There are two sets of criteria using PET to monitor metabolic changes to anti-cancer treatment: the criteria developed by the European Organization for Research and Treatment of Cancer (EORTC criteria) and the PET Response Criteria in Solid Tumors (PERCIST). We conducted this pooled study to investigate the strength of agreement between the EORTC criteria and PERCIST in the assessment of tumor response.
We searched for all relevant studies written in English through the following searching strategy. A systematic literature search of MEDLINE, PUBMED, and EMBASE from 2009 when the PERCIST criteria were proposed to January 2016 was carried out to find articles including the following terms in their title, abstract, or key words; ‘tumor response’, ‘EORTC criteria’, or ‘PERCIST.’ We used the ‘related articles’ feature of the PUBMED to identify the related articles. Articles were considered for inclusion in this pooled study if they compared tumor responses by the EORTC criteria and PERCIST.
There were six articles with the data on the comparison of the EORTC criteria and PERCIST. A total of 348 patients were collected; 190 (54.6%) with breast cancer, 81 with colorectal cancer, 45 with lung cancer, 14 with basal cell carcinoma in the skin, 12 with stomach cancer, and 6 with head and neck cancer. The agreement of tumor response between the EORTC criteria and PERCIST was excellent (k = 0.946). Of 348 patients, only 12 (3.4%) showed disagreement between two criteria in the assessment of tumor response. The shift of tumor response between two criteria occurred mostly in patients with PMR and SMD. The estimated overall response rates were not significantly different between two criteria (72.7% byEORTC vs. 73.6% by PERCIST).
In conclusion, this pooled study demonstrates that the EORTC criteria and PERCIST showed almost perfect concordance in the assessment of tumor response in patients with solid tumors. However, it is still necessary to investigate potential differences between the two criteria in studies with larger homogeneous patients' cohort to elucidate if the criteria can be used interchangeably in clinical practice.
Clinical trial identification
Legal entity responsible for the study
Hallym Medical Center
All authors have declared no conflicts of interest.