SA-CME ArticlesImaging of Novel Oncologic Treatments in Lung Cancer Part 1 Systemic TherapiesHalpenny, Darragh MB, BCh, BAO; O’Dwyer, Elisabeth MB, BCh BAO; Girshman, Jeffrey MD; Ginsberg, Michelle S. MDAuthor Information Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY Dr Halpenny is an Assistant Attending Radiologist at Memorial Sloan Kettering Cancer Center, New York, NY; Dr O’Dwyer is currently a Molecular Imaging Fellow at Memorial Sloan Kettering Cancer Center, New York, NY; Dr Girshman is an Assistant Attending Radiologist at Memorial Sloan Kettering Cancer Center, and Director of 60th St. Outpatient Center, New York, NY; Dr Ginsberg is an Attending Radiologist at Memorial Sloan Kettering Cancer Center, and Director of Cardiothoracic Imaging, New York, NY. This research was funded in part by the National Institute of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748. The authors, faculty and all staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity. Correspondence to: Darragh Halpenny, MB, BCh, BAO, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 (e-mail: [email protected]). Journal of Thoracic Imaging: January 2020 - Volume 35 - Issue 1 - p 26-36 doi: 10.1097/RTI.0000000000000451 Buy CME Test Metrics Abstract Thoracic tumors are a leading cause of cancer-related morbidity and mortality. In recent years, developments in oncologic treatments for these tumors have ushered in an era of targeted therapy, and, in many cases, these novel treatments have replaced conventional strategies to become standard therapeutic options, particularly in those with lung cancer. Targeted medical therapies for lung cancer now include angiogenesis inhibitors, tyrosine kinase inhibitors, and immunotherapeutic agents. Several novel ablative therapies have also gained widespread acceptance as alternatives to conventional surgical options in appropriately selected patients. Tumors treated with targeted medical therapies can respond to treatment differently when compared with conventional therapies. For example, pseudoprogression is a well-described phenomenon in patients receiving checkpoint inhibitor immunotherapy in which an initial increase in tumor burden is followed by a decrease in tumor burden and sometimes partial or complete response, while the frequent cavitating responses seen when antiangiogenic agents are used can be difficult to quantify using existing response assessment criteria. In some cases, novel response assessment criteria are needed to adequately capture response. In addition, numerous treatment-related side effects have been described, which are important to recognize, both to ensure appropriate treatment and to avoid misclassification as worsening tumor. Imaging plays a vital role in the assessment of patients receiving targeted medical therapy, and it is essential that thoracic radiologists are familiar with the rationale underpinning these treatments and the expected posttherapy findings. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.