IrRADIOMICS: Assessing Response and Predictive Utility of Advanced Imaging in Dogs Receiving Cancer Immunotherapy

摘要

Although immunotherapy is becoming one of the cornerstones of modern cancer therapy resulting in durable favorable outcomes for patients, the assessment of clinical response to immunotherapy is still a very challenging task.1 Immunotherapy response patterns can be substantially different from those of classical cytotoxic therapies.2 A significant subset of patients first experience a pseudo-progression after the administration of immunotherapy, and the actual response/ shrinkage of tumours can be delayed and only observed later in the time course of therapy. Four different distinct immunotherapy response patterns are associated with favorable survival;2 (a) shrinkage in baseline lesions with no new lesions, (b) long-term stable disease, (c) responseafter an initial increase (pseudoprogression) of tumors, and (d) response of initial lesions but with appearance of new lesions. Therefore, the standard Response Evaluation Criteria in Solid Tumours (RECIST l.l.)3 are not appropriate for assessing the effects of immunotherapy. For example, as defined by RECIST, patients experiencing early pseudoprogression or patients with response in the presence of new lesions would be characterized as progressive disease (PD), indicating treatment failure and suggesting cessation of therapy. However, as mentioned before, such treatment response patterns following immunotherapy can be associated with eventual tumor regression/ stabilization and potentially long-term survival. In 2009, immune-related response criteria (irRC), based upon data from ipilimumab trials (monoclonal antibody targeting CTLA-4) were recommended for use in immunotherapy.