Imaging Findings of Complications of New Anticancer Drugs

Area of Science:

• Oncology
• Radiology
• Pharmacology

Background:

• Anticancer drug development has advanced significantly, introducing molecular targeted therapeutics (MTTs), immune checkpoint inhibitors (ICIs), chimeric antigen receptor T-cell (CAR-T) therapy, and antibody-drug conjugates (ADCs).
• Each class of novel anticancer agents possesses distinct mechanisms of action, leading to a wide spectrum of potential complications.
• Understanding these drug-specific toxicities is crucial for effective patient management.

Purpose of the Study:

• To review the diverse complications associated with novel anticancer therapeutics.
• To highlight the importance of medical imaging in identifying and managing these drug-induced toxicities.
• To emphasize the evolving role of radiologists in multidisciplinary cancer care teams.

Main Methods:

• Review of current literature on the mechanisms of action and associated toxicities of MTTs, ICIs, CAR-T therapy, and ADCs.
• Analysis of imaging findings related to common and rare complications.
• Discussion of the clinical implications for patient care and the role of radiologists.

Main Results:

• MTTs can cause ischemia or endothelial damage (anti-angiogenic) or specific toxicities based on targets.
• ICIs are linked to immune-related adverse events (pneumonitis, colitis, hepatitis, etc.).
• CAR-T therapy presents unique risks like cytokine release syndrome and neurotoxicity, while ADCs involve payload-related toxicities.

Conclusions:

• Novel anticancer drugs present a broad range of drug-specific complications.
• Medical imaging is essential for the early detection and characterization of these toxicities.
• Radiologists require updated knowledge of these imaging manifestations to support oncologists and ensure optimal patient outcomes.