The clinical paradigm for managing patients with advanced cancer is evolving from population-based to increasingly individualized treatment regimens. Biomarkers from imaging, tissue, and blood can support decisions to deliver personalized combinations and sequences of cancer therapies, targeting diverse driver mutations, modulating immune responses, and synergizing with radiation. Within this framework, novel approaches for assessing response to therapy include fluorodeoxyglucose positron emission tomography imaging of immunologic flare with correlative studies of cytotoxic T-lymphocyte activation in peripheral blood. Artificial intelligence and radiomic pipelines are being leveraged to evaluate the tumor microenvironment and predict treatment response from longitudinal images. Molecular imaging biomarkers of the immune system are derived from metabolic probes, ex-vivo cell labeling, reporter gene techniques, and cell surface targets using antibodies and proteins. Preclinical and early phase clinical trial findings will be presented on visualization of immune cell subsets such as effector CD8+ T-cells. The role of molecular diagnostics and advanced tumor tissue analytics to guide optimal therapy selection will be elucidated. Investigations on quantitative imaging and peripheral blood biomarkers, including correlative dynamics of cancer metabolic response and immune cell repertoire, will be summarized in the context of personalized radiation and immune modulating therapy combinations. The session will conclude with a moderated panel discussion to promote engagement of medical physicists in this exciting area of multi-disciplinary clinical and translational science.
1. Identify imaging methods for assessing response to immunotherapy
2. Distinguish among artificial intelligence and radiomic pipelines for biomarker applications
3. Recognize emerging techniques for molecular imaging of the immune system
4. Understand the role of tissue molecular diagnostics in precision oncology
5. Appreciate complementary strengths of quantitative imaging and peripheral blood biomarkers
Funding Support, Disclosures, and Conflict of Interest: DM consults for GE Healthcare, serves on scientific advisory board for Reflexion and ImaginAb, and has ownership in Trevarx. MF receives grants from Merck, BMS/Celgene, ImaginAb, and Carisma Therapeutics. MF and AW consult for ImaginAb. AW serves as board member and holds stock ownership in ImaginAb. AW consults for AstraZeneca.