Center, Hackensack.</nlm:affiliation>
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<author>
<name sortKey="Smith, M" sort="Smith, M" uniqKey="Smith M" first="M" last="Smith">M. Smith</name>
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<nlm:affiliation>Cleveland Clinic, Cleveland, USA.</nlm:affiliation>
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<name sortKey="Ansell, S" sort="Ansell, S" uniqKey="Ansell S" first="S" last="Ansell">S. Ansell</name>
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<nlm:affiliation>Mayo Clinic, Rochester, USA.</nlm:affiliation>
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<name sortKey="Kuruvilla, J" sort="Kuruvilla, J" uniqKey="Kuruvilla J" first="J" last="Kuruvilla">J. Kuruvilla</name>
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<nlm:affiliation>Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.</nlm:affiliation>
</affiliation>
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<name sortKey="Dreyling, M" sort="Dreyling, M" uniqKey="Dreyling M" first="M" last="Dreyling">M. Dreyling</name>
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<nlm:affiliation>Medicine Clinic III, Ludwig Maximilian University, Munich, Germany.</nlm:affiliation>
</affiliation>
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<author>
<name sortKey="Thieblemont, C" sort="Thieblemont, C" uniqKey="Thieblemont C" first="C" last="Thieblemont">C. Thieblemont</name>
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<nlm:affiliation>Haemato-Oncology, Hôpital Saint Louis, Paris, France.</nlm:affiliation>
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<author>
<name sortKey="Little, R F" sort="Little, R F" uniqKey="Little R" first="R F" last="Little">R F Little</name>
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<nlm:affiliation>Divisions of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, USA.</nlm:affiliation>
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<author>
<name sortKey="Aurer, I" sort="Aurer, I" uniqKey="Aurer I" first="I" last="Aurer">I. Aurer</name>
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<nlm:affiliation>Department of Hematology, University Hospital Centre Zagreb, Zagreb, Croatia.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Van Oers, M H J" sort="Van Oers, M H J" uniqKey="Van Oers M" first="M H J" last="Van Oers">M H J. Van Oers</name>
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<nlm:affiliation>Academic Medical Center, Amsterdam, The Netherlands.</nlm:affiliation>
</affiliation>
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<author>
<name sortKey="Takeshita, K" sort="Takeshita, K" uniqKey="Takeshita K" first="K" last="Takeshita">K. Takeshita</name>
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<nlm:affiliation>Celgene, Summit.</nlm:affiliation>
</affiliation>
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<author>
<name sortKey="Gopal, A" sort="Gopal, A" uniqKey="Gopal A" first="A" last="Gopal">A. Gopal</name>
<affiliation>
<nlm:affiliation>Fred Hutchinson Cancer Research Center, Seattle, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Rule, S" sort="Rule, S" uniqKey="Rule S" first="S" last="Rule">S. Rule</name>
<affiliation>
<nlm:affiliation>Haematology Department, Plymouth University, UK.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="De Vos, S" sort="De Vos, S" uniqKey="De Vos S" first="S" last="De Vos">S. De Vos</name>
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<nlm:affiliation>Oncology, UCLA, Los Angeles, USA.</nlm:affiliation>
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<name sortKey="Kloos, I" sort="Kloos, I" uniqKey="Kloos I" first="I" last="Kloos">I. Kloos</name>
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<nlm:affiliation>Servier, Neuilly sur Seine, France.</nlm:affiliation>
</affiliation>
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<author>
<name sortKey="Kaminski, M S" sort="Kaminski, M S" uniqKey="Kaminski M" first="M S" last="Kaminski">M S Kaminski</name>
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<nlm:affiliation>University of Michigan Comprehensive Cancer Center, Ann Arbor, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Meignan, M" sort="Meignan, M" uniqKey="Meignan M" first="M" last="Meignan">M. Meignan</name>
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<nlm:affiliation>Nuclear Medicine, Hôpitaux Universitaires Henri Mondor, Créteil, France.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Schwartz, L H" sort="Schwartz, L H" uniqKey="Schwartz L" first="L H" last="Schwartz">L H Schwartz</name>
<affiliation>
<nlm:affiliation>Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Leonard, J P" sort="Leonard, J P" uniqKey="Leonard J" first="J P" last="Leonard">J P Leonard</name>
<affiliation>
<nlm:affiliation>Weill Cornell Medicine and and New York Presbyterian Hospital, New York.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Schuster, S J" sort="Schuster, S J" uniqKey="Schuster S" first="S J" last="Schuster">S J Schuster</name>
<affiliation>
<nlm:affiliation>University of Pennsylvania School of Medicine, Philadelphia, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Seshan, V E" sort="Seshan, V E" uniqKey="Seshan V" first="V E" last="Seshan">V E Seshan</name>
<affiliation>
<nlm:affiliation>Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA.</nlm:affiliation>
</affiliation>
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<title xml:lang="en">International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017).</title>
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<name sortKey="Younes, A" sort="Younes, A" uniqKey="Younes A" first="A" last="Younes">A. Younes</name>
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<nlm:affiliation>Lymphoma Service.</nlm:affiliation>
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<name sortKey="Hilden, P" sort="Hilden, P" uniqKey="Hilden P" first="P" last="Hilden">P. Hilden</name>
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<nlm:affiliation>Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA.</nlm:affiliation>
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<name sortKey="Coiffier, B" sort="Coiffier, B" uniqKey="Coiffier B" first="B" last="Coiffier">B. Coiffier</name>
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<nlm:affiliation>Hematology, Université Lyon-1, Lyon-Sud Charles Mérieux, Lyon, France.</nlm:affiliation>
</affiliation>
</author>
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<name sortKey="Hagenbeek, A" sort="Hagenbeek, A" uniqKey="Hagenbeek A" first="A" last="Hagenbeek">A. Hagenbeek</name>
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<nlm:affiliation>Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Salles, G" sort="Salles, G" uniqKey="Salles G" first="G" last="Salles">G. Salles</name>
<affiliation>
<nlm:affiliation>Hematology, Université Lyon-1, Lyon-Sud Charles Mérieux, Lyon, France.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Wilson, W" sort="Wilson, W" uniqKey="Wilson W" first="W" last="Wilson">W. Wilson</name>
<affiliation>
<nlm:affiliation>Lymphoid Malignancies Branch, National Cancer Institute, Bethesda, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Seymour, J F" sort="Seymour, J F" uniqKey="Seymour J" first="J F" last="Seymour">J F Seymour</name>
<affiliation>
<nlm:affiliation>Peter MacCallum Cancer Centre and University of Melbourne, Australia.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Kelly, K" sort="Kelly, K" uniqKey="Kelly K" first="K" last="Kelly">K. Kelly</name>
<affiliation>
<nlm:affiliation>Pediatrics Department, Roswell-Park Cancer Institute, Buffalo, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Gribben, J" sort="Gribben, J" uniqKey="Gribben J" first="J" last="Gribben">J. Gribben</name>
<affiliation>
<nlm:affiliation>Department of Haemato-Oncology, Barts Cancer Institute, London, UK.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Pfreunschuh, M" sort="Pfreunschuh, M" uniqKey="Pfreunschuh M" first="M" last="Pfreunschuh">M. Pfreunschuh</name>
<affiliation>
<nlm:affiliation>Department of Internal Medicine, Universität des Saarlandes, Homburg, Germany.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Morschhauser, F" sort="Morschhauser, F" uniqKey="Morschhauser F" first="F" last="Morschhauser">F. Morschhauser</name>
<affiliation>
<nlm:affiliation>Department of Hematology, Université de Lille 2, Lille, France.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Schoder, H" sort="Schoder, H" uniqKey="Schoder H" first="H" last="Schoder">H. Schoder</name>
<affiliation>
<nlm:affiliation>Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Zelenetz, A D" sort="Zelenetz, A D" uniqKey="Zelenetz A" first="A D" last="Zelenetz">A D Zelenetz</name>
<affiliation>
<nlm:affiliation>Lymphoma Service.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Rademaker, J" sort="Rademaker, J" uniqKey="Rademaker J" first="J" last="Rademaker">J. Rademaker</name>
<affiliation>
<nlm:affiliation>Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Advani, R" sort="Advani, R" uniqKey="Advani R" first="R" last="Advani">R. Advani</name>
<affiliation>
<nlm:affiliation>Department of Oncology, Stanford University, Stanford.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Valente, N" sort="Valente, N" uniqKey="Valente N" first="N" last="Valente">N. Valente</name>
<affiliation>
<nlm:affiliation>Genentech, San Francisco, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Fortpied, C" sort="Fortpied, C" uniqKey="Fortpied C" first="C" last="Fortpied">C. Fortpied</name>
<affiliation>
<nlm:affiliation>Statistics, EORTC, Brussels, Belgium.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Witzig, T E" sort="Witzig, T E" uniqKey="Witzig T" first="T E" last="Witzig">T E Witzig</name>
<affiliation>
<nlm:affiliation>Mayo Clinic, Rochester, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Sehn, L H" sort="Sehn, L H" uniqKey="Sehn L" first="L H" last="Sehn">L H Sehn</name>
<affiliation>
<nlm:affiliation>British Columbia Cancer Agency, Vancouver, Canada.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Engert, A" sort="Engert, A" uniqKey="Engert A" first="A" last="Engert">A. Engert</name>
<affiliation>
<nlm:affiliation>Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Fisher, R I" sort="Fisher, R I" uniqKey="Fisher R" first="R I" last="Fisher">R I Fisher</name>
<affiliation>
<nlm:affiliation>Fox Chase Cancer Center, Philadelphia, USA.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Zinzani, P L" sort="Zinzani, P L" uniqKey="Zinzani P" first="P-L" last="Zinzani">P-L Zinzani</name>
<affiliation>
<nlm:affiliation>Department of Hematology, University of Bologna, Bologna.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Federico, M" sort="Federico, M" uniqKey="Federico M" first="M" last="Federico">M. Federico</name>
<affiliation>
<nlm:affiliation>Department of Diagnostic Medicine, University of Modena, Modena, Italy.</nlm:affiliation>
</affiliation>
</author>
<author>
<name sortKey="Hutchings, M" sort="Hutchings, M" uniqKey="Hutchings M" first="M" last="Hutchings">M. Hutchings</name>
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<name sortKey="Tobinai, K" sort="Tobinai, K" uniqKey="Tobinai K" first="K" last="Tobinai">K. Tobinai</name>
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<author>
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<name sortKey="Ansell, S" sort="Ansell, S" uniqKey="Ansell S" first="S" last="Ansell">S. Ansell</name>
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<name sortKey="Little, R F" sort="Little, R F" uniqKey="Little R" first="R F" last="Little">R F Little</name>
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<name sortKey="Aurer, I" sort="Aurer, I" uniqKey="Aurer I" first="I" last="Aurer">I. Aurer</name>
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</affiliation>
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<title level="j">Annals of oncology : official journal of the European Society for Medical Oncology</title>
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<div type="abstract" xml:lang="en">In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.</div>
</front>
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<Year>2017</Year>
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<Title>Annals of oncology : official journal of the European Society for Medical Oncology</Title>
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<ArticleTitle>International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017).</ArticleTitle>
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<MedlinePgn>1436-1447</MedlinePgn>
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<AbstractText>In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.</AbstractText>
<CopyrightInformation>© The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology.</CopyrightInformation>
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