Assessment of treatment response to dendritic cell vaccine in patients with glioblastoma using a multiparametric MRI-based prediction model

• Published in: Journal of neuro-oncology Vol. 163; no. 1; pp. 173 - 183
• Main Authors: de Godoy, Laiz Laura, Chawla, Sanjeev, Brem, Steven, Wang, Sumei, O’Rourke, Donald M., Nasrallah, MacLean P., Desai, Arati, Loevner, Laurie A., Liau, Linda M., Mohan, Suyash
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2023; Springer Nature B.V
• Subjects: Brain cancer; Dendritic cells; DNA methylation; Glioblastoma; Histopathology; Magnetic resonance imaging; Medicine; Medicine & Public Health; Neurology; Oncology; Patients; Prediction models; Tumors; Vaccines; Treatment response; Dendritic cell vaccine; Multiparametric MRI; Immunotherapy; Glioblastoma
• ISSN: 0167-594X; 1573-7373; 1573-7373
• DOI: 10.1007/s11060-023-04324-4

Purpose Autologous tumor lysate-loaded dendritic cell vaccine (DCVax-L) is a promising treatment modality for glioblastomas. The purpose of this study was to investigate the potential utility of multiparametric MRI-based prediction model in evaluating treatment response in glioblastoma patients treated with DCVax-L. Methods Seventeen glioblastoma patients treated with standard-of-care therapy + DCVax-L were included. When tumor progression (TP) was suspected and repeat surgery was being contemplated, we sought to ascertain the number of cases correctly classified as TP + mixed response or pseudoprogression (PsP) from multiparametric MRI-based prediction model using histopathology/mRANO criteria as ground truth. Multiparametric MRI model consisted of predictive probabilities (PP) of tumor progression computed from diffusion and perfusion MRI-derived parameters. A comparison of overall survival (OS) was performed between patients treated with standard-of-care therapy + DCVax-L and standard-of-care therapy alone (external controls). Additionally, Kaplan–Meier analyses were performed to compare OS between two groups of patients using PsP, Ki-67, and MGMT promoter methylation status as stratification variables. Results Multiparametric MRI model correctly predicted TP + mixed response in 72.7% of cases (8/11) and PsP in 83.3% (5/6) with an overall concordance rate of 76.5% with final diagnosis as determined by histopathology/mRANO criteria. There was a significant concordant correlation coefficient between PP values and histopathology/mRANO criteria (r = 0.54; p  = 0.026). DCVax-L-treated patients had significantly prolonged OS than those treated with standard-of-care therapy (22.38 ± 12.8 vs. 13.8 ± 9.5 months, p  = 0.040). Additionally, glioblastomas with PsP, MGMT promoter methylation status, and Ki-67 values below median had longer OS than their counterparts. Conclusion Multiparametric MRI-based prediction model can assess treatment response to DCVax-L in patients with glioblastoma.