Neoadjuvant immune-checkpoint inhibitors in lung cancer - a primer for radiologists

Daria Kifjak; Maximilian J Hochmair; Dagmar Krenbek; Ruxandra-Iulia Milos; Benedikt H Heidinger; Florian Prayer; Sebastian Röhrich; Martin L Watzenboeck; Felicitas Oberndorfer; Thomas Klikovits; Clemens Aigner; Katharina Sinn; Mir Alireza Hoda; Konrad Hoetzenecker; Alexander R Haug; Helmut Prosch; Lucian Beer

doi:10.1016/j.ejrad.2023.110732

Neoadjuvant immune-checkpoint inhibitors in lung cancer - a primer for radiologists

Eur J Radiol. 2023 Apr:161:110732. doi: 10.1016/j.ejrad.2023.110732. Epub 2023 Feb 8.

Authors

Daria Kifjak¹, Maximilian J Hochmair², Dagmar Krenbek³, Ruxandra-Iulia Milos⁴, Benedikt H Heidinger⁴, Florian Prayer⁴, Sebastian Röhrich⁴, Martin L Watzenboeck⁴, Felicitas Oberndorfer⁵, Thomas Klikovits⁶, Clemens Aigner⁶, Katharina Sinn⁷, Mir Alireza Hoda⁷, Konrad Hoetzenecker⁷, Alexander R Haug⁸, Helmut Prosch⁴, Lucian Beer⁹

Affiliations

¹ Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Machine Learning Driven Precision Imaging, Medical University of Vienna, Vienna, Austria; Department of Radiology, UMass Memorial Medical Center and University of Massachusetts Chan Medical School, Worcester, MA, USA.
² Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Klinik Floridsdorf, Vienna Healthcare Group, Vienna, Austria.
³ Department of Pathology, Klinik Floridsdorf, Vienna Healthcare Group, Vienna, Austria.
⁴ Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Machine Learning Driven Precision Imaging, Medical University of Vienna, Vienna, Austria.
⁵ Clinical Institute of Pathology, Medical University Vienna, Vienna, Austria.
⁶ Department of Thoracic Surgery, Klinik Floridsdorf, Vienna Healthcare Group, Vienna, Austria.
⁷ Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
⁸ Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
⁹ Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Machine Learning Driven Precision Imaging, Medical University of Vienna, Vienna, Austria. Electronic address: lucian.beer@meduniwien.ac.at.

PMID: 36804313
DOI: 10.1016/j.ejrad.2023.110732

Abstract

The introduction of neoadjuvant immune checkpoint inhibitors plus platinum-based chemotherapy has changed treatment regimens of patient's early-stage lung cancer. This treatment combination induces high rates of complete pathologic response and improves clinical endpoints. Imaging plays a fundamental role in assessment of treatment response, monitoring of (immune-related) adverse events and enables both the surgeon and pathologist optimal treatment and diagnostic workup of the resected tumor samples. Knowledge of the strengths and weaknesses of diagnostic imaging in this setting are essential for radiologists to provide valuable input in multidisciplinary team decisions.

Keywords: Immune-checkpoint inhibitor therapy; Immunotherapy; Lung cancer; NSCLC; Neoadjuvant; PET-CT; Response.

Publication types

Review

MeSH terms

Carcinoma, Non-Small-Cell Lung* / pathology
Humans
Immune Checkpoint Inhibitors
Immunotherapy / methods
Lung Neoplasms* / diagnostic imaging
Lung Neoplasms* / drug therapy
Lung Neoplasms* / pathology
Neoadjuvant Therapy / methods
Radiologists

Substances

Immune Checkpoint Inhibitors