SCI
21 Mar 2020
IASLC Multidisciplinary Recommendations for Pathologic Assessment of Lung Cancer Resection Specimens After Neoadjuvant Therapy
Travis WD, Dacic S, Wistuba I, Sholl L, Adusumilli P, Bubendorf L, Bunn P, Cascone T, Chaft J, Chen G, Chou T-Y, Cooper W, Erasmus JJ, Ferreira CG, Goo J-M, Heymach J,Hirsch FR, Horinouchi H, Kerr K, Kris M, Jain D, Kim YT, Lopez-Rios F, Lu S, Mitsudomi T, Moreira A, Motoi N, Nicholson AG, Oliveira R, Papotti M, Pastorino U, Paz-Ares L, Pelosi G, Poleri C, Provencio M, Roden AC, Scagliotti G, Swisher SG, Thunnissen E, Tsao MS, Vansteenkiste J, Weder W, Yatabe Y, IASLC MULTIDISCIPLINARY RECOMMENDATIONS FOR PATHOLOGIC ASSESSMENT OF LUNG CANCER RESECTION SPECIMENS FOLLOWING NEOADJUVANT THERAPY, Journal of Thoracic Oncology (2020)
Correspondence: William D. Travis, M.D.; Dept of Pathology; Memorial Sloan Kettering 139 Cancer Center; 1275 York Ave; New York, NY 10065 140 Tel: 212-639-3325; Fax: 212-717-3576; Email: travisw@mskcc.org
Abstract 摘要
Currently, there is no established guidance on how to process and evaluate resected lung cancer specimens after neoadjuvant therapy in the setting of clinical trials and clinical practice. There is also a lack of precise definitions on the degree of pathologic response, including major pathologic response or complete pathologic response. For other cancers such as osteosarcoma and colorectal, breast, and esophageal carcinomas, there have been multiple studies investigating pathologic assessment of the effects of neoadjuvant therapy, including some detailed recommendations on how to handle these specimens. A comprehensive mapping approach to gross and histologic processing of osteosarcomas after induction therapy has been used for over 40 years.
目前，在临床试验和临床实践中，对于如何处理和评价新辅助治疗后切除的肺癌标本，尚无既定的指南。对于病理缓解的程度包括主要病理缓解或完全病理缓解，也缺乏准确的定义。而其他癌症，如骨肉瘤、结直肠癌、乳腺癌和食管癌，已有多项研究对新辅助治疗效果的病理评估进行了研究，包括一些关于如何处理这些标本的详细建议。对诱导治疗后骨肉瘤进行大体和组织学处理的综合分析方法已经使用了40多年。
The purpose of this article is to outline detailed recommendations on how to process lung cancer resection specimens and to define pathologic response, including major pathologic response or complete pathologic response after neoadjuvant therapy. A standardized approach is recommended to assess the percentages of (1) viable tumor, (2) necrosis, and (3) stroma (including inflammation and fibrosis) with a total adding up to 100%. This is recommended for all systemic therapies, including chemotherapy, chemoradiation, molecular-targeted therapy, immunotherapy, or any future novel therapies yet to be discovered, whether administered alone or in combination. Specific issues may differ for certain therapies such as immunotherapy, but the grossing process should be similar, and the histologic evaluation should contain these basic elements.
本文的目的是概述对于如何处理肺癌切除标本的详细建议，并定义病理缓解，包括新辅助治疗后的主要病理缓解（MPR）或完全病理缓解（CPR）。建议采用一种标准化的方法来评估(1)活肿瘤、(2)坏死和(3)间质(包括炎症和纤维化)各占的百分比，总和为100%。推荐所有的全身疗法，包括化疗、放化疗、分子靶向治疗、免疫治疗，或其他尚未发掘的新疗法，无论是单一疗法还是联合疗法。某些治疗如免疫治疗的具体问题可能不同，但大体过程应该相似，组织学评估应包含这些基本要素。
Standard pathologic response assessment should allow for comparisons between different therapies and correlations with disease-free survival and overall survival in ongoing and future trials. The International Association for the Study of Lung Cancer has an effort to collect such data from existing and future clinical trials. These recommendations are intended as guidance for clinical trials, although it is hoped they can be viewed as suggestion for good clinical practice outside of clinical trials, to improve consistency of pathologic assessment of treatment response.
标准的病理缓解评估应考虑不同治疗方法之间的比较，以及在目前和未来的临床试验中与无病生存和总生存的相关性。国际肺癌研究协会(IASLC)正努力从现有和未来的临床试验中收集这些数据。这些建议旨在作为临床试验的指导，也希望它们可以被视为临床试验之外良好的临床实践的建议，以提高治疗反应的病理评估的一致性。
喜欢SCI天天读的理由
陪您一起学习SCI医学论文
每天5分钟，让自己的英语牛逼起来
特殊福利让您惊喜连连
长按二维码，即可下载SCI原文
提取码：n5sq
