About 35% of patients with a type of blood cancer called diffuse large B-cell lymphoma don`t
respond well to standard treatment or their cancer comes back. When this happens, newer
treatments like CAR T-cell therapy (using modified immune cells) or bispecific antibodies (special
proteins that help the immune system fight cancer) are an option. However, these treatments are
only successful in about half the patients. It is currently difficult to predict which patients will
respond to these treatments or experience serious side effects. This makes it hard to choose the
best treatment plan for a given patient.
In this project, a special type of magnetic resonance imaging (MRI) scan will be used to track
immune cells called macrophages that live around tumors. These cells can either help fight cancer or
help cancer grow. By understanding how these cells behave, it may be possible to predict treatment
success. The MRI technique involves injecting an iron-based substance called ferumoxytol, which can
be used as an MRI contrast agent, into patients` veins. This contrast agent gets absorbed by the
macrophages, making them visible on MRI scans throughout the entire body - not just one tumor
spot. Sixty patients will be scanned before and after treatment (30 getting CAR T-cells, 30 getting
bispecific antibodies), and results will be compared with traditional tissue samples.
The goals are to predict which patients will go into complete remission, predict who will survive
longer without cancer progression, and identify patients at risk for serious side effects like cytokine
release syndrome. If successful, this imaging technique could help to personalize treatment choices,
potentially improving outcomes while avoiding unnecessary toxicity in patients who will not benefit
from these intensive therapies.