Novel oncologic drugs: what they do and how they affect images

Area of Science:

• Oncology
• Radiology
• Molecular Imaging

Background:

• Targeted therapies aim to disrupt specific aberrant biologic pathways crucial for tumor development.
• Cancer cells exploit normal growth factor signaling pathways to promote proliferation and survival.
• Novel oncologic drugs include antiangiogenic agents, antivascular agents, receptor inhibitors (EGFR-HER2, KIT), PI3K/Akt/mTOR pathway inhibitors, and hormonal therapies.

Purpose of the Study:

• To review the role of functional and molecular imaging in evaluating tumor response to targeted therapies.
• To familiarize radiologists with imaging findings associated with targeted therapy response.
• To highlight how advanced imaging can augment conventional tumor response assessment.

Main Methods:

• Review of current literature on targeted therapies and their impact on tumor biology.
• Discussion of various imaging modalities used to assess tumor response.
• Specific mention of perfusion imaging (CT, MRI) for angiogenesis, diffusion-weighted MRI for cellularity, and PET/MR spectroscopy for metabolism.

Main Results:

• Targeted therapies interfere with key tumor processes like neoangiogenesis, metabolism, and proliferation.
• Anatomic, qualitative, and functional/molecular imaging are used to assess treatment response.
• Perfusion imaging, diffusion-weighted MRI, PET, and MR spectroscopy offer insights into tumor response.

Conclusions:

• Familiarity with imaging findings of targeted therapy response is essential for accurate clinical assessment.
• Functional and molecular imaging provide valuable data to supplement conventional response evaluation.
• Radiologists play a key role in assisting clinicians by accurately evaluating tumor response to targeted anticancer treatments.