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Multiparametric MRI of early tumor response to immune checkpoint blockade in metastatic melanoma. | LitMetric

AI Article Synopsis

  • - The study investigates how multiparametric MRI can detect early changes in metastatic melanoma following immune checkpoint therapy, aiming to understand tumor behavior better than traditional imaging methods.
  • - Fifteen patients were analyzed, showing varied responses in their tumors, with some lesions demonstrating early signs of tumor cell death and increased diffusivity after three weeks of treatment.
  • - Results indicated that tumor heterogeneity was higher in progressive lesions compared to responding ones, highlighting multiparametric MRI's potential for assessing treatment efficacy in real-time.

Article Abstract

Background: Immune checkpoint inhibitors are now standard of care treatment for many cancers. Treatment failure in metastatic melanoma is often due to tumor heterogeneity, which is not easily captured by conventional CT or tumor biopsy. The aim of this prospective study was to investigate early microstructural and functional changes within melanoma metastases following immune checkpoint blockade using multiparametric MRI.

Methods: Fifteen treatment-naïve metastatic melanoma patients (total 27 measurable target lesions) were imaged at baseline and following 3 and 12 weeks of treatment on immune checkpoint inhibitors using: T-weighted imaging, diffusion kurtosis imaging, and dynamic contrast-enhanced MRI. Treatment timepoint changes in tumor cellularity, vascularity, and heterogeneity within individual metastases were evaluated and correlated to the clinical outcome in each patient based on Response Evaluation Criteria in Solid Tumors V.1.1 at 1 year.

Results: Differential tumor growth kinetics in response to immune checkpoint blockade were measured in individual metastases within the same patient, demonstrating significant intertumoral heterogeneity in some patients. Early detection of tumor cell death or cell loss measured by a significant increase in the apparent diffusivity (D) (p<0.05) was observed in both responding and pseudoprogressive lesions after 3 weeks of treatment. Tumor heterogeneity, as measured by apparent diffusional kurtosis (K), was consistently higher in the pseudoprogressive and true progressive lesions, compared with the responding lesions throughout the first 12 weeks of treatment. These preceded tumor regression and significant tumor vascularity changes (K, v, and v) detected after 12 weeks of immunotherapy (p<0.05).

Conclusions: Multiparametric MRI demonstrated potential for early detection of successful response to immune checkpoint inhibitors in metastatic melanoma.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475139PMC
http://dx.doi.org/10.1136/jitc-2021-003125DOI Listing

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