# Progressive disease and radiographic progression

Source: https://onco.cc/terms/progressive-disease/  
OnCo record `progressive-disease` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The point at which a cancer is judged to be growing again despite treatment, usually a 20% increase on scans or a new lesion (RECIST). It ends progression-free survival, usually triggers a change of treatment, and defines 'lines' of therapy.

## Summary

Progression is assessed on scheduled scans (every 6-12 weeks in trials), so recorded progression dates depend on imaging frequency; blinded central review reduces investigator bias. Immunotherapy introduced pseudoprogression (apparent growth from immune infiltration before shrinkage), handled by iRECIST's 'unconfirmed progression' category, and hyperprogression (rapid acceleration in a minority). Molecular progression (rising ctDNA or PSA) precedes radiographic progression by months and is now used to trigger treatment switches in trials (SERENA-6). Oligoprogression, growth at one or a few sites while the rest is controlled, is treated with local therapy while continuing the systemic drug.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: progressive disease; progression; disease progression; radiographic progression; radiological progression; clinical progression; progressed; progressing; on progression; at progression; after progression; post-progression; upon progression; time of progression; pseudoprogression; pseudo-progression; hyperprogression; iRECIST; iUPD; iCPD; PSA progression; biochemical progression; molecular progression; ctDNA progression; oligoprogressive

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Response_Evaluation_Criteria_in_Solid_Tumors
- Wikipedia: https://en.wikipedia.org/wiki/Response_Evaluation_Criteria_in_Solid_Tumors

## Connected records

- terms: [Circulating tumour DNA (ctDNA)](https://onco.cc/terms/ctdna/), [Complete response (CR) and partial response (PR)](https://onco.cc/terms/complete-response-term/), [Lines of therapy](https://onco.cc/terms/first-line/), [Oligometastatic disease](https://onco.cc/terms/oligometastatic/), [Progression-free survival (PFS)](https://onco.cc/terms/pfs/), [RECIST](https://onco.cc/terms/recist/)
- fronts: [Drug Discovery Platforms](https://onco.cc/fronts/drug-discovery/)
- trials: [SERENA-6](https://onco.cc/trials/serena-6/)
- key papers: [Therasse 2000: RECIST, the standard rules for measuring whether a tumour responds](https://onco.cc/key-papers/paper-therasse-recist-jnci-2000/)

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