Prognostic value of volumetric PET parameters at early response evaluation in melanoma patients treated with immunotherapy

Nakamoto, Ryusuke; Zaba, Lisa C.; Rosenberg, Jarrett; Reddy, Sunil; Nobashi, Tomomi W.; Davidzon, Guido; Aparici, Carina Marí; Nguyen, Judy; Moradi, Farshad; Iagaru, Andrei; Franc, Benjamin L.

doi:10.1007/s00259-020-04792-0

Cited by 22 publications

(14 citation statements)

References 32 publications

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“…The role of volumetric parameters in FDG-PET/CT as a predictive biomarker has been demonstrated in different types of cancers [5,[13][14][15][16][17]. The total metabolic tumor volume is a valuable parameter as it reflects the extent and activity of the tumor [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome

et al. 2021

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PD-1 Immune checkpoint inhibitors, such as Pembrolizumab, can have a durable beneficial therapeutic effect in patients with advanced melanoma. However, not all patients will benefit equally from these therapies, and (potentially life-threatening) immune-related adverse events may occur. In this study, we investigate the value of early response assessment by FDG-PET/CT as a biomarker for predicting survival. We identified all patients with advanced melanoma who were treated with Pembrolizumab in our medical center and underwent a baseline and at least one follow-up FDG-PET/CT. The total metabolic tumor volume (TMTV) was calculated, and the evolution was compared to survival parameters. A total of 77 patients underwent a baseline and at least one follow-up FDG-PET/CT, 36 patients had follow-up imaging within 2–4 months, and 21 patients an FDG-PET/CT 5–6 months after baseline. When the TMTV evolution was categorized into two subgroups (stable/decrease versus increase), an association was found between stability or decrease in TMTV and better PFS and OS. A similar trend, however non-significant, was observed at 5–6 months. The evolution in TMTV as assessed by FDG-PET/CT 2–4 months after treatment initiation is associated with long-term outcomes in patients with advanced melanoma treated with Pembrolizumab.

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Section: Discussionmentioning

confidence: 99%

Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome

et al. 2021

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“…Metabolic tumor volume (MTV) and glucose metabolism of normal tissues associated with immunity on 18 F-FDG PET/CT before and during immune checkpoint inhibitor (ICI) therapy have been explored as predictors of therapeutic efficacy (1)(2)(3)(4). The link between 18 F-FDG uptake by immunemediating tissues, such as the bone marrow (BM) and spleen, and poor cancer outcomes is hypothesized to be explained by generalized (5,6).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Bone Marrow Metabolism on Pretreatment ¹⁸F-FDG PET/CT in Patients with Metastatic Melanoma Treated with Anti-PD-1 Therapy

et al. 2021

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To investigate the prognostic value of F-FDG PET/CT parameters in melanoma patients before beginning anti-PD-1 therapy.Methods: Imaging parameters including SUVmax, metabolic tumor volume (MTV), and bone marrow to liver SUVmean ratio (BLR) were measured from baseline PET/CT in 92 patients before the start of anti-PD-1 therapy. Association with survival and imaging parameters combined with clinical factors was evaluated. Clinical and laboratory data between high (> median) and low (≤ median) BLR groups were compared.Results: Multivariate analyses demonstrated that BLR was an independent prognostic factor for PFS and OS (P = 0.017, P = 0.011, respectively). The high BLR group had higher levels of white blood cell count/neutrophil count and C-Reactive Protein than the low BLR group (P < 0.05). Conclusion:Patients with high BLR were associated with poor PFS and OS, potentially explained by evidence of systemic inflammation known to be associated with immunosuppression.

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“…In conclusion, despite the more effective way of assessing the [ 18 F]FDG PET-based response in patients treated with ICPIs, available studies suggest that [ 18 F]FDG PET can support decision-making about the continuation/discontinuation of therapy, as it can open several windows able to capture different aspects associated with the effect of treatment (i.e., pseudoprogression, hyperprogression, and IRAE) [56]. Table 2 reports the characteristics of published studies involving the use of [ 18 F]FDG PET to assess the response to ICI [46][47][48]50,51,54,[57][58][59][60][61][62][63][64][65][66][67][68]. Figure 2 shows a representative example of baseline and post-treatment [ 18 F]FDG PET in a patient with advanced NSCLC treated with Nivolumab.…”

Section: Pet-based Response To Icpis In Patients With Nsclcmentioning

confidence: 99%

Positron Emission Tomography-Based Response to Target and Immunotherapies in Oncology

et al. 2020

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2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) is a promising tool to support the evaluation of response to either target therapies or immunotherapy with immune checkpoint inhibitors both in clinical trials and, in selected patients, at the single patient’s level. The present review aims to discuss available evidence related to the use of [18F]FDG PET (Positron Emission Tomography) to evaluate the response to target therapies and immune checkpoint inhibitors. Criteria proposed for the standardization of the definition of the PET-based response and complementary value with respect to morphological imaging are commented on. The use of PET-based assessment of the response through metabolic pathways other than glucose metabolism is also relevant in the framework of personalized cancer treatment. A brief discussion of the preliminary evidence for the use of non-FDG PET tracers in the evaluation of the response to new therapies is also provided.

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Prognostic value of volumetric PET parameters at early response evaluation in melanoma patients treated with immunotherapy

Cited by 22 publications

References 32 publications

Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome

Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome

Prognostic Value of Bone Marrow Metabolism on Pretreatment ¹⁸F-FDG PET/CT in Patients with Metastatic Melanoma Treated with Anti-PD-1 Therapy

Positron Emission Tomography-Based Response to Target and Immunotherapies in Oncology

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Prognostic value of volumetric PET parameters at early response evaluation in melanoma patients treated with immunotherapy

Cited by 22 publications

References 32 publications

Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome

Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome

Prognostic Value of Bone Marrow Metabolism on Pretreatment 18F-FDG PET/CT in Patients with Metastatic Melanoma Treated with Anti-PD-1 Therapy

Positron Emission Tomography-Based Response to Target and Immunotherapies in Oncology

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Prognostic Value of Bone Marrow Metabolism on Pretreatment ¹⁸F-FDG PET/CT in Patients with Metastatic Melanoma Treated with Anti-PD-1 Therapy