Improving imaging based assessment of tumours’ response to treatment
Writer: Dror Nir, PhD.
The protocol for imaging-based assessment of cancer patients’ response to oncological drugs is known as the RECIST 1.1 criteria; The Role of Medical Imaging in Personalized Medicine . RECIST is mainly relying on morphological evaluation of tumors’ size . I recently participated to a webinar organised by Oncodesign which presented the potential use of more advanced imaging techniques as tools to improve the assessment of cancer patients’ response during oncological clinical trials.
It’s first part, describes a methodology developed based on the original approach of the DITEP* at the “Institut Gustave Roussy”. A method that takes into account kinetics of tumor growth at the pre-treatment phase and along the entire treatment sequence. The conclusion is that adding Tumor Growth Rate (TGR) assessment in Phase I and Phase III clinical trials is simple and provides clinically relevant information: (i) It allows for an early and precise assessment of the tumor growth, (ii) It reveals drug-specific profiles, suggesting its potential use for the early assessment of drug activity, (iii)TGR is independently associated with prognosis both in early clinical trials and in phase III setting.
The second part presents two functional imaging modalities based on MRI: diffusion-weighted imaging (Dw-MRI) and Dynamic Contrast-Enhanced MRI (DCE-MRI). Dw-MRI gives measures of tissue architecture at the cellular level, whereas DCE-MRI provides information on the vascular status of tumors. Both methods have been standardized and used extensively as early PD biomarkers of the efficacy of anticancer therapies. The presentation goes through preclinical and clinical case studies illustrating how these two techniques can be used to evaluate the activity of novel drug candidates.
I recommend watching a recording of this webinar on YouTube . Note, the voice recording is not so good but, the effort is worthwhile….