Quantitative Diffusion-Weighted Imaging Analyses to Predict Response to Neoadjuvant Immunotherapy in Patients with Locally Advanced Head and Neck Carcinoma
Cancers, vol. 14, pp. 6235
Abstract
Background: Neoadjuvant immune checkpoint blockade (ICB) prior to surgery may induce early pathological responses in head and neck squamous cell carcinoma (HNSCC) patients. Routine imaging parameters fail to diagnose these responses early on. Magnetic resonance (MR) diffusion-weighted imaging (DWI) has proven to be useful for detecting HNSCC tumor mass after (chemo)radiation therapy. METHODS: 32 patients with stage II–IV, resectable HNSCC, treated at a phase Ib/IIa IMCISION trial (NCT03003637), were retrospectively analyzed using MR-imaging before and after two doses of single agent nivolumab (anti-PD-1) (n = 6) or nivolumab with ipilimumab (anti-CTLA-4) ICB (n = 26). The primary tumors were delineated pre- and post-treatment. A total of 32 features were derived from the delineation and correlated with the tumor regression percentage in the surgical specimen. Results: MR-DWI data was available for 24 of 32 patients. Smaller baseline tumor diameter (p = 0.01−0.04) and higher sphericity (p = 0.03) were predictive of having a good pathological response to ICB. Post-treatment skewness and the change in skewness between MRIs were negatively correlated with the tumor’s regression (p = 0.04, p = 0.02). Conclusion: Pre-treatment DWI tumor diameter and sphericity may be quantitative biomarkers for the prediction of an early pathological response to ICB. Furthermore, our data indicate that ADC skewness could be a marker for individual response evaluation.
Authors 8
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Hedda J. van der Hulst corresponding
The Netherlands Cancer Institute · Maastricht University
Affiliation as printed
Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
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Memorial Sloan Kettering Cancer Center · The Netherlands Cancer Institute
Affiliation as printed
Department of Head and Neck Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
Human Oncology and Pathology Program, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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The Netherlands Cancer Institute
Affiliation as printed
Department of pathology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
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Amsterdam University Medical Centers · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center (AUMC), Location VUmc, 081 HV Amsterdam, The Netherlands
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University of Southern Denmark · The Netherlands Cancer Institute · Maastricht University
Affiliation as printed
Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark
GROW School for Oncology and Developmental Biology, University of Maastricht, 6211 LK Maastricht, The Netherlands
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Amsterdam UMC Location University of Amsterdam · The Netherlands Cancer Institute · Amsterdam University Medical Centers
Affiliation as printed
Department of Head and Neck Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (AUMC), Location AMC, 1105 AZ Amsterdam, The Netherlands
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Leiden University Medical Center · Amsterdam UMC Location University of Amsterdam · The Netherlands Cancer Institute · Amsterdam University Medical Centers
Affiliation as printed
Department of Head and Neck Surgery, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (AUMC), Location AMC, 1105 AZ Amsterdam, The Netherlands
Department of Otorhinolaryngology Head Neck Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
Division of Tumor Biology and Immunology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
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The Netherlands Cancer Institute
Affiliation as printed
Department of Radiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
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