Imaging the Cancer Immune Environment and Its Response to Pharmacologic Intervention, Part 2: The Role of Novel PET Agents.
Although 18F-FDG PET/CT is widely available and is increasingly being used to monitor response to immunotherapy and simultaneously identify immune-related adverse events, there are several challenges in interpreting the results of this investigation, especially early in the course of treatment. It also has limited utility in selecting the optimal type of immunotherapy. As knowledge about immune contexture increases, new targets that may be amenable to imaging are being defined. These exciting advances, coupled with increasingly sophisticated methods for generating radiopharmaceuticals, provide the potential for either replacing or complementing 18F-FDG PET/CT in the selection and monitoring of immunotherapy. Approaches include imaging specific characteristics of immune cell infiltrates or aspects of the tumor microenvironment that are known to be associated with suppression of the innate and adaptive immune response. Following a large body of preclinical work, promising agents that are entering into early clinical evaluation are discussed. We suggest a speculative algorithm as to how these might be used in routine practice, subject to validation in clinical trials.
['Iravani|Amir|A|', 'Hicks|Rodney J|RJ|']
D018414:CD8-Positive T-Lymphocytes D019788:Fluorodeoxyglucose F18 D006801:Humans D000082082:Immune Checkpoint Inhibitors D007167:Immunotherapy D009369:Neoplasms D000072078:Positron Emission Tomography Computed Tomography D019275:Radiopharmaceuticals D059016:Tumor Microenvironment
PET radiopharmaceuticals immune checkpoint molecular imaging oncology: melanoma