Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma: Increased Tumor Size on MRI Associated with Favorable Pathology

Mariam H. Goreish; Nicolò Gennaro; Laetitia Perronne; Gorkem Durak; Amir A. Borhani; Hatice Savas; Linda Kelahan; Ryan Avery; Kamal Subedi; Tugce Agirlar Trabzonlu; Ulas Bagci; Baris Turkbey; Spyridon Bakas; Sean Sachdev; Ronen Sumagin; Borislav A. Alexiev; Pedro Hermida de Viveiros; Seth M. Pollack; Yuri S. Velichko

doi:10.3390/cancers17050830

Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma: Increased Tumor Size on MRI Associated with Favorable Pathology

Mariam H. Goreish, Nicolò Gennaro, Laetitia Perronne, Gorkem Durak, Amir A. Borhani, Hatice Savas, Linda Kelahan, Ryan Avery, Kamal Subedi, Tugce Agirlar Trabzonlu, Ulas Bagci, Baris Turkbey, Spyridon Bakas, Sean Sachdev, Ronen Sumagin, Borislav A. Alexiev, Pedro Hermida de Viveiros, Seth M. Pollack, Yuri S. Velichko^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

MRI measurements can effectively differentiate UPS patients into good and poor pathological responders to neoadjuvant therapy. Interestingly, a tumor size increase across all dimensions on MRI may paradoxically indicate a favorable response. In contrast, tumors exhibiting minimal size increase or even shrinkage on MRI after therapy warrant caution, as they are associated with a higher risk of local recurrence following surgery. These findings highlight the limitations of RECIST criteria in accurately assessing the response of UPS to neoadjuvant therapy.

Original language	English (US)
Article number	830
Journal	Cancers
Volume	17
Issue number	5
DOIs	https://doi.org/10.3390/cancers17050830
State	Published - Mar 2025

Funding

Support for this work was provided by the Department of Radiology, Feinberg School of Medicine, Northwestern University.

Keywords

MRI
RECIST
neoadjuvant chemoradiotherapy
pathology
sarcoma

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/cancers17050830

Cite this

Goreish, M. H., Gennaro, N., Perronne, L., Durak, G., Borhani, A. A., Savas, H., Kelahan, L., Avery, R., Subedi, K., Agirlar Trabzonlu, T., Bagci, U., Turkbey, B., Bakas, S., Sachdev, S., Sumagin, R., Alexiev, B. A., Hermida de Viveiros, P., Pollack, S. M., & Velichko, Y. S. (2025). Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma: Increased Tumor Size on MRI Associated with Favorable Pathology. Cancers, 17(5), Article 830. https://doi.org/10.3390/cancers17050830

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title = "Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma: Increased Tumor Size on MRI Associated with Favorable Pathology",

abstract = "MRI measurements can effectively differentiate UPS patients into good and poor pathological responders to neoadjuvant therapy. Interestingly, a tumor size increase across all dimensions on MRI may paradoxically indicate a favorable response. In contrast, tumors exhibiting minimal size increase or even shrinkage on MRI after therapy warrant caution, as they are associated with a higher risk of local recurrence following surgery. These findings highlight the limitations of RECIST criteria in accurately assessing the response of UPS to neoadjuvant therapy.",

keywords = "MRI, RECIST, neoadjuvant chemoradiotherapy, pathology, sarcoma",

author = "Goreish, {Mariam H.} and Nicol{\`o} Gennaro and Laetitia Perronne and Gorkem Durak and Borhani, {Amir A.} and Hatice Savas and Linda Kelahan and Ryan Avery and Kamal Subedi and {Agirlar Trabzonlu}, Tugce and Ulas Bagci and Baris Turkbey and Spyridon Bakas and Sean Sachdev and Ronen Sumagin and Alexiev, {Borislav A.} and {Hermida de Viveiros}, Pedro and Pollack, {Seth M.} and Velichko, {Yuri S.}",

note = "Publisher Copyright: {\textcopyright} 2025 by the authors.",

year = "2025",

month = mar,

doi = "10.3390/cancers17050830",

language = "English (US)",

volume = "17",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

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Goreish, MH, Gennaro, N, Perronne, L, Durak, G, Borhani, AA , Savas, H , Kelahan, L , Avery, R , Subedi, K , Agirlar Trabzonlu, T , Bagci, U, Turkbey, B, Bakas, S, Sachdev, S , Sumagin, R , Alexiev, BA , Hermida de Viveiros, P , Pollack, SM & Velichko, YS 2025, 'Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma: Increased Tumor Size on MRI Associated with Favorable Pathology', Cancers, vol. 17, no. 5, 830. https://doi.org/10.3390/cancers17050830

TY - JOUR

T1 - Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma

T2 - Increased Tumor Size on MRI Associated with Favorable Pathology

AU - Goreish, Mariam H.

AU - Gennaro, Nicolò

AU - Perronne, Laetitia

AU - Durak, Gorkem

AU - Borhani, Amir A.

AU - Savas, Hatice

AU - Kelahan, Linda

AU - Avery, Ryan

AU - Subedi, Kamal

AU - Agirlar Trabzonlu, Tugce

AU - Bagci, Ulas

AU - Turkbey, Baris

AU - Bakas, Spyridon

AU - Sachdev, Sean

AU - Sumagin, Ronen

AU - Alexiev, Borislav A.

AU - Hermida de Viveiros, Pedro

AU - Pollack, Seth M.

AU - Velichko, Yuri S.

PY - 2025/3

Y1 - 2025/3

N2 - MRI measurements can effectively differentiate UPS patients into good and poor pathological responders to neoadjuvant therapy. Interestingly, a tumor size increase across all dimensions on MRI may paradoxically indicate a favorable response. In contrast, tumors exhibiting minimal size increase or even shrinkage on MRI after therapy warrant caution, as they are associated with a higher risk of local recurrence following surgery. These findings highlight the limitations of RECIST criteria in accurately assessing the response of UPS to neoadjuvant therapy.

AB - MRI measurements can effectively differentiate UPS patients into good and poor pathological responders to neoadjuvant therapy. Interestingly, a tumor size increase across all dimensions on MRI may paradoxically indicate a favorable response. In contrast, tumors exhibiting minimal size increase or even shrinkage on MRI after therapy warrant caution, as they are associated with a higher risk of local recurrence following surgery. These findings highlight the limitations of RECIST criteria in accurately assessing the response of UPS to neoadjuvant therapy.

KW - MRI

KW - RECIST

KW - neoadjuvant chemoradiotherapy

KW - pathology

KW - sarcoma

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U2 - 10.3390/cancers17050830

DO - 10.3390/cancers17050830

M3 - Article

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SN - 2072-6694

VL - 17

JO - Cancers

JF - Cancers

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ER -

Paradoxical Response to Neoadjuvant Therapy in Undifferentiated Pleomorphic Sarcoma: Increased Tumor Size on MRI Associated with Favorable Pathology

Abstract

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Keywords

ASJC Scopus subject areas

UN SDGs

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