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免疫检查点抑制:影像学引导的未来。

Immune checkpoint inhibition: a future guided by radiology.

机构信息

Foundation Doctor, Buckinghamshire Hospitals NHS Trust, Amersham, Buckinghamshire, United Kingdom.

Academic Clinical Lecturer Nuffield Department of Surgical Sciences University of Oxford, Wellington Square, Oxford, United Kingdom.

出版信息

Br J Radiol. 2023 Jul;96(1147):20220565. doi: 10.1259/bjr.20220565. Epub 2023 Feb 27.

Abstract

The limitation of the function of antitumour immune cells is a common hallmark of cancers that enables their survival. As such, the potential of immune checkpoint inhibition (ICI) acts as a paradigm shift in the treatment of a range of cancers but has not yet been fully capitalised. Combining minimally and non-invasive locoregional therapies offered by radiologists with ICI is now an active field of research with the aim of furthering therapeutic capabilities in medical oncology. In parallel to this impending advancement, the "imaging toolbox" available to radiologists is also growing, enabling more refined tumour characterisation as well as greater accuracy in evaluating responses to therapy. Options range from metabolite labelling to cellular localisation to immune checkpoint screening. It is foreseeable that these novel imaging techniques will be integrated into personalised treatment algorithms. This growth in the field must include updating the current standardised imaging criteria to ensure they are fit for purpose. Such criteria is crucial to both appropriately guide clinical decision-making regarding next steps of treatment, but also provide reliable prognosis. Quantitative approaches to these novel imaging techniques are also already being investigated to further optimise personalised therapeutic decision-making. The therapeutic potential of specific ICIs and locoregional therapies could be determined before administration thus limiting unnecessary side-effects whilst maintaining efficacy. Several radiological aspects of oncological care are advancing simultaneously. Therefore, it is essential that each development is assessed for clinical use and optimised to ensure the best treatment decisions are being offered to the patient. In this review, we discuss state of the art advances in novel functional imaging techniques in the field of immuno-oncology both pre-clinically and clinically.

摘要

肿瘤免疫细胞功能受限是癌症的共同特征之一,使它们能够存活。因此,免疫检查点抑制(ICI)的潜力在治疗多种癌症方面带来了范式转变,但尚未得到充分利用。放射科医生提供的最小侵袭性和局部区域疗法与 ICI 的结合,现在是一个活跃的研究领域,旨在进一步提高肿瘤学的治疗能力。与此同时,放射科医生可用的“成像工具箱”也在不断发展,能够更精细地对肿瘤进行特征描述,并更准确地评估对治疗的反应。这些选择从代谢物标记到细胞定位再到免疫检查点筛选不等。可以预见,这些新的成像技术将被整合到个性化治疗算法中。该领域的增长必须包括更新当前的标准化成像标准,以确保其符合目的。这些标准对于适当指导治疗下一步的临床决策以及提供可靠的预后都至关重要。这些新的成像技术的定量方法也已经在研究中,以进一步优化个性化治疗决策。在给药之前,可以确定特定的 ICI 和局部区域治疗的治疗潜力,从而限制不必要的副作用,同时保持疗效。肿瘤学护理的几个放射学方面正在同时推进。因此,评估每个发展的临床用途并进行优化以确保为患者提供最佳治疗决策至关重要。在这篇综述中,我们讨论了免疫肿瘤学领域中新型功能成像技术在临床前和临床中的最新进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93b7/10321249/bb40d23eed7c/bjr.20220565.g001.jpg

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