Multiparametric magnetic resonance imaging in the assessment of anti-EGFRvIII chimeric antigen receptor T cell therapy in patients with recurrent glioblastoma

Wang, Sumei; O’Rourke, Donald M.; Chawla, Sanjeev; Verma, Gaurav; Nasrallah, MacLean P.; Morrissette, Jennifer J.D.; Plesa, Gabriela; June, Carl H.; Brem, Steven; Maloney, Eileen; Desai, Arati; Poptani, Harish; Mohan, Suyash

doi:10.1038/s41416-018-0342-0

Cited by 30 publications

(34 citation statements)

References 7 publications

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“…Treatment response to CAR-T cell therapy from 10 recurrent GBM patients was evaluated at 1, 2 and 3 month follow-up periods using MR methods ( Figure 11 ) [ 115 ]. In this study, all tumors exhibited increased volume relative to baseline on post-contrast T1-weighted images secondary to the presence of pronounced inflammatory response, making it difficult to assess therapeutic response, based on conventional imaging.…”

Section: Role Of Physiologic Mr and Pet Imaging In The Assessment Of Treatment Response To Immunotherapiesmentioning

confidence: 99%

Physiological Imaging Methods for Evaluating Response to Immunotherapies in Glioblastomas

Chawla

Shehu

Gupta

et al. 2021

IJMS

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Glioblastoma (GBM) is the most malignant brain tumor in adults, with a dismal prognosis despite aggressive multi-modal therapy. Immunotherapy is currently being evaluated as an alternate treatment modality for recurrent GBMs in clinical trials. These immunotherapeutic approaches harness the patient’s immune response to fight and eliminate tumor cells. Standard MR imaging is not adequate for response assessment to immunotherapy in GBM patients even after using refined response assessment criteria secondary to amplified immune response. Thus, there is an urgent need for the development of effective and alternative neuroimaging techniques for accurate response assessment. To this end, some groups have reported the potential of diffusion and perfusion MR imaging and amino acid-based positron emission tomography techniques in evaluating treatment response to different immunotherapeutic regimens in GBMs. The main goal of these techniques is to provide definitive metrics of treatment response at earlier time points for making informed decisions on future therapeutic interventions. This review provides an overview of available immunotherapeutic approaches used to treat GBMs. It discusses the limitations of conventional imaging and potential utilities of physiologic imaging techniques in the response assessment to immunotherapies. It also describes challenges associated with these imaging methods and potential solutions to avoid them.

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Section: Role Of Physiologic Mr and Pet Imaging In The Assessment Of Treatment Response To Immunotherapiesmentioning

confidence: 99%

Physiological Imaging Methods for Evaluating Response to Immunotherapies in Glioblastomas

Chawla

Shehu

Gupta

et al. 2021

IJMS

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“…While multimodal imaging has been shown possible (133), CAR T-cell tracking in animals has demonstrated homing and persistence in the tumors and spleen by ex vivo MRI of tissue samples after CAR T-cell labeling with perfluorocarbon (134) and in whole animals by immuno-PET (135). Although the context of CAR T-cell therapy would be appropriate to develop genetic modification of the T-cells to express reporter genes as discussed above, the outcome of therapy remains monitored mostly by functional imaging and especially by MRI (136).…”

Section: Car (Chimeric Antigen Receptor) T-cell Therapymentioning

confidence: 99%

Cell Tracking in Cancer Immunotherapy

et al. 2020

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The impressive development of cancer immunotherapy in the last few years originates from a more precise understanding of control mechanisms in the immune system leading to the discovery of new targets and new therapeutic tools. Since different stages of disease progression elicit different local and systemic inflammatory responses, the ability to longitudinally interrogate the migration and expansion of immune cells throughout the whole body will greatly facilitate disease characterization and guide selection of appropriate treatment regiments. While using radiolabeled white blood cells to detect inflammatory lesions has been a classical nuclear medicine technique for years, new non-invasive methods for monitoring the distribution and migration of biologically active cells in living organisms have emerged. They are designed to improve detection sensitivity and allow for a better preservation of cell activity and integrity. These methods include the monitoring of therapeutic cells but also of all cells related to a specific disease or therapeutic approach. Labeling of therapeutic cells for imaging may be performed in vitro, with some limitations on sensitivity and duration of observation. Alternatively, in vivo cell tracking may be performed by genetically engineering cells or mice so that may be revealed through imaging. In addition, SPECT or PET imaging based on monoclonal antibodies has been used to detect tumors in the human body for years. They may be used to detect and quantify the presence of specific cells within cancer lesions. These methods have been the object of several recent reviews that have concentrated on technical aspects, stressing the differences between direct and indirect labeling. They are briefly described here by distinguishing ex vivo (labeling cells with paramagnetic, radioactive, or fluorescent tracers) and in vivo (in vivo capture of injected radioactive, fluorescent or luminescent tracers, or by using labeled antibodies, ligands, or pre-targeted clickable substrates) imaging methods. This review focuses on cell tracking in specific therapeutic applications, namely cell therapy, and particularly CAR (Chimeric Antigen Receptor) T-cell therapy, which is a fast-growing research field with various therapeutic indications. The potential impact of imaging on the progress of these new therapeutic modalities is discussed.

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“…Higher values of FA correlate with greater directionality of the white matter tracts . The geometric indices (CL, CP, and CS) have been used to differentiate GBM from metastasis and lymphoma, TP from PsP, brain infections from necrotic neoplasms, and to evaluate treatment response to immunotherapy in GBM patients, suggesting that directional organization of tissue microstructure may provide additional useful information …”

Section: Diffusion Tensor Imagingmentioning

confidence: 99%

“…. In additional studies from our group, we employed 3D‐EPSI in assessing treatment response to anti‐EGFRvIII chimeric antigen receptor T‐cell therapy and tumor treating fields in patients with GBM. These studies indicate that 3D‐EPSI may be a valuable tool to study brain tumor metabolism and assess for treatment response.…”

Section: Proton Magnetic Resonance Spectroscopymentioning

confidence: 99%

“…While assessing the therapeutic effect of anti‐EGFRvIII chimeric antigen receptor T‐cell therapy in patients with recurrent GBM, our group recently demonstrated that progression probability values derived from multiparametric MRI might allow a more accurate evaluation of treatment response than the use of individual parameters in isolation. Some other studies have also demonstrated the potential of multiparametric MRI in assessing treatment response to immunotherapies and targeted therapies in GBM patients …”

Section: Importance Of Multiparametric Analysismentioning

confidence: 99%

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Emerging MRI Techniques to Redefine Treatment Response in Patients With Glioblastoma

Gonçalves

Chawla

Mohan

2020

Magnetic Resonance Imaging

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Glioblastoma is the most common and most malignant primary brain tumor. Despite aggressive multimodal treatment, its prognosis remains poor. Even with continuous developments in MRI, which has provided us with newer insights into the diagnosis and understanding of tumor biology, response assessment in the posttherapy setting remains challenging. We believe that the integration of additional information from advanced neuroimaging techniques can further improve the diagnostic accuracy of conventional MRI. In this article, we review the utility of advanced neuroimaging techniques such as diffusion‐weighted imaging, diffusion tensor imaging, perfusion‐weighted imaging, proton magnetic resonance spectroscopy, and chemical exchange saturation transfer in characterizing and evaluating treatment response in patients with glioblastoma. We will also discuss the existing challenges and limitations of using these techniques in clinical settings and possible solutions to avoiding pitfalls in study design, data acquisition, and analysis for future studies. Level of Evidence 2 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2020;52:978–997.

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Multiparametric magnetic resonance imaging in the assessment of anti-EGFRvIII chimeric antigen receptor T cell therapy in patients with recurrent glioblastoma

Cited by 30 publications

References 7 publications

Physiological Imaging Methods for Evaluating Response to Immunotherapies in Glioblastomas

Physiological Imaging Methods for Evaluating Response to Immunotherapies in Glioblastomas

Cell Tracking in Cancer Immunotherapy

Emerging MRI Techniques to Redefine Treatment Response in Patients With Glioblastoma

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