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EJNMMI Research
Published in: EJNMMI Research 1/2019

Open Access 01-12-2019 | Glioblastoma | Review

Imaging-guided precision medicine in glioblastoma patients treated with immune checkpoint modulators: research trend and future directions in the field of imaging biomarkers and artificial intelligence

Authors: Mathieu Sinigaglia, Tarek Assi, Florent L. Besson, Samy Ammari, Myriam Edjlali, Whitney Feltus, Laura Rozenblum-Beddok, Binsheng Zhao, Lawrence H. Schwartz, Fatima-Zohra Mokrane, Laurent Dercle

Published in: EJNMMI Research | Issue 1/2019

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Abstract

Immunotherapies that employ immune checkpoint modulators (ICMs) have emerged as an effective treatment for a variety of solid cancers, as well as a paradigm shift in the treatment of cancers. Despite this breakthrough, the median survival time of glioblastoma patients has remained at about 2 years. Therefore, the safety and anti-cancer efficacy of combination therapies that include ICMs are being actively investigated. Because of the distinct mechanisms of ICMs, which restore the immune system’s anti-tumor capacity, unconventional immune-related phenomena are increasingly being reported in terms of tumor response and progression, as well as adverse events. Indeed, immunotherapy response assessments for neuro-oncology (iRANO) play a central role in guiding cancer patient management and define a “wait and see strategy” for patients treated with ICMs in monotherapy with progressive disease on MRI. This article deciphers emerging research trends to ameliorate four challenges unaddressed by the iRANO criteria: (1) patient selection, (2) identification of immune-related phenomena other than pseudoprogression (i.e., hyperprogression, the abscopal effect, immune-related adverse events), (3) response assessment in combination therapies including ICM, and (4) alternatives to MRI. To this end, our article provides a structured approach for standardized selection and reporting of imaging modalities to enable the use of precision medicine by deciphering the characteristics of the tumor and its immune environment. Emerging preclinical or clinical innovations are also discussed as future directions such as immune-specific targeting and implementation of artificial intelligence algorithms.
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Metadata
Title
Imaging-guided precision medicine in glioblastoma patients treated with immune checkpoint modulators: research trend and future directions in the field of imaging biomarkers and artificial intelligence
Authors
Mathieu Sinigaglia
Tarek Assi
Florent L. Besson
Samy Ammari
Myriam Edjlali
Whitney Feltus
Laura Rozenblum-Beddok
Binsheng Zhao
Lawrence H. Schwartz
Fatima-Zohra Mokrane
Laurent Dercle
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
EJNMMI Research / Issue 1/2019
Electronic ISSN: 2191-219X
DOI
https://doi.org/10.1186/s13550-019-0542-5

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