Recently, we published an article reporting an
example of the potential misinterpretation in the evaluation of osteoblastic
changes during tyrosine-kinase inhibitor treatment in metastatic ALKrearranged
non-small cell lung cancer.
Bone metastases are common in disseminated
NSCLC, occurring in approximately 30% to 40% of patients. In the majority of
cases, they present an osteolytic imaging pattern, even though osteoblastic or mixed-type patterns have also
been reported in nearly 8% of cases. Generally, in the assessment of objective
response to anticancer agents, bone metastases are classified as non-target
lesions and therefore “not evaluable” for response.
However, according to the revised Response
Evaluation Criteria in Solid Tumors guideline, the appearance of new non-target
lesions, including lytic or osteoblastic bone metastases, is a criterion for
defining progressive disease. Sometimes, the evaluation of bone lesion response
may be challenging and misinterpreted.
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