HER2 Support Group Forums - View Single Post - When does your oncologist decide the cancer has progressed from current regimen?

Nguyen · 04-29-2022, 08:44 AM

When does your oncologist decide the cancer has progressed from current regimen?

1- A definitive trend in rising tumour’s marker such as Ca27.29 or Ca15-3. Note that there are 7-10 benign causes of a jump in marker, although I haven’t read any paper with respect to benign cause for definitive rising trend.

2- Imaging shows tumor increases in size regardless of the size increase

3- Imaging shows tumor increase in size and has to be at least “20% bigger” per RECIST 1.1 standard. If yes, is “20% bigger” in comparison to the previous scan or image from the scan at the start of the current regimen?

4- Imaging shows new tumor regardless of new tumor size

5- Imaging shows new tumor and its size must be bigger than imaging minimum resolution. For example, typical CT scan resolution is 5mm, so if the new tumor is less than 5mm, the scan result dims not definitive. Note newer CT machine has resolution of 1-3mm. Also reading images is very subjective (per radiologist) especially for small tumor. I looked at a few, it’s really tough.

6- Some combination of above, if so please specify.

Thanks so much for your response.

Nguyen

Ps: If you are curious about Recist 1.1

https://radiologyassistant.nl/more/r...1/recist-1-1-1

https://ctep.cancer.gov/protocoldeve..._guideline.pdf

04-29-2022, 08:44 AM	#1
Nguyen Senior Member Join Date: Nov 2005 Posts: 516	When does your oncologist decide the cancer has progressed from current regimen? When does your oncologist decide the cancer has progressed from current regimen? 1- A definitive trend in rising tumour’s marker such as Ca27.29 or Ca15-3. Note that there are 7-10 benign causes of a jump in marker, although I haven’t read any paper with respect to benign cause for definitive rising trend. 2- Imaging shows tumor increases in size regardless of the size increase 3- Imaging shows tumor increase in size and has to be at least “20% bigger” per RECIST 1.1 standard. If yes, is “20% bigger” in comparison to the previous scan or image from the scan at the start of the current regimen? 4- Imaging shows new tumor regardless of new tumor size 5- Imaging shows new tumor and its size must be bigger than imaging minimum resolution. For example, typical CT scan resolution is 5mm, so if the new tumor is less than 5mm, the scan result dims not definitive. Note newer CT machine has resolution of 1-3mm. Also reading images is very subjective (per radiologist) especially for small tumor. I looked at a few, it’s really tough. 6- Some combination of above, if so please specify. Thanks so much for your response. Nguyen Ps: If you are curious about Recist 1.1 https://radiologyassistant.nl/more/r...1/recist-1-1-1 https://ctep.cancer.gov/protocoldeve..._guideline.pdf