{"id":7529,"date":"2023-08-17T06:52:46","date_gmt":"2023-08-17T06:52:46","guid":{"rendered":"http:\/\/d1s07skqdwll4z.cloudfront.net\/mrcc-tool\/3-management-of-mrcc\/3-4-response-evaluation\/"},"modified":"2025-02-10T09:15:24","modified_gmt":"2025-02-10T09:15:24","slug":"3-4-response-evaluation","status":"publish","type":"page","link":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-4-response-evaluation\/","title":{"rendered":"3.4 Response evaluation"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:-60px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-search-element fusion-search-element-1 fusion-search-form-clean\" 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\/>\n\t\t\t\t\t\t\t\t\t\t<div class=\"fusion-slider-loading\"><\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t<input type=\"hidden\" name=\"post_type[]\" value=\"any\" \/><input type=\"hidden\" name=\"search_limit_to_post_titles\" value=\"0\" \/><input type=\"hidden\" name=\"live_min_character\" value=\"4\" \/><input type=\"hidden\" name=\"live_posts_per_page\" value=\"100\" \/><input type=\"hidden\" name=\"live_search_display_featured_image\" value=\"1\" \/><input type=\"hidden\" name=\"live_search_display_post_type\" value=\"1\" \/><input type=\"hidden\" name=\"fs\" value=\"1\" \/>\n\t\t\t<\/div>\n\n\n\t\t\t\t\t\t\t<div class=\"fusion-search-results-wrapper\"><div class=\"fusion-search-results\"><\/div><\/div>\n\t\t\t\n\t\t<\/form>\n\t\t<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-title-center fusion-title-text fusion-title-size-five\" style=\"--awb-text-color:#c1c1c1;--awb-sep-color:#e2e2e2;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">3.4 Responsevaluering<\/h5><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p>RECIST (Response Evaluation Criteria in Solid Tumours) er utformet for \u00e5 v\u00e6re en standardisert og relativt enkel metode for \u00e5 evaluere behandlingseffekten p\u00e5 tumorer i protokollerte studier. RECIST-kriteriene brukes imidlertid ogs\u00e5 som et verkt\u00f8y for \u00e5 evaluere behandlingseffekten hos de fleste kreftpasienter p\u00e5 standard behandling (kjemoterapi, m\u00e5lrettet behandling, immunterapi, endokrin behandling). RECIST-kriteriene ble vedtatt i 2000 og revidert i 2009. Gjeldende standard er RECIST 1.1.<sup>1<\/sup><\/p>\n<\/div><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">F\u00f8lgende begreper\/definisjoner er viktige i RECIST version 1.1<\/h5><\/div><div class=\"fusion-text fusion-text-2\"><ul>\n<li>M\u00e5lbar sykdom (measurable disease)<\/li>\n<li>Ikke-m\u00e5lbar sykdom (non-measurable disease)<\/li>\n<li>M\u00e5llesjoner (target lesions)<\/li>\n<li>Ikke-m\u00e5llesjoner (non-target lesions)<\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-3 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Ovenst\u00e5ende kan evalueres ved bruk av f\u00f8lgende m\u00e5lemetoder:<\/h5><\/div><div class=\"fusion-text fusion-text-3\"><ul>\n<li>CT- eller MR-skanning<\/li>\n<li>Klinisk<\/li>\n<li>R\u00f8ntgen thorax<\/li>\n<\/ul>\n<p>Det er viktig at samme modalitet brukes ved evaluering av effekten av en behandling.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-4 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">M\u00e5lbar sykdom \u2013 tumorer og lymfeknuter<\/h5><\/div><div class=\"fusion-text fusion-text-4\"><p>Tumorer \u2013 m\u00e5lt p\u00e5 lengste diameter der minimumsst\u00f8rrelsen er:<\/p>\n<ul>\n<li>\u226510 mm p\u00e5 CT eller MR<\/li>\n<li>\u226510 mm ved klinisk unders\u00f8kelse \u2013 synlige\/kutane\/subkutane metastaser<\/li>\n<li>\u226520 mm p\u00e5 r\u00f8ntgen thorax<\/li>\n<\/ul>\n<p>Lymfeknuter \u2013 m\u00e5lt p\u00e5 korteste ledd, der minimumsst\u00f8rrelsen er:<\/p>\n<ul>\n<li>\u226515 mm lymfeknute \u2013 patologisk forst\u00f8rret lymfeknute<\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-5 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Ikke-m\u00e5lbar sykdom \u2013 alle andre lesjoner og faktisk ikke-m\u00e5lbare lesjoner<\/h5><\/div><div class=\"fusion-text fusion-text-5\"><p>Andre lesjoner:<\/p>\n<ul>\n<li>Sm\u00e5 tumorer\/lesjoner &lt;10 mm<\/li>\n<li>10 mm <u>&lt;<\/u> lymfeknuter <u>&lt;<\/u>15 mm<\/li>\n<\/ul>\n<p>Ikke-m\u00e5lbare lesjoner:<\/p>\n<ul>\n<li>Ascites, pleural- og perikardialv\u00e6ske, leptomeningeal sykdom, inflammatorisk brystkreft, lymfangitt, karcinomatose i lungene og huden, abdominalmasser eller organomegali, cystiske lesjoner, skleroserende skjelettmetastaser<\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-6 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">M\u00e5llesjoner<\/h5><\/div><div class=\"fusion-text fusion-text-6\"><p>Basert p\u00e5 baselineunders\u00f8kelsen (oftest CT-skanning) blir m\u00e5lbare tumorer\/lymfeknuter definert, og m\u00e5llesjoner som skal m\u00e5les\/sammenlignes fra unders\u00f8kelse til unders\u00f8kelse blir valgt med tanke p\u00e5 vurdering av behandlingseffekt. Disse m\u00e5 v\u00e6re:<\/p>\n<ul>\n<li>Fra alle involverte organer<\/li>\n<li>Valgt ut fra st\u00f8rrelse og egnethet for gjentatte m\u00e5linger<\/li>\n<li>Ved flere m\u00e5lbare lesjoner velges inntil fem representative lesjoner totalt, men ikke mer enn to lesjoner per organ.<\/li>\n<\/ul>\n<p>Diameteren til hver m\u00e5llesjon legges til et tall \u2013 baselinesummen \u2013 som senere vil bli brukt til \u00e5 m\u00e5le respons.<\/p>\n<\/div><div class=\"fusion-title title fusion-title-7 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Ikke-m\u00e5llesjoner<\/h5><\/div><div class=\"fusion-text fusion-text-7\"><p>De resterende lesjonene, b\u00e5de ikke-m\u00e5lbare lesjoner og resterende m\u00e5lbare lesjoner, b\u00f8r registreres:<\/p>\n<ul>\n<li>M\u00e5lbare tumorer som <strong><em>ikke<\/em><\/strong> er valgt som m\u00e5llesjoner<\/li>\n<li>For sm\u00e5 tumorer\/lymfeknuter<\/li>\n<li>Ikke-m\u00e5lbare lesjoner (skjalettmetastaser, pleuraeffusjon, ascites, peritonealt karsinom osv.)<\/li>\n<li>Tidligere bestr\u00e5lte lesjoner<\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-8 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Responsevaluering<\/h5><\/div><div class=\"fusion-text fusion-text-8\"><p>Ved evaluering av respons kan det v\u00e6re 4 utfall:<\/p>\n<ul>\n<li>CR \u2013 komplett respons<\/li>\n<li>PR \u2013 delvis respons<\/li>\n<li>PD \u2013 progressiv sykdom\/progresjon<\/li>\n<li>SD \u2013 stabil sykdom<\/li>\n<\/ul>\n<\/div><div class=\"fusion-title title fusion-title-9 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">CR \u2013 komplett respons<\/h5><\/div><div class=\"fusion-text fusion-text-9\"><ul>\n<li>Krymping av alle m\u00e5llesjoner, og alle patologisk forst\u00f8rrede lymfeknuter er redusert til  &lt;10 mm i korteste ledd<\/li>\n<li>Tap av alle ikke-m\u00e5llesjoner<\/li>\n<li>Ingen nye lesjoner<\/li>\n<\/ul>\n<p><b><i>Alle kriteriene ovenfor m\u00e5 v\u00e6re oppfylt.<\/i><\/b><\/p>\n<\/div><div class=\"fusion-title title fusion-title-10 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">PR \u2013 delvis respons<\/h5><\/div><div class=\"fusion-text fusion-text-10\"><ul>\n<li>Minst 30 % redusert totalsum for m\u00e5llesjoner kontra baselinesummen<\/li>\n<li>Ikke samtidig tydelig progresjon av ikke-m\u00e5llesjoner<\/li>\n<li>Ingen nye lesjoner<\/li>\n<\/ul>\n<p><b><i>Alle kriteriene ovenfor m\u00e5 v\u00e6re oppfylt.<\/i><\/b><\/p>\n<\/div><div class=\"fusion-title title fusion-title-11 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">PD \u2013 progressiv sykdom\/progresjon<\/h5><\/div><div class=\"fusion-text fusion-text-11\"><ul>\n<li>Minst 20 % \u00f8kt totalsum for m\u00e5llesjoner kontra der summen var lavest (nadirsum) og en absolutt \u00f8kning p\u00e5 minst 5 mm fra nadirsum<\/li>\n<li>Ny lesjon<\/li>\n<li>Tydelig progresjon av ikke-m\u00e5llesjoner<\/li>\n<li>Klinisk progresjon<\/li>\n<\/ul>\n<p><b><i>Bare ett av kriteriene ovenfor m\u00e5 v\u00e6re oppfylt for \u00e5 kalle det progressiv sykdom.<\/i><\/b><\/p>\n<\/div><div class=\"fusion-title title fusion-title-12 fusion-sep-none fusion-title-text fusion-title-size-five\"><h5 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">SD \u2013 stabil sykdom<\/h5><\/div><div class=\"fusion-text fusion-text-12\"><ul>\n<li>Verken PR eller PD<\/li>\n<li>Ingen nye lesjoner<\/li>\n<\/ul>\n<\/div><div class=\"fusion-text fusion-text-13\"><p>Alternativene ovenfor er her vist i en tabell for \u00e5 gi en bedre oversikt over totalrespons i henhold til RECIST 1.1.<\/p>\n<\/div>\n<div class=\"table-1\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\">M\u00c5LLESJON<\/th>\n<th align=\"left\">IKKE-M\u00c5LLESJON<\/th>\n<th align=\"left\">NY LESJON<\/th>\n<th align=\"left\">TOTAL RESPONS<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td align=\"left\">CR<\/td>\n<td align=\"left\">CR<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nei<\/span><\/span><\/td>\n<td align=\"left\">CR<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">CR<\/td>\n<td align=\"left\">SD<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nei<\/span><\/span><\/td>\n<td align=\"left\">PR<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">CR<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke evaluerbar (NE)<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nei<\/span><\/span><\/td>\n<td align=\"left\">PR<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">PR<\/td>\n<td align=\"left\">SD<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nei<\/span><\/span><\/td>\n<td align=\"left\">PR<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">SD<\/td>\n<td align=\"left\">SD<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nei<\/span><\/span><\/td>\n<td align=\"left\">SD<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">PD<\/td>\n<td align=\"left\">CR, PR, SD, PD, NE<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ja eller nei<\/span><\/span><\/td>\n<td align=\"left\">PD<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Alle ikke evaluert<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke <\/span><\/span>PD<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nei<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke evaluerbar (NE)<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Alle<\/span><\/span><\/td>\n<td align=\"left\">PD<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ja eller nei<\/span><\/span><\/td>\n<td align=\"left\">PD<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Alle<\/span><\/span><\/td>\n<td align=\"left\">CR, PR, SD, PD, NE<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ja<\/span><\/span><\/td>\n<td align=\"left\">PD<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-14\"><p>Eksempel p\u00e5 evaluering:<\/p>\n<\/div>\n<div class=\"table-1\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\">&nbsp;<\/th>\n<th align=\"left\">BASELINE<\/th>\n<th align=\"left\">&nbsp;<\/th>\n<th align=\"left\">F\u00d8RSTE RESPONSEVALUERING<\/th>\n<th align=\"left\">ANDRE RESPONSEVALUERING<\/th>\n<th align=\"left\">TREDJE RESPONSEVALUERING<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">M\u00c5LLESJONER<\/span><\/span><\/td>\n<td align=\"left\">ORGAN<\/td>\n<td align=\"left\">mm<\/td>\n<td align=\"left\">mm<\/td>\n<td align=\"left\">mm<\/td>\n<td align=\"left\">mm<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">&nbsp;<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Lever<\/span><\/span><\/td>\n<td align=\"left\">47<\/td>\n<td align=\"left\">28<\/td>\n<td align=\"left\">31<\/td>\n<td align=\"left\">45<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">&nbsp;<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Lunge<\/span><\/span><\/td>\n<td align=\"left\">30<\/td>\n<td align=\"left\">19<\/td>\n<td align=\"left\">19<\/td>\n<td align=\"left\">25<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">&nbsp;<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Lymfeknute<\/span><\/span><\/td>\n<td align=\"left\">25<\/td>\n<td align=\"left\">16<\/td>\n<td align=\"left\">17<\/td>\n<td align=\"left\">24<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Sum av m\u00e5llesjoner<\/span><\/span><\/td>\n<td align=\"left\">&nbsp;<\/td>\n<td align=\"left\">102<\/td>\n<td align=\"left\">63<\/td>\n<td align=\"left\">67<\/td>\n<td align=\"left\">94<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">% <span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">endring fra baseline<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\">&nbsp;<\/td>\n<td align=\"left\">-38.2%<\/td>\n<td align=\"left\">&nbsp;<\/td>\n<td align=\"left\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Endring i % fra nadir<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\">&nbsp;<\/td>\n<td align=\"left\">&nbsp;<\/td>\n<td align=\"left\">+6.3%<\/td>\n<td align=\"left\">+49.2%<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Respons for m\u00e5llesjoner<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\">&nbsp;<\/td>\n<td align=\"left\">PR<\/td>\n<td align=\"left\">PR<\/td>\n<td align=\"left\">PD<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke-m\u00e5llesjoner<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Flere levermetastaser<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Flere levermetastaser<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Flere levermetastaser<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Flere levermetastaser<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Respons for ikke-m\u00e5llesjoner<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\">&nbsp;<\/td>\n<td align=\"left\">SD<\/td>\n<td align=\"left\">SD<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Tydelig progresjon<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nye lesjoner<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\">&nbsp;<\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">nei<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">nei<\/span><\/span><\/td>\n<td align=\"left\">&nbsp;<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Total respons<\/span><\/span><\/td>\n<td colspan=\"2\" align=\"left\">&nbsp;<\/td>\n<td align=\"left\">PR<\/td>\n<td align=\"left\">PR<\/td>\n<td align=\"left\">PD<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><\/div><div class=\"fusion-title title fusion-title-13 fusion-sep-none fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">iRECIST \u2013 RECIST for immunbasert behandling<\/h4><\/div><div class=\"fusion-text fusion-text-15\"><p>Ved immunterapi f\u00e5r man kroppens eget immunsystem til \u00e5 angripe kreften <a href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/4-treatment\/4-3-oncology-treatment-immunotherapy\/\">(se avsnittet om immunterapi i onkologisk behandling)<\/a>.   I kliniske studier med immunterapi ble det observert annen\/uvanlig respons i forhold til det som tidligere er sett ved andre onkologiske behandlinger. Dvs. innledningsvis progresjon i henhold til RECIST 1.1, med \u00f8kende st\u00f8rrelse p\u00e5 m\u00e5llesjoner samt nye lesjoner, men med p\u00e5f\u00f8lgende positiv og langvarig respons. P\u00e5 bakgrunn av dette bestemte RECIST-arbeidsgruppen seg for \u00e5 lage retningslinjer med modifiserte RECIST-kriterier for kliniske studier med immunterapi (iRECIST) for \u00e5 sikre ensartet design og datainnhenting<sup>2<\/sup>.<\/p>\n<p>iRECIST er basert p\u00e5 RECIST 1.1, men flere konsepter er tilf\u00f8yd for responsevalueringen:<\/p>\n<ul>\n<li>iCR \u2013 komplett respons p\u00e5 immunterapi<\/li>\n<li>iPR \u2013 delvis respons p\u00e5 immunterapi<\/li>\n<li>iUPD \u2013 ubekreftet progressiv sykdom ved immunterapi<\/li>\n<li>iCPD \u2013 bekreftet progressiv sykdom ved immunterapi<\/li>\n<li>iSD \u2013 stabil sykdom ved immunterapi<\/li>\n<li>Nye lesjoner er underkategorisert som:\n<ul>\n<li>M\u00e5llesjoner<\/li>\n<li>Ikke-m\u00e5llesjoner<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>De viktigste forskjellene mellom RECIST 1.1 og iRECIST:<\/p>\n<\/div>\n<div class=\"table-1\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\">&nbsp;<\/th>\n<th align=\"left\">RESIST 1.1<\/th>\n<th align=\"left\">iRECIST<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Definisjon av m\u00e5lbar og &nbsp;ikke-m\u00e5lbar sykdom antall og type m\u00e5llesjoner<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">M\u00e5lbare lesjoner er <\/span><\/span> \u226510 mm <span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">i diameter <\/span><\/span>(\u226515 mm <span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">for lymfeknuter<\/span><\/span>); <span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">maksimalt fem <\/span><\/span><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">lesjoner (to per organ); alle andre sykdommer betraktes som ikke-m\u00e5l (korteste akse m\u00e5 v\u00e6re <\/span><\/span>\u226510 <span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">ved sykdom i lymfeknuter)<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ingen endring fra RECIST 1.1. Nye lesjoner vil imidlertid bli vurdert p\u00e5 bakgrunn av RECIST 1.1, men blir registrert separat p\u00e5 egnet kasusrapportskjema (blir ikke inkludert i summen av lesjoner for m\u00e5llesjoner identifisert ved baseline)<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Komplett respons, delvis respons eller &nbsp;stabil sykdom<\/span><\/span><\/td>\n<td align=\"left\">Har kanskje ikke oppfylt kriteriet &nbsp;progresjon f\u00f8r fullstendig respons, delvis &nbsp;respons eller stabil sykdom.<\/td>\n<td align=\"left\">Kan ha hatt iUPD (\u00e9n eller flere ganger), men ikke iCPD f\u00f8r iCR, iPR eller iSD<\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Bekreftet komplett respons eller delvis respons<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Kun p\u00e5krevet for ikke-randomiserte studier<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">I samsvar med RECIST 1.1<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Bekreftet stabil sykdom<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke p\u00e5krevet<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">I samsvar med RECIST 1.1<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Nye lesjoner<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Resultater under progresjon; registrert, men ikke m\u00e5lt<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Resultater ved iUPD, men iCPD bare hvis nye lensjoner oppdages ved neste skanning eller de nye lesjonene p\u00e5 forrige skanning har blitt st\u00f8rre (\u2265 5 mm for summen av nye m\u00e5llesjoner eller \u00f8kt st\u00f8rrelse p\u00e5 nye ikke-m\u00e5llesjoner, uavhengig av st\u00f8rrelses\u00f8kning<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Uavhengig blindet gjennomgang og sentral &nbsp;vurdering av skanninger<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Anbefales i noen tilfeller \u2013 f.eks. i noen studier med progresjonsbaserte endepunkter for markedsf\u00f8ringstillatelse<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Innsamling av alle skanninger (men ikke en uavhengig gjennomgang) anbefales for alle studier<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Bekreftet progresjon<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke p\u00e5krevet (med mindre det er tvetydig)<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">P\u00e5krevet<\/span><\/span><\/td>\n<\/tr>\n<tr>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Vurdering av allmenntilstand<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Ikke inkludert i evalueringen<\/span><\/span><\/td>\n<td align=\"left\"><span aria-labelledby=\"value\"><span class=\"objectBox objectBox-string\">Uendret allmenntilstand\/FS skal tas i betraktning ved beslutning om behandlingen skal fortsette etter iUPD<\/span><\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-16\"><p>Ytterligere informasjon om iRECIST og h\u00e5ndtering av nye lesjoner og iUPD finnes i &laquo;iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics&raquo;, Seymour et al. Lancet Oncol 2017<sup>2<\/sup>.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-14 fusion-sep-none fusion-title-text fusion-title-size-four\"><h4 class=\"fusion-title-heading title-heading-left\" style=\"margin:0;\">Referanse<\/h4><\/div><div class=\"fusion-text fusion-text-17\"><div>\n<ol>\n<li><i>Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45(2):228-47.<\/i><\/li>\n<li><i>Seymour L, Bogaerts J, Perrone A, Ford R, Schwartz LH, Mandrekar S, et al. iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics. Lancet Oncol. 2017;18(3):e143-52.<\/i><\/li>\n<\/ol>\n<\/div>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-overflow:hidden;--awb-bg-size:cover;--awb-border-radius:7px 7px 7px 7px;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-default fusion-button-default button-1 fusion-button-default-span fusion-button-default-type\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-5-malignant-hypercalcaemia\/\"><span class=\"fusion-button-text\">Se neste avsnitt: 3.5 Malign hyperkalsemi<\/span><i class=\"fa-arrow-alt-circle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:7px;--awb-border-radius-top-right:7px;--awb-border-radius-bottom-right:7px;--awb-border-radius-bottom-left:7px;--awb-overflow:hidden;--awb-margin-top:4px;--awb-background-color:var(--awb-color3);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-15 fusion-title-center fusion-title-text fusion-title-size-five\" style=\"--awb-text-color:#c1c1c1;--awb-margin-top:25px;--awb-sep-color:#e2e2e2;\"><div class=\"title-sep-container title-sep-container-left\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><span class=\"awb-title-spacer\"><\/span><h5 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Utforsk denne kapittelmenyen<\/h5><span class=\"awb-title-spacer\"><\/span><div class=\"title-sep-container title-sep-container-right\"><div class=\"title-sep sep-single sep-solid\" style=\"border-color:#e2e2e2;\"><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.88%;--awb-width-medium:66.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:2.88%;--awb-spacing-left-medium:2.88%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-2 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_bevel_color:rgba(89,96,104,0.7);--button_bevel_color_hover:rgba(89,96,104,0.9);--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:15px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-1-treatment-algorithm\/\"><span class=\"fusion-button-text\">3.1 Behandlingsalgoritme<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-3 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-2-treatment-criteria-for-initiation-of-tki\/\"><span class=\"fusion-button-text\">3.2 Behandlingskriterier for igangsetting av TKI<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-4 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-3-treatment-criteria-for-initiation-of-checkpoint-inhibitors\/\"><span class=\"fusion-button-text\">3.3 Behandlingskriterier for oppstart av sjekkpunkthemmere<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-5 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-4-response-evaluation\/\"><span class=\"fusion-button-text\">3.4 Responsevaluering<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-6 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-5-malignant-hypercalcaemia\/\"><span class=\"fusion-button-text\">3.5 Malign hyperkalsemi<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-7 fusion-button-span-yes fusion-has-button-gradient\" style=\"--button_accent_color:var(--awb-color6);--button_border_color:#e0e0e0;--button_accent_hover_color:var(--awb-color1);--button_border_hover_color:var(--awb-color3);--button_border_width-top:1px;--button_border_width-right:1px;--button_border_width-bottom:1px;--button_border_width-left:1px;--button_gradient_top_color:rgba(89,96,104,0.07);--button_gradient_bottom_color:rgba(89,96,104,0.33);--button_gradient_top_color_hover:#003c68;--button_gradient_bottom_color_hover:#003c68;--button_padding-top:20px;--button_padding-bottom:20px;--button_margin-top:3px;--button_margin-bottom:3px;\" target=\"_self\" data-hover=\"icon_slide\" href=\"http:\/\/d1s07skqdwll4z.cloudfront.net\/no\/mrcc-tool\/3-management-of-mrcc\/3-6-performance-status\/\"><span class=\"fusion-button-text\">3.6 Funksjonsstatus (PS)<\/span><i class=\"fa-angle-right fas button-icon-right\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_6 1_6 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:16.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:11.52%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:11.52%;--awb-width-medium:16.666666666667%;--awb-order-medium:0;--awb-spacing-right-medium:11.52%;--awb-spacing-left-medium:11.52%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><\/div><\/div>\n<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":7513,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"footnotes":""},"class_list":["post-7529","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/pages\/7529","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/comments?post=7529"}],"version-history":[{"count":49,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/pages\/7529\/revisions"}],"predecessor-version":[{"id":12478,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/pages\/7529\/revisions\/12478"}],"up":[{"embeddable":true,"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/pages\/7513"}],"wp:attachment":[{"href":"https:\/\/d1s07skqdwll4z.cloudfront.net\/no\/wp-json\/wp\/v2\/media?parent=7529"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}