RADIOGENOMICS FOR IMMUNOTHERAPY IN GLIOBLASTOMA

Abstract

AIMS: Immunotherapy is an effective precision medicine treatment for several cancers. Obtaining imaging signatures of the underlying genome (radiogenomics) in glioblastoma patients, has the potential to identify immune biomarkers pre-operatively and allow personalized neo-adjuvant treatment. The increased use of whole genome sequencing data, and the developments in bioinformatics and machine learning provide the opportunity for such developments. Therefore, we performed a systematic review of radiogenomic biomarkers for immunotherapy in glioblastoma to identify current and potential targets for immunotherapy. METHOD: A systematic review was performed following PRISMA guidelines on the databases of PubMed, Medline and Embase. QUADAS 2 questionnaire was utilized for quality assessment. Qualitative analysis was performed. Insufficient data prevented meta-analysis. PROSPERO: CRD42022340968 RESULTS: Five articles were included, and all articles were retrospective studies. Biomarkers identified from MRI im- ages included apparent diffusion coefficient (ADC) values, relative cerebral blood flow (rCBV) values and radiomic features that correlated with genomic markers from tumour cells and immune cells (tumour associated macrophages (TAMs), T cells and antigen presenting cells. Risk of Bias and applicability concerns were raised by QUADAS quality assessment. CONCLUSIONS: Radiogenomic immune biomarkers are likely to provide early treatment options to patients with glioblastoma and will help improve quality of life of patients. There is a paucity of prospective studies identifying these diagnostic biomarkers, and interpretation is limited due to high risk of bias and poor generalisability . Targeted immunotherapy based on these biomarkers has the potential to allow individualised neo-adjuvant precision treatment options in clinical trials, plausibly leading to enhanced overall survival of these patients.