Neoadjuvant immune-checkpoint inhibitors in lung cancer - a primer for radiologists. Issue 161 (April 2023)

• Record Type: Journal Article
• Authors: Kifjak, Daria; Hochmair, Maximilian J.; Krenbek, Dagmar; Milos, Ruxandra-Iulia; Heidinger, Benedikt H.; Prayer, Florian; Röhrich, Sebastian; Watzenboeck, Martin L.; Oberndorfer, Felicitas; Klikovits, Thomas; Aigner, Clemens; Sinn, Katharina; Hoda, Mir Alireza; Hoetzenecker, Konrad; Haug, Alexander R.; Prosch, Helmut; Beer, Lucian
• Is Part Of: European journal of radiology. Issue 161(2023)
• Publication Date: 2023-04
• Subjects: Lung cancer -- NSCLC -- Immunotherapy -- Immune-checkpoint inhibitor therapy -- Neoadjuvant -- PET-CT -- Response; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2023.110732
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Neoadjuvant chemo-immuntherapy induces high rates of complete pathologic response in patients with NSCLC. Metabolic and morphologic tumour regression is associated with histopathologic response. Pre-operative imaging is mandatory for surgery planning and improves pathologic workup so surgical specimens. Nodal-immune fare (sarcoid like reaction) can mimic nodal tumour progression. 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.