Quantitative, longitudinal measurements of response to immunotherapy for glioblastoma using multiparametric MRI in a long-term survivor treated with autologous tumor lysate-loaded dendritic cell vaccine: an illustrative case.
8 affiliations
- 1Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
- 2Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
- 3Glioblastoma Translational Center of Excellence, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
- 4Miller School of Medicine, University of Miami, Florida.
- 5Division of Hematology/Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
- 6Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
- 7Clinical Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
- 8Hoag Specialty Clinics, Newport Beach, California.
Abstract
Background
Neurosurgeons are in the forefront of developing clinical trials that harness the immune system to combat glioblastoma. Autologous tumor lysate-loaded dendritic cell vaccine (DCVax-L) is a novel immunotherapy for glioblastoma. An unmet need is to develop a sensitive, specific, feasible, clinically relevant, neuroimaging biomarker that accurately reflects response to immunotherapy.Observations
This illustrative case involves a 63-year-old female who survived for 64 months following near-total resection of a glioblastoma and enrollment in a clinical trial (NCT00045968) using DCVax-L. A multivariate logistic regression model was used to assess treatment response longitudinally at 11 time points measuring predictive probability (PP) of tumor progression based on diffusion tensor imaging- and perfusion-weighted imaging-derived parameters within the contrast-enhancing region. Lesions were considered true progression (TP) if the PP was ≥ 50% and pseudoprogression (PsP; predominant treatment effects) if the PP was < 50 %. These findings were subsequently validated by histopathological analysis during resection for tumor recurrence.Lessons
These findings support the use of multiparametric MRI to monitor the effects of immunotherapy in patients with glioblastoma. Such multiparametric prediction models using noninvasive, advanced neuroimaging may be helpful to differentiate TP from PsP in longitudinal assessment of treatment response. https://thejns.org/doi/10.3171/CASE26655.
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BibTeX
@article{rajan2026quantitative,
title = {{Quantitative, longitudinal measurements of response to immunotherapy for glioblastoma using multiparametric MRI in a long-term survivor treated with autologous tumor lysate-loaded dendritic cell vaccine: an illustrative case.}},
author = {Archith Rajan and Steven Brem and Daniel Gewolb and Ajay Kumar and Laiz Laura de Godoy and Arati Desai and MacLean P Nasrallah and Timothy Lucas and Laurie A Loevner and Suyash Mohan and Sanjeev Chawla},
journal = {Journal of neurosurgery. Case lessons},
year = {2026},
month = oct,
doi = {10.3171/case26655},
url = {https://europepmc.org/article/MED/42896233},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Quantitative, longitudinal measurements of response to immunotherapy for glioblastoma using multiparametric MRI in a long-term survivor treated with autologous tumor lysate-loaded dendritic cell vaccine: an illustrative case.
AU - Archith Rajan
AU - Steven Brem
AU - Daniel Gewolb
AU - Ajay Kumar
AU - Laiz Laura de Godoy
AU - Arati Desai
AU - MacLean P Nasrallah
AU - Timothy Lucas
AU - Laurie A Loevner
AU - Suyash Mohan
AU - Sanjeev Chawla
PY - 2026
DA - 2026/10/19
JO - Journal of neurosurgery. Case lessons
DO - 10.3171/case26655
UR - https://europepmc.org/article/MED/42896233
AB - Background Neurosurgeons are in the forefront of developing clinical trials that harness the immune system to combat glioblastoma. Autologous tumor lysate-loaded dendritic cell vaccine (DCVax-L) is a novel immunotherapy for glioblastoma. An unmet need is to develop a sensitive, specific, feasible, clinically relevant, neuroimaging biomarker that accurately reflects response to immunotherapy.Observations This illustrative case involves a 63-year-old female who survived for 64 months following near-total resection of a glioblastoma and enrollment in a clinical trial (NCT00045968) using DCVax-L. A multivariate logistic regression model was used to assess treatment response longitudinally at 11 time points measuring predictive probability (PP) of tumor progression based on diffusion tensor imaging- and perfusion-weighted imaging-derived parameters within the contrast-enhancing region. Lesions were considered true progression (TP) if the PP was ≥ 50% and pseudoprogression (PsP; predominant treatment effects) if the PP was < 50 %. These findings were subsequently validated by histopathological analysis during resection for tumor recurrence.Lessons These findings support the use of multiparametric MRI to monitor the effects of immunotherapy in patients with glioblastoma. Such multiparametric prediction models using noninvasive, advanced neuroimaging may be helpful to differentiate TP from PsP in longitudinal assessment of treatment response. https://thejns.org/doi/10.3171/CASE26655.
SN - 2694-1902
ER -