Frequency and imaging features of abdominal immune-related adverse events in metastatic lung cancer patients treated with PD-1 inhibitor

Alessandrino, Francesco; Sahu, Sangeeta; Nishino, Mizuki; Adeni, Anika E.; Tirumani, Sree Harsha; Shinagare, Atul B.; Awad, Mark M.

doi:10.1007/s00261-019-01935-2

Cited by 38 publications

(41 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Complications include perforation, sepsis, frank bleeding, or dehydration [49]. At computed tomography (CT), ICI-induced colitis appears as a diffuse inflammatory pattern characterised by wall thickening, mucosal hyperenhancement, mesenteric hyperaemia, and air-fluid levels [47,50,51]. Segmental involvement has also been reported.…”

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

“…Segmental involvement has also been reported. At positron emission tomography (PET)/CT, colitis results in diffuse and intense 18F-fluorodeoxyglucose ( 18 F-FDG)-avidity along the entire bowel [47,50] (Fig. 5).…”

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

“…These features may precede the onset of symptoms. Colonoscopy may show erythaema, ulceration, and mucosal friability, whereas neutrophilic, lymphocytic, or eosinophilic intraepithelial infiltrates and crypt invasion can be found on pathologic specimens [49,50]. ICI-related hepatitis has been reported in up to 19% of patients receiving anti-CTLA4, whereas it is rarely reported when using anti-PD1 or anti-PDL1 [40,42].…”

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

“…Although it is usually limited to a mild elevation of transaminases, life-threatening liver dysfunction may occur [38,39]. Imaging findings are shared with other causes of acute liver dysfunction, ranging from the absence of detectable abnormalities to hepatomegaly with parenchymal heterogeneity, periportal oedema, and perihepatic ascites [47,50,51]. While physiological 18 F-FDG uptake is usually not affected by diffuse liver diseases, a case of ICI-induced hepatitis showing an intense liver 18 F-FDG-uptake area at PET/CT has been reported [52].…”

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

“…Symptomatic pancreatitis is very rare. Classic features of acute pancreatitis including enlargement and oedema of the pancreatic gland associated with peripancreatic oedema and fluid collections can be observed [50]. Diffuse pancreatic FDG uptake on positron emission tomography/CT has been reported [53].…”

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

See 4 more Smart Citations

Imaging of tumour response to immunotherapy

et al. 2020

View full text Add to dashboard Cite

A wide range of cancer immunotherapy approaches has been developed including non-specific immune-stimulants such as cytokines, cancer vaccines, immune checkpoint inhibitors (ICIs), and adoptive T cell therapy. Among them, ICIs are the most commonly used and intensively studied. Since 2011, these drugs have received marketing authorisation for melanoma, lung, bladder, renal, and head and neck cancers, with remarkable and long-lasting treatment response in some patients. The novel mechanism of action of ICIs, with immune and T cell activation, leads to unusual patterns of response on imaging, with the advent of so-called pseudoprogression being more pronounced and frequently observed when compared to other anticancer therapies. Pseudoprogression, described in about 2-10% of patients treated with ICIs, corresponds to an increase of tumour burden and/or the appearance of new lesions due to infiltration by activated T cells before the disease responds to therapy. To overcome the limitation of response evaluation criteria in solid tumors (RECIST) to assess these specific changes, new imaging criteria-so-called immune-related response criteria and then immune-related RECIST (irRECIST)-were proposed. The major modification involved the inclusion of the measurements of new target lesions into disease assessments and the need for a 4-week re-assessment to confirm or not confirm progression. The RECIST working group introduced the new concept of "unconfirmed progression", into the irRECIST. This paper reviews current immunotherapeutic approaches and summarises radiologic criteria to evaluate new patterns of response to immunotherapy. Furthermore, imaging features of immunotherapy-related adverse events and available predictive biomarkers of response are presented.

show abstract

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

Section: Gastrointestinal Liver and Pancreatic Toxicitiesmentioning

confidence: 99%

See 3 more Smart Citations

Imaging of tumour response to immunotherapy

et al. 2020

View full text Add to dashboard Cite

show abstract

Role of medical imaging for immune checkpoint blockade therapy: From response assessment to prognosis prediction

2019

View full text Add to dashboard Cite

Immune checkpoint blockade (ICB) represents a promising approach in cancer therapy. Owing to the peculiar biologic mechanisms of anticancer activity, checkpoint blockers are accompanied with distinctive response patterns and toxicity profiles. Medical imaging is the cornerstone for response assessment to immunotherapy and plays a critical role in monitoring of immune‐related adverse events (irAEs). Imaging‐based biomarkers have shown tremendous potential for the prediction of therapeutic efficacies and clinical outcomes in patients treated with checkpoint inhibitors. In this article, the landscape of current response assessment systems for immunotherapy was reviewed with a special focus on the latest advances in the assessment of responses to ICB. Emerging imaging biomarkers were discussed along with the challenges regarding their clinical transformation. In addition, the biological mechanisms and clinical applications of ICB and irAEs were also within the scope of this review.

show abstract