title: Mechanism and non-mechanism based imaging biomarkers for assessing biological response to treatment in non-small cell lung cancer.
abstract: Therapeutic options in locally advanced non-small cell lung cancer (NSCLC) have expanded in the past decade to include a palate of targeted interventions such as high dose targeted thermal ablations, radiotherapy and growing platform of antibody and small molecule therapies and immunotherapies. Although these therapies have varied mechanisms of action, they often induce changes in tumour architecture and microenvironment such that response is not always accompanied by early reduction in tumour mass, and evaluation by criteria other than size is needed to report more effectively on response. Functional imaging techniques, which probe the tumour and its microenvironment through novel positron emission tomography and magnetic resonance imaging techniques, offer more detailed insights into and quantitation of tumour response than is available on anatomical imaging alone. Use of these biomarkers, or other rational combinations as readouts of pathological response in NSCLC have potential to provide more accurate predictors of treatment outcomes. In this article, the robustness of the more commonly available positron emission tomography and magnetic resonance imaging biomarker indices is examined and the evidence for their application in NSCLC is reviewed.
authors.affiliation: CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, UK. Electronic address: alex.weller@icr.ac.uk.
authors.forename: A
authors.initials: A
authors.lastname: Weller
authors.affiliation: Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: M E R
authors.initials: MER
authors.lastname: O'Brien
authors.affiliation: Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: S
authors.initials: S
authors.lastname: Popat
authors.affiliation: Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: J
authors.initials: J
authors.lastname: Bhosle
authors.affiliation: Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: F
authors.initials: F
authors.lastname: McDonald
authors.affiliation: Department of Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: T A
authors.initials: TA
authors.lastname: Yap
authors.affiliation: Department of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Du
authors.affiliation: Radiology Department, St George's Hospital NHS Trust, London, SW17 0QT, UK.
authors.forename: I
authors.initials: I
authors.lastname: Vlahos
authors.affiliation: CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, UK.
authors.forename: N M
authors.initials: NM
authors.lastname: deSouza
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D015687:Cell Hypoxia; D049109:Cell Proliferation; D005544:Forecasting; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008175:Lung Neoplasms / Q000098:blood supply / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D058990:Molecular Targeted Therapy / Q000379:methods; D064847:Multimodal Imaging; D015588:Observer Variation; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016896:Treatment Outcome; D059016:Tumor Microenvironment
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals
keywords: CT; Diffusion; Dynamic contrast; Imaging biomarkers; MRI; Non-small cell lung cancer; PET; PET tracer; Targeted cancer therapy; Treatment response