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Review
. 2020 Jan 1;10(4):1708-1718.
doi: 10.7150/thno.38339. eCollection 2020.

Molecular imaging biomarkers for immune checkpoint inhibitor therapy

Affiliations
Review

Molecular imaging biomarkers for immune checkpoint inhibitor therapy

Pim P van de Donk et al. Theranostics. .

Abstract

Immune checkpoint inhibitors (ICIs) have substantially changed the field of oncology over the past few years. ICIs offer an alternative treatment strategy by exploiting the patients' immune system, resulting in a T cell mediated anti-tumor response. These therapies are effective in multiple different tumor types. Unfortunately, a substantial group of patients do not respond to ICIs. Molecular imaging, using single-photon emission computed tomography (SPECT) and positron emission tomography (PET), can provide non-invasive whole-body visualization of tumor and immune cell characteristics and might support patient selection or response evaluations for ICI therapies. In this review, recent studies with 18F-fluorodeoxyglucose-PET imaging, imaging of immune checkpoints and imaging of immune cells will be discussed. These studies are until now mainly exploratory, but the first results suggest that molecular imaging biomarkers could have a role in the evaluation of ICI therapy.

Keywords: biomarkers; immune checkpoint inhibitor; immunotherapy.; molecular imaging; positron emitting tomography.

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Conflict of interest statement

Competing Interests: E.G.E. de Vries reports institutional financial support for her advisory role from Daiichi Sankyo, Merck, NSABP, Pfizer, Sanofi, Synthon and for clinical trials or contracted research from Amgen, AstraZeneca, Bayer, Chugai Pharma, CytomX Therapeutics, G1 Therapeutics, Genentech, Nordic Nanovector, Radius Health, Roche, Synthon. S.F. Oosting reports institutional financial support for clinical trials or contracted research from Celldex, Pfizer, Novartis, Bristol Myers Squibb, Kura Oncology, MedImmune, Roche, Merck Sharp & Dohme. A.J. van der Wekken reports institutional financial support for his advisory role from Pfizer, Boehringer-Ingelheim, Roche (diagnostics), Astra Zeneca and institutional financial support for clinical trials from AstraZeneca. All remaining authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of 18F-FDG-PET and 89Zr-atezolizumab-PET imaging. Maximum intensity projections of 18F-FDG-PET, 1 h after tracer injection (A) and 89Zr-atezolizumab-PET, 7 days after tracer injection (B) of a 53 year old woman diagnosed with NSCLC. Both imaging modalities show uptake in multiple intra-pulmonary metastases. The 18F-FDG-PET scan shows physiological high uptake in the brain and excretion via the kidneys. At the moment of this scan the patient had a post-renal obstruction due to a kidney stone. The 89Zr-atezolizumab-PET scan shows high uptake in the spleen (red arrow). The 18F-FDG-PET scan was performed 46 days prior to the 89Zr-atezolizumab-PET scan. Both scans were scaled equally (0-8).

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