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多参数磁共振成像在评估抗 EGFRvIII 嵌合抗原受体 T 细胞疗法治疗复发性胶质母细胞瘤患者中的应用。

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

机构信息

Department of Radiology, Division of Neuroradiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Br J Cancer. 2019 Jan;120(1):54-56. doi: 10.1038/s41416-018-0342-0. Epub 2018 Nov 27.

DOI:10.1038/s41416-018-0342-0
PMID:30478409
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6325110/
Abstract

EGFRvIII targeted chimeric antigen receptor T (CAR-T) cell therapy has recently been reported for treating glioblastomas (GBMs); however, physiology-based MRI parameters have not been evaluated in this setting. Ten patients underwent multiparametric MRI at baseline, 1, 2 and 3 months after CAR-T therapy. Logistic regression model derived progression probabilities (PP) using imaging parameters were used to assess treatment response. Four lesions from "early surgery" group demonstrated high PP at baseline suggestive of progression, which was confirmed histologically. Out of eight lesions from remaining six patients, three lesions with low PP at baseline remained stable. Two lesions with high PP at baseline were associated with large decreases in PP reflecting treatment response, whereas other two lesions with high PP at baseline continued to demonstrate progression. One patient didn't have baseline data but demonstrated progression on follow-up. Our findings indicate that multiparametric MRI may be helpful in monitoring CAR-T related early therapeutic changes in GBM patients.

摘要

EGFRvIII 靶向嵌合抗原受体 T (CAR-T) 细胞疗法最近被报道可用于治疗胶质母细胞瘤 (GBM);然而,在这种情况下,尚未评估基于生理学的 MRI 参数。10 名患者在 CAR-T 治疗前、治疗后 1、2 和 3 个月进行了多参数 MRI。使用影像参数建立的逻辑回归模型推导进展概率 (PP) 用于评估治疗反应。“早期手术”组的 4 个病灶在基线时显示出较高的 PP,提示进展,这在组织学上得到了证实。在其余 6 名患者的 8 个病灶中,3 个基线时 PP 较低的病灶保持稳定。2 个基线时 PP 较高的病灶与治疗反应相关的 PP 大幅下降有关,而另外 2 个基线时 PP 较高的病灶继续显示进展。1 名患者没有基线数据,但在随访中显示进展。我们的研究结果表明,多参数 MRI 可能有助于监测 GBM 患者 CAR-T 相关的早期治疗变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4626/6325110/ebb69f486737/41416_2018_342_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4626/6325110/ebb69f486737/41416_2018_342_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4626/6325110/ebb69f486737/41416_2018_342_Fig1_HTML.jpg

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Commentary: Pitfalls in the Neuroimaging of Glioblastoma in the Era of Antiangiogenic and Immuno/Targeted Therapy.评论:抗血管生成及免疫/靶向治疗时代胶质母细胞瘤神经影像学的陷阱
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Recurrent glioma clinical trial, CheckMate-143: the game is not over yet.
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