Progressive Lesion Type is Predictive of Post-progression Survival in First-line Chemoimmunotherapy for Non-small Cell Lung Cancer

Date

2026

Authors

Gao, Y.
Li, L.X.
Rowland, A.
Karapetis, C.S.
Parent, N.
Kichenadasse, G.
Hopkins, A.M.
Sorich, M.J.

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Cancer Letters, 2026; 639:218191-1-218191-4

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Yuan Gao, Lee X. Li, Andrew Rowland, Christos S. Karapetis, Natalie Parent, Ganessan Kichenadasse, Ashley M. Hopkins, Michael J. Sorich

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Abstract

The revised Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) marked a significant advancement in the standardised assessment of solid tumours [1]. To evaluate treatment response and prognosis comprehensively, RECIST 1.1 incorporates target, non-target, and new lesions to describe tumour dynamics [1]. However, a key limitation of RECIST 1.1 is that it does not consider lesion-level heterogeneity and the lesion type(s) (i.e. existing lesions, new lesions, or both) causing progression [1]. Prior studies have shown that patients progressing with new metastatic lesions had nearly double the mortality risk compared to those with progression limited to pre-existing lesions [[2], [3], [4]]. Moreover, progression involving multiple lesion types has been associated with significantly worse post-progression survival than progression involving a single lesion type [4,5]. Nonetheless, RECIST 1.1 classifies all such progression events uniformly as progressive disease (PD), limiting its value in clinical prognostication.

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© 2025 Published by Elsevier

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