Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Urgent need for a validated tumor response evaluation system for use in immunotherapy

Bone Marrow Transplantation volume 33, pages 255–256 (2004)Cite this article

Hentschke et al recently reported a detailed case series on reduced-intensity stem-cell transplantation (RIST) for the treatment of renal cell and colon cancers.1 While they provided important information on the feasibility of RIST and its possible antitumor effect, we would like to comment on their study design, especially focusing on the feasibility of response evaluation criteria. Although the Response Evaluation Criteria in Solid Tumors (RECIST) system has been used as a gold standard to evaluate the response of solid tumors to treatment,2 mainly in the field of cancer chemotherapy, it has not been fully validated in the area of allogeneic transplantation for solid tumors, where the immune-mediated destruction of tumor cells is the principle mechanism of tumor destruction (graft-versus-tumor effect, GVT). Compared to hematological malignancies, solid tumors are generally more resistant to the cytotoxic agents used in conditioning regimens administered before transplantation. Consequently, we considered that there may be some important differences in evaluating the response of solid tumors between RIST and conventional chemotherapy.

Second, the proper time to measure the tumor size as a baseline for evaluating a subsequent tumor response has not been clearly defined. In contrast to the results with chemotherapy, the tumor often temporarily increases in size following RIST. Some metastases initially progress slowly, while others progress rapidly. Accordingly, when the size at transplantation is used as a baseline, as in chemotherapy, a therapeutic effect following the initial progression could be overlooked or underestimated (Figure 1c). On the other hand, evaluating regression from the largest size after transplant certainly overestimates the effect of treatment (Figure 1b), and gives an unacceptable bias.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

References

  1. Hentschke P, Barkholt L, Uzunel M et al. Low-intensity conditioning and hematopoietic stem cell transplantation in patients with renal and colon carcinoma. Bone Marrow Transplant 2003; 31: 253–261.

    Article  CAS  Google Scholar 

  2. Therasse P, Arbuck SG, Eisenhauer EA et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000; 92: 205–216.

    Article  CAS  Google Scholar 

  3. Childs R, Chernoff A, Contentin N et al. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med 2000; 343: 750–758.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, 100-0045, Tokyo, Japan

    A Hori, M Kami, S-W Kim, N Murashige, M Sakiyama, R Kojima, T Hamaki, A Makimoto & Y Takaue

  2. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    S Miyakoshi & S Taniguchi

  3. Department of Hematology and Rheumatology, JR Tokyo General Hospital, Tokyo, Japan

    S Masuo

  4. Department of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan

    H Kunitoh

Authors
  1. A Hori
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Kami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S-W Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N Murashige
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Sakiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Kojima
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T Hamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A Makimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. S Miyakoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S Masuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. S Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. H Kunitoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Y Takaue
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hori, A., Kami, M., Kim, SW. et al. Urgent need for a validated tumor response evaluation system for use in immunotherapy. Bone Marrow Transplant 33, 255–256 (2004). https://doi.org/10.1038/sj.bmt.1704371

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704371

This article is cited by

Search

Advanced search

Quick links