Significantly higher 5-year DFS and OS were seen in 19 responders (TRG 3 or 4) than in 19 nonresponders (TRG 0-2; 94.4 vs. 48.8 %, p = 0.001; 94.7 vs. 63.2 %, p = 0.02, respectively). In multivariate analysis the only PET/CT SUVmax-based parameter significantly correlated with the likelihood of recurrence and survival was ∆SUV% <65 % (HR = 5.95, p = 0.02, for DFS; HR = 5.26, p = 0.04, for OS) CONCLUSION: This prospective study proved that (18)F-FDG PET/CT is a valuable imaging tool for assessing rectal cancer TRG and long-term prognosis, and could potentially serve as an intermediate endpoint in treatment optimization research and rectal cancer patient care.
Methods: Patients treated with an immune checkpoint inhibitor at the Medical University of Vienna from 2015-2018 have been identified using the in-house pharmacy records (n¼580; most frequent entities: 35.6% melanoma, 29.3% lungcancer; 89% stage-IV-disease). A retrospective chart-review was performed to screen for VTE and/or ATE. Cumulative incidences and between-group differences were analysed within a competing-risk framework. Multi-state modelling was applied to study the impact of VTE/ATE on clinical outcomes (mortality & progression of disease).Results: Over a median follow-up of 8.0 months, 39 VTE and 7 ATE were observed. Cumulative incidences of VTE and ATE were 12.9% [95%CI: 7.7-19.5)] and 1.9% [0.7-4.0]. Occurrence of VTE was associated with increased mortality (transition hazardratio (THR): 3.16 [95%CI: 2.06-4.86]) and an increase in risk of early disease progression (THR: 3.51 [95%CI: 2.25-5.48]). Disease-stage (all VTE occurred in stage IV tumors) and history of ) predicted VTE occurrence. No association of VTE with ECOG performance-status, Charlson-Comorbidity-Index or the Khorana-score was observed, and rates of VTE were comparable among subgroups of tumour types and checkpoint-inhibitory agents.Conclusions: Patients with cancer under immune checkpoint inhibitor therapy are at high risk of thromboembolism, especially VTE. Clinical predictors of VTE were advanced disease and history of VTE. Furthermore, VTE occurrence under immunotherapy was associated with increased risk of mortality and disease progression.Legal entity responsible for the study: The authors.
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