Transcript DELIVER IMAGING BIOMARKERS INTO THE CLINIC at

Imaging approaches for delivery of personalised cancer treatment
CRUK Cancer Imaging Centre
Institute of Cancer Research London and
Royal Marsden Hospital, London, UK.
M O Leach, N deSouza, D-M Koh, G Flux,
S Robinson, G ter Haar, J Bamber
Theme 5 – Developing whole body multiparametric imaging
Theme 5 - Informatics and imaging developments
PRECISION MEDICINE
2. Image heterogeneity of phenotype to
predict and monitor treatment response
3. Image response to
targetted treatment
DWI b900
Whole body imaging can evaluate:
heterogeneous disease
body burden
Subtracted CE
ADC
4.Imaging
biomarker driven
therapy
Whole-cohort processing pipelines
3-D interaction with registered
multimodality data
Microscopy
• whole-slide
• confocal
• time-lapse
Optical CT
Carbozantinib (XL184) promising
MET, AXL and VEGFR2 inhibitor
62 yr metastatic CRPC
• absorption
• emission
• FLIM/FRET
Pretreatment
OCT
IVIS
Photoacoustic
Differential imaging response
Elastography
5.METHODOLOGY AND INFORMATICS
Repository for
multi-centre trials
DICOM modalities
New approaches for functional
contrast imaging
Normalised Contrast enhanced
Imaging
1. Link
imaging
phenotype to
genotype
MRIS
CT
PET
SPECT
US
Seamless integration with both ICR
and open-source applications
Spectral CZT
Combined imaging shows
response and action despite
differential imaging effects
Import images with complete
metadata regardless of origin
b = 900 s2 / mm
18F-FDG
PET/CT
Same interface for both patient and
pre-clinical data
Increased emphasis on ontology,
controlled vocabulary and contentbased image search
micro x-ray CT
MALDI
genomic
Post 6 weeks XL184 treatment
non-DICOM modalities
With J deBono and DDU
DELIVERING A VISION OF PRECISION MEDICINE
Clinical need: Response & predictive biomarkers in sclerotic disease
orthotopic model of VCaP
prostate cancer
Molecular
Pathology
Therapeutic
development
Genetics &
Epidemiology
vehicle
Pre treatment
PSA 357
12 wks of
abiraterone
PSA 31.5
cabozantinib
Tc-99m MDP
Tc-99m MDP
CANCER IMAGING
INNOVATE AND TRANSLATE
DELIVER IMAGING BIOMARKERS INTO THE CLINIC
at
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CT
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ADC 879
Day 0
Identify response and resistance
ADC1496
Day 15
DW-MRI
DW-MRI
C Messiou
Aid detection
Stratify patients for targetted therapy
CT
Day 0
T Graham, S Robinson
Day 15
Impact: Relate pattern of
change in imaging biomarkers
to subsequent relapse
Drive and guide therapy delivery
The research programme encompasses a range of
cancer and scientific questions. Questions range from
improved detection and diagnosis, prognosis,
planning, guidance and response
A range of modalities include MR, PET, SPECT, US,
opticaland opto-acoustic techniques. research is
closely integrated and highly translational. There is
emphasis on new biomarkers.
Research is closely integrated with a range of other
programmes, including drug development,
radiotherapy, basic cancer biology, clinical units in
major cancers.