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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