Prof. Balyasnikova's project is truly game-changing for brain cancer treatment. The development of this novel non-invasive imaging approach is analogous to giving our medical experts a powerful new pair of glasses for the brain, allowing them to witness in real-time how immunotherapy battles GBM. This cutting-edge approach provides a dynamic and detailed view, ensuring quicker and more accurate assessments of treatment effectiveness. By enabling timely adjustments to therapy plans, it not only enhances patient care but also offers the precious gift of time – a crucial factor in the challenging journey against brain cancer. This innovative project represents a significant leap forward, promising a more proactive and effective approach to monitoring GBM and improving outcomes for those facing this formidable disease.

Prof. Balyasnikova's innovative imaging tool promises clinicians and researchers not only a more reliable but also an earlier indication of therapy effectiveness. This ensures timely adjustments to treatment plans, avoiding unnecessary delays. By incorporating an effective early monitoring program, we can provide patients with the gift of time, enabling a seamless transition to alternative therapies and enhancing the proactive and engaging approach to caring for brain cancer patients.

The recent success of immunotherapy in extracranial malignancies has translated into active clinical trials. However, the standard assessment for therapeutic response relies on conventional CT and MRI, both of which detect primary changes in the tumour (e.g., morphology, size) but fail to reflect the molecular alteration induced by immunotherapy, which often translates into subtle modifications at the cellular level directly linked to positive therapeutic response without early morphological manifestations. In this perspective, clinicians often have difficulty differentiating between actual tumour progression and pseudoprogression (i.e., the complex set of changes that mimic actual progression but, in reality, reflect positive therapeutic outcomes). Developing an imaging approach for monitoring immunotherapy response, which can improve the clinical ability to distinguish between the two regimens, represents an unmet clinical need. The proposed study will employ a preclinical framework aiming to monitor immunotherapeutic response in vivo using a multimodality imaging approach, allowing the detection of spatiotemporal changes in the tumour microenvironment with a particular focus on a quantitative regional assessment of early tumoural apoptosis, which plays an essential role in determining therapeutic outcome early before macroscopic morphological manifestations. The specific strength of our preclinical experimental design is in combined quantitative multiparametric MRI with 99mTc-duramycin SPECT (imaging agent targeting apoptosis) to capture the early changes in cellular and molecular tumour microenvironment linked to immunotherapeutic intervention. This approach will allow the visualization and GBM response to immunotherapy, facilitate toxicity monitoring in the surrounding healthy brain tissue, and identify patient responders and non-responders in the clinic.