Immunotherapy response evaluation with magnetic resonance elastography (MRE) in advanced HCC

Area of Science:

• Hepatobiliary imaging
• Oncology
• Immunotherapy

Background:

• Hepatocellular carcinoma (HCC) lacks established imaging predictors for immunotherapy outcomes.
• Magnetic resonance elastography (MRE) measures tissue stiffness, a potential indicator of tumor response.

Purpose of the Study:

• To investigate if changes in liver stiffness, assessed by MRE, can predict immunotherapy response in advanced HCC patients.
• To correlate MRE-derived stiffness changes with overall survival (OS), time to disease progression (TTP), and T-cell infiltration.

Main Methods:

• Prospective study of 15 advanced HCC patients treated with Pembrolizumab.
• Liver MRE and biopsy performed at baseline and 6 weeks.
• Spearman correlation analyzed the relationship between stiffness changes, OS, TTP, and intratumoral CD3+ T lymphocytes.

Main Results:

• Early changes in HCC stiffness at 6 weeks significantly correlated with OS (R=0.81) and TTP (R=0.88, p<0.01).
• HCC stiffness changes also correlated significantly with intratumoral T lymphocyte abundance (R=0.79, p=0.007).
• Non-tumor liver stiffness showed no significant change.

Conclusions:

• Pilot MRE data suggests early changes in tumor stiffness may serve as an indicator of immunotherapy response in advanced HCC.
• MRE-derived stiffness changes show promise as a non-invasive imaging biomarker for predicting treatment efficacy.