Radiopharmacology and molecular imaging of PD-L1 expression in cancer
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Immunotherapy [(specifically, antibodies blocking programmed death ligand-1 (PD-L1)] is a valuable option in cancer treatment because it leads to durable tumour regression and improves survival in several cancers. Patients with PD-L1 expressing tumours benefit from this therapy, but currently it can only be determined through biopsy, which may be inconclusive or impossible due to lesion location, associated risks, intratumoral and interlesional heterogeneity. Therefore, radio-immune-imaging with a specific radiopharmaceutical is ideally placed to play an important role when performing real-time, in vivo, whole-body and non-invasive PD-L1 expression mapping.
To describe and summarise published scientific data on imaging PD-L1 expression using radiopharmaceuticals and discuss future directions in this research field.
A summary review of the literature was done through PubMed to search papers that described and included radiopharmaceuticals to image PD-L1 expression. Only English papers published until April 2018 that detailed laboratorial and animal procedures were selected.
Eleven pre-clinical papers published between 2015 and 2018 were included. Four studies used anti-PD-L1 radiopharmaceuticals labelled with Indium-111, 4 with Copper-64, 2 with Fluoride-18 and 1 with both Copper-64 and Gallium-68. All of them had identical protocols and showed similar radiopharmaceutical biodistribution. They reported successful anti-PD-L1 labelling, with high tumour–background ratio (mainly when spleen uptake was saturated with unlabelled/cold antibody).
All reported radiopharmaceuticals had high sensitivity and specificity to identify tumours with PD-L1 expression in animal model. Clinical experiments appear to be now justifiable.
KeywordsAnti-PD-L1 Checkpoint inhibitors Immunotherapy Radiopharmacology Molecular imaging Nuclear medicine
SCV: Literature Search and Review; Manuscript Writing, Editing and Content Planning. ASC: Literature Review; Manuscript Writing, Editing and Content Planning. FPO: Literature Review; Manuscript Writing, Editing and Content Planning. NG: Editing and Content Planning. CB: Editing and Content Planning. AP: Editing and Content Planning. DCC: Manuscript Writing, Editing and Content Planning.
S. C. Vaz, A. S. Capacho and D. C. Costa received antibody anti-PDL1 [clone 6E11] through a MTA from Genentech.
Compliance with ethical standards
Conflict of interest
F. P. Oliveira, N. Gil, C. Barros and A. Parreira declare no conflict of interest.
Not applicable. This is a literature review. This article does not contain any studies with human participants or animals performed by any of the authors.
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