Author: A98jVsg334QQ

Immunotherapy agents show great promise and are currently used to treat a growing range of cancers. However, emerging evidence from randomized trials and clinical practice demonstrate highly variable patterns of toxicity and treatment response that can lead to severe immune-related adverse events. The complex interplay between tumor response, immune-induced organ toxicity and immune system activation make a comprehensive assessment of treatment response extremely difficult.

Theranostic therapies combine molecular targeted diagnostics with radionuclides for imaging and therapy in many advanced malignancies. Frequently however, due to heterogeneity of treatment response, complete remission in theranostic treatment is rare; residual lesions often progress and the treatment can induce severe symptoms. Contributing to the problem, are the number of lesions that often metastasize to other areas of the body such as bone and liver. Identifying, measuring and tracking the treatment response of numerous metastatic lesions, using standard medical images, is difficult and challenges the ability to understand the efficacy and safety of a new theranostic treatment expeditiously. This lapse of understanding can cost researchers valuable time and resources.

The ASCO Educational Book recently published a paper by Dr. William McKean and colleagues that speaks to both the promise and challenges of treating cancer patients with immunotherapies. This well-researched article, titled “Biomarkers in Precision Cancer Immunotherapy: Promise and Challenges,” systematically reviews the effectiveness of different classes of biomarkers in predicting both beneficial treatment response and harmful side effects. Ultimately, the authors conclude that “none of these are comprehensive in predicting potential benefit.” The paper makes only a brief mention, however, of another technology that could offer a real solution: advanced imaging. At AIQ Solutions (AIQ) we are working on technology that combines PET/CT scan data with advanced algorithms to better determine which patients will have a desirable response to immunotherapy.

It’s generally accepted that not all patients respond the same way to a given therapy. This makes a lot of sense because we’re all different. However, what’s less understood, is how each individual lesion within our body responds differently to a specific therapy. With access to better tools, we’re able to capture more information with less invasive techniques in order to visualize what’s truly happening inside a patient as they undergo treatment.

A substantial amount of excitement and hope has been placed on the promise of “Precision Medicine.” And for good reason! The idea that medicine is finally reaching a point where we can personalize treatment for individuals in order to improve overall outcomes is very exciting. For the first time, there is a real possibility that we will be able to treat individuals based on prediction and personalization rather than treating a patient based on how a population responded to a given drug. However, we must collectively set our overall expectations accordingly…for now. Precision medicine in practice is still complex and presents limitations on how it can be effectively applied individually, as well as scaled to the general public.

Heterogeneity is defined as the state of diverseness. Although greatly appreciated as a unique part of human nature, it leads to immense unpredictability when treating human disease. Inter-patient heterogeneity is well studied where each patient responds differently to a particular therapy. However, intra-patient heterogeneity is under-recognized where individual disease sites within a patient respond differently to the same therapy at different times.