Abstract
Purpose :
The Response Evaluation Criteria In Solid Tumors (RECIST) provide radiological standards for solid tumor assessment. However, RECIST is not sufficiently compatible with the evaluation of RB. In May 2021, Berry JL et al. presented a new guideline about response criteria for retinoblastoma (RB-RECIST). We considered the clinical outcomes of RB patients treated with IAC according to the RB-RECIST recommendations.
Methods :
A retrospective analysis of all RB patients treated with IAC (melphalan with additional topotecan and/or carboplatin) at Kellogg Eye Center between 2015 and 2021 was performed. Patients who had at least 6 months of follow-up after cessation of first- and/or second-line plus consolidation therapy were included.
Results :
21 eyes of 18 patients (72% females) were analyzed. The eyes were classified according to the International Classification of Retinoblastoma as group B (n=2), C (n=7), D (n=6), or E (n=6). The mean age at IAC was 21 months. Each eye received a mean of 5.6 ± 1.4 IAC sessions (range, 3-9). Consolidation therapy (cryotherapy or transpupillary thermotherapy) was applied in 76%, and intravitreal chemotherapy was injected in 57%. After IAC with a mean follow-up time of 33 months, globe salvage was achieved in 16 eyes(76%). Tumor recurrence (n=1, group C), vitreous hemorrhage (n=1, group D), and neovascular glaucoma (n=3, group E) were the reasons for enucleation. The ocular findings in the last follow-up exam or the exam before enucleation were assessed according to RB-RECIST. Tumor and vitreous seeds regression patterns were demonstrated in Table 1. A complete response(CR) in the tumor was seen 100% in group B, 86% in C, 100% in D, 50% in E. 1 eye(14%) in group C showed progressive disease(PD), and 3 eyes(50%) in group E had a partial response(PR) in the tumor. There was no stable disease(SD). During the study, vitreous seeds were observed in 14 eyes(67%) and subretinal seeds in 12 eyes(57%). CR in vitreous seeds was noted 50% in Group C, 83% in D, 67% in E; CR in subretinal seeding was established 100% in C, 83% in D, 60 % in E (Table 2).
Conclusions :
Reporting of outcomes in RB is not standardized. These RB-RECIST guidelines may provide a standardized assessment for tumor response in studies of RB therapy.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.