FDG PET/CT for tumoral and systemic immune response monitoring of advanced melanoma during first-line combination ipilimumab and nivolumab treatment
Purpose We aimed to investigate the role of FDG-PET/CT in monitoring of response and immune-related adverse events (irAEs) following first-line combination-immune checkpoint inhibitor (combination-ICI) therapy for advanced melanoma. Methods We retrospectively reviewed outcomes in patients who had (1...
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| Veröffentlicht in: | European journal of nuclear medicine and molecular imaging 2020-11, Vol.47 (12), p.2776-2786 |
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| creator | Iravani, Amir Osman, Medhat M. Weppler, Alison M. Wallace, Roslyn Galligan, Anna Lasocki, Arian Hunter, Morgan O. Akhurst, Tim Hofman, Michael S. Lau, Peter K. H. Kee, Damien Au-Yeung, George Sandhu, Shahneen Hicks, Rodney J. |
| description | Purpose
We aimed to investigate the role of FDG-PET/CT in monitoring of response and immune-related adverse events (irAEs) following first-line combination-immune checkpoint inhibitor (combination-ICI) therapy for advanced melanoma.
Methods
We retrospectively reviewed outcomes in patients who had (1) first-line nivolumab plus ipilimumab; (2) pre- and post-treatment FDG-PET/CT scans (pre-FDG-PET/CT and post-FDG-PET/CT) within 2 and 4 months of starting ICI, respectively; and (3) at least one lesion assessable by PET response criteria in solid tumors (PERCIST). Extracranial response was monitored by 3 monthly FDG-PET/CT. Whole-body metabolic tumor volume (wbMTV) was measured pre- and post-treatment and correlated with outcome. FDG-PET/CT manifestations of irAE were defined as new increased non-tumoral uptake on post-FDG-PET/CT and were correlated with clinical presentation.
Results
Thirty-one consecutive patients, median age 60 years (range, 30–78), were identified from 2016 to 2018. The median number of combination-ICI cycles to the first post-FDG-PET/CT response assessment was 3 (interquartile range (IQR), 2–4). The best-overall responses were complete metabolic response (CMR) in 25 (80%), partial metabolic response (PMR) in 3 (10%), and progressive metabolic disease (PMD) in 3 (10%) patients. Patients with PMD had significantly higher pre-treatment wbMTV (
p
= 0.009). At a median follow-up of 21.5 months, 26 (84%) patients were alive with median progression-free and overall survival not reached. Secondary progression occurred in 9/31 (29%) patients at a median of 8.2 months (IQR, 6.9–15.5), of those majority (78%) was detected by FDG-PET/CT. Of 36 findings on post-FDG-PET/CT suggestive of irAE, 29 (80%) had clinical confirmation. In 3 (7%), the FDG-PET/CT findings preceded clinical presentation. The most common FDG-PET/CT detectable irAEs were endocrinopathies (36%) and enterocolitis (35%).
Conclusion
FDG-PET/CT response evaluation predicts the long-term outcome of patients treated with first-line combination-ICIs. Long-term treatment response monitoring for detection of extracranial secondary progression is feasible by FDG-PET/CT. Beyond response assessment, FDG-PET/CT frequently detects clinically relevant irAEs, which may involve multiple systems contemporaneously or at various time-points and may precede clinical diagnosis. |
| doi_str_mv | 10.1007/s00259-020-04815-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_proquest_journals_2579873676</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2579873676</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-84a2fafc7a623674c903f8bec27573214b4eaa6b322cbbbab6215f54e2b784d13</originalsourceid><addsrcrecordid>eNqNkc9uFSEUxidGY2v1BVwYEjcmZix_hoFZmrGtJk10cV0TYMDQDHAFpjd9jz6wdKZeExfGFYfw-w7fOV_TvEbwA4KQnWcIMR1aiGELO45oe3jSnKIeDS2DfHh6rBk8aV7kfAMh4pgPz5sTggnhBPanzf3lpyvw7WJ3Pu6AjQmUxcckZyDDBPJdLsY7DZz3SzAgmbyPIRvgY3AlJhd-gGiBnG5l0GYC3swyRC_BtKxv1qVc2tlVqY5euSCLiwG4vZudX7xU6y_B3cZ5vZVkZPEmlJfNMyvnbF49nmfN98uL3fi5vf569WX8eN1qwmhpeSexlVYz2WPSs04PkFiujMaMMoJRpzojZa8IxlopJVWPEbW0M1gx3k2InDXvtr77FH8uJhfhXdZmrmOYuGSByUAxrb2Gir79C72JSwrVncCUDZxVA32l8EbpFHNOxop9cl6mO4GgeMhMbJmJmplYMxOHKnrz2HpR3kxHye-QKsA34GBUtFk7U9d9xCCEtKbaY14riEZX1jWPcQmlSt__v7TSZKPz_iFAk_4M-Q__vwA0NMWV</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2579873676</pqid></control><display><type>article</type><title>FDG PET/CT for tumoral and systemic immune response monitoring of advanced melanoma during first-line combination ipilimumab and nivolumab treatment</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><creator>Iravani, Amir ; Osman, Medhat M. ; Weppler, Alison M. ; Wallace, Roslyn ; Galligan, Anna ; Lasocki, Arian ; Hunter, Morgan O. ; Akhurst, Tim ; Hofman, Michael S. ; Lau, Peter K. H. ; Kee, Damien ; Au-Yeung, George ; Sandhu, Shahneen ; Hicks, Rodney J.</creator><creatorcontrib>Iravani, Amir ; Osman, Medhat M. ; Weppler, Alison M. ; Wallace, Roslyn ; Galligan, Anna ; Lasocki, Arian ; Hunter, Morgan O. ; Akhurst, Tim ; Hofman, Michael S. ; Lau, Peter K. H. ; Kee, Damien ; Au-Yeung, George ; Sandhu, Shahneen ; Hicks, Rodney J.</creatorcontrib><description>Purpose
We aimed to investigate the role of FDG-PET/CT in monitoring of response and immune-related adverse events (irAEs) following first-line combination-immune checkpoint inhibitor (combination-ICI) therapy for advanced melanoma.
Methods
We retrospectively reviewed outcomes in patients who had (1) first-line nivolumab plus ipilimumab; (2) pre- and post-treatment FDG-PET/CT scans (pre-FDG-PET/CT and post-FDG-PET/CT) within 2 and 4 months of starting ICI, respectively; and (3) at least one lesion assessable by PET response criteria in solid tumors (PERCIST). Extracranial response was monitored by 3 monthly FDG-PET/CT. Whole-body metabolic tumor volume (wbMTV) was measured pre- and post-treatment and correlated with outcome. FDG-PET/CT manifestations of irAE were defined as new increased non-tumoral uptake on post-FDG-PET/CT and were correlated with clinical presentation.
Results
Thirty-one consecutive patients, median age 60 years (range, 30–78), were identified from 2016 to 2018. The median number of combination-ICI cycles to the first post-FDG-PET/CT response assessment was 3 (interquartile range (IQR), 2–4). The best-overall responses were complete metabolic response (CMR) in 25 (80%), partial metabolic response (PMR) in 3 (10%), and progressive metabolic disease (PMD) in 3 (10%) patients. Patients with PMD had significantly higher pre-treatment wbMTV (
p
= 0.009). At a median follow-up of 21.5 months, 26 (84%) patients were alive with median progression-free and overall survival not reached. Secondary progression occurred in 9/31 (29%) patients at a median of 8.2 months (IQR, 6.9–15.5), of those majority (78%) was detected by FDG-PET/CT. Of 36 findings on post-FDG-PET/CT suggestive of irAE, 29 (80%) had clinical confirmation. In 3 (7%), the FDG-PET/CT findings preceded clinical presentation. The most common FDG-PET/CT detectable irAEs were endocrinopathies (36%) and enterocolitis (35%).
Conclusion
FDG-PET/CT response evaluation predicts the long-term outcome of patients treated with first-line combination-ICIs. Long-term treatment response monitoring for detection of extracranial secondary progression is feasible by FDG-PET/CT. Beyond response assessment, FDG-PET/CT frequently detects clinically relevant irAEs, which may involve multiple systems contemporaneously or at various time-points and may precede clinical diagnosis.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-020-04815-w</identifier><identifier>PMID: 32338306</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adverse events ; Cardiology ; Computed tomography ; Endocrine disorders ; Enterocolitis ; Fluorodeoxyglucose F18 ; Health services ; Humans ; Imaging ; Immune checkpoint inhibitors ; Immune response ; Immune system ; Immunity ; Immunotherapy ; Ipilimumab - adverse effects ; Life Sciences & Biomedicine ; Medicine ; Medicine & Public Health ; Melanoma ; Melanoma - diagnostic imaging ; Melanoma - drug therapy ; Metabolic disorders ; Metabolic response ; Metabolism ; Middle Aged ; Monitoring ; Monoclonal antibodies ; Nivolumab - therapeutic use ; Nuclear Medicine ; Oncology ; Oncology – General ; Original Article ; Orthopedics ; Patients ; Positron emission ; Positron emission tomography ; Positron Emission Tomography Computed Tomography ; Radiology ; Radiology, Nuclear Medicine & Medical Imaging ; Retrospective Studies ; Science & Technology ; Solid tumors ; Targeted cancer therapy ; Telemedicine ; Tomography ; Treatment Outcome ; Tumors</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2020-11, Vol.47 (12), p.2776-2786</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>41</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000528962800001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c375t-84a2fafc7a623674c903f8bec27573214b4eaa6b322cbbbab6215f54e2b784d13</citedby><cites>FETCH-LOGICAL-c375t-84a2fafc7a623674c903f8bec27573214b4eaa6b322cbbbab6215f54e2b784d13</cites><orcidid>0000-0002-1273-5835 ; 0000-0003-2656-8393 ; 0000-0002-4685-1666 ; 0000-0002-8660-4475 ; 0000-0001-8622-159X ; 0000-0003-1071-7956 ; 0000-0002-3344-6178</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-020-04815-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-020-04815-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32338306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iravani, Amir</creatorcontrib><creatorcontrib>Osman, Medhat M.</creatorcontrib><creatorcontrib>Weppler, Alison M.</creatorcontrib><creatorcontrib>Wallace, Roslyn</creatorcontrib><creatorcontrib>Galligan, Anna</creatorcontrib><creatorcontrib>Lasocki, Arian</creatorcontrib><creatorcontrib>Hunter, Morgan O.</creatorcontrib><creatorcontrib>Akhurst, Tim</creatorcontrib><creatorcontrib>Hofman, Michael S.</creatorcontrib><creatorcontrib>Lau, Peter K. H.</creatorcontrib><creatorcontrib>Kee, Damien</creatorcontrib><creatorcontrib>Au-Yeung, George</creatorcontrib><creatorcontrib>Sandhu, Shahneen</creatorcontrib><creatorcontrib>Hicks, Rodney J.</creatorcontrib><title>FDG PET/CT for tumoral and systemic immune response monitoring of advanced melanoma during first-line combination ipilimumab and nivolumab treatment</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>EUR J NUCL MED MOL I</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose
We aimed to investigate the role of FDG-PET/CT in monitoring of response and immune-related adverse events (irAEs) following first-line combination-immune checkpoint inhibitor (combination-ICI) therapy for advanced melanoma.
Methods
We retrospectively reviewed outcomes in patients who had (1) first-line nivolumab plus ipilimumab; (2) pre- and post-treatment FDG-PET/CT scans (pre-FDG-PET/CT and post-FDG-PET/CT) within 2 and 4 months of starting ICI, respectively; and (3) at least one lesion assessable by PET response criteria in solid tumors (PERCIST). Extracranial response was monitored by 3 monthly FDG-PET/CT. Whole-body metabolic tumor volume (wbMTV) was measured pre- and post-treatment and correlated with outcome. FDG-PET/CT manifestations of irAE were defined as new increased non-tumoral uptake on post-FDG-PET/CT and were correlated with clinical presentation.
Results
Thirty-one consecutive patients, median age 60 years (range, 30–78), were identified from 2016 to 2018. The median number of combination-ICI cycles to the first post-FDG-PET/CT response assessment was 3 (interquartile range (IQR), 2–4). The best-overall responses were complete metabolic response (CMR) in 25 (80%), partial metabolic response (PMR) in 3 (10%), and progressive metabolic disease (PMD) in 3 (10%) patients. Patients with PMD had significantly higher pre-treatment wbMTV (
p
= 0.009). At a median follow-up of 21.5 months, 26 (84%) patients were alive with median progression-free and overall survival not reached. Secondary progression occurred in 9/31 (29%) patients at a median of 8.2 months (IQR, 6.9–15.5), of those majority (78%) was detected by FDG-PET/CT. Of 36 findings on post-FDG-PET/CT suggestive of irAE, 29 (80%) had clinical confirmation. In 3 (7%), the FDG-PET/CT findings preceded clinical presentation. The most common FDG-PET/CT detectable irAEs were endocrinopathies (36%) and enterocolitis (35%).
Conclusion
FDG-PET/CT response evaluation predicts the long-term outcome of patients treated with first-line combination-ICIs. Long-term treatment response monitoring for detection of extracranial secondary progression is feasible by FDG-PET/CT. Beyond response assessment, FDG-PET/CT frequently detects clinically relevant irAEs, which may involve multiple systems contemporaneously or at various time-points and may precede clinical diagnosis.</description><subject>Adverse events</subject><subject>Cardiology</subject><subject>Computed tomography</subject><subject>Endocrine disorders</subject><subject>Enterocolitis</subject><subject>Fluorodeoxyglucose F18</subject><subject>Health services</subject><subject>Humans</subject><subject>Imaging</subject><subject>Immune checkpoint inhibitors</subject><subject>Immune response</subject><subject>Immune system</subject><subject>Immunity</subject><subject>Immunotherapy</subject><subject>Ipilimumab - adverse effects</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melanoma</subject><subject>Melanoma - diagnostic imaging</subject><subject>Melanoma - drug therapy</subject><subject>Metabolic disorders</subject><subject>Metabolic response</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Monitoring</subject><subject>Monoclonal antibodies</subject><subject>Nivolumab - therapeutic use</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Oncology – General</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Radiology</subject><subject>Radiology, Nuclear Medicine & Medical Imaging</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Solid tumors</subject><subject>Targeted cancer therapy</subject><subject>Telemedicine</subject><subject>Tomography</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkc9uFSEUxidGY2v1BVwYEjcmZix_hoFZmrGtJk10cV0TYMDQDHAFpjd9jz6wdKZeExfGFYfw-w7fOV_TvEbwA4KQnWcIMR1aiGELO45oe3jSnKIeDS2DfHh6rBk8aV7kfAMh4pgPz5sTggnhBPanzf3lpyvw7WJ3Pu6AjQmUxcckZyDDBPJdLsY7DZz3SzAgmbyPIRvgY3AlJhd-gGiBnG5l0GYC3swyRC_BtKxv1qVc2tlVqY5euSCLiwG4vZudX7xU6y_B3cZ5vZVkZPEmlJfNMyvnbF49nmfN98uL3fi5vf569WX8eN1qwmhpeSexlVYz2WPSs04PkFiujMaMMoJRpzojZa8IxlopJVWPEbW0M1gx3k2InDXvtr77FH8uJhfhXdZmrmOYuGSByUAxrb2Gir79C72JSwrVncCUDZxVA32l8EbpFHNOxop9cl6mO4GgeMhMbJmJmplYMxOHKnrz2HpR3kxHye-QKsA34GBUtFk7U9d9xCCEtKbaY14riEZX1jWPcQmlSt__v7TSZKPz_iFAk_4M-Q__vwA0NMWV</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Iravani, Amir</creator><creator>Osman, Medhat M.</creator><creator>Weppler, Alison M.</creator><creator>Wallace, Roslyn</creator><creator>Galligan, Anna</creator><creator>Lasocki, Arian</creator><creator>Hunter, Morgan O.</creator><creator>Akhurst, Tim</creator><creator>Hofman, Michael S.</creator><creator>Lau, Peter K. H.</creator><creator>Kee, Damien</creator><creator>Au-Yeung, George</creator><creator>Sandhu, Shahneen</creator><creator>Hicks, Rodney J.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature</general><general>Springer Nature B.V</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1273-5835</orcidid><orcidid>https://orcid.org/0000-0003-2656-8393</orcidid><orcidid>https://orcid.org/0000-0002-4685-1666</orcidid><orcidid>https://orcid.org/0000-0002-8660-4475</orcidid><orcidid>https://orcid.org/0000-0001-8622-159X</orcidid><orcidid>https://orcid.org/0000-0003-1071-7956</orcidid><orcidid>https://orcid.org/0000-0002-3344-6178</orcidid></search><sort><creationdate>20201101</creationdate><title>FDG PET/CT for tumoral and systemic immune response monitoring of advanced melanoma during first-line combination ipilimumab and nivolumab treatment</title><author>Iravani, Amir ; Osman, Medhat M. ; Weppler, Alison M. ; Wallace, Roslyn ; Galligan, Anna ; Lasocki, Arian ; Hunter, Morgan O. ; Akhurst, Tim ; Hofman, Michael S. ; Lau, Peter K. H. ; Kee, Damien ; Au-Yeung, George ; Sandhu, Shahneen ; Hicks, Rodney J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-84a2fafc7a623674c903f8bec27573214b4eaa6b322cbbbab6215f54e2b784d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adverse events</topic><topic>Cardiology</topic><topic>Computed tomography</topic><topic>Endocrine disorders</topic><topic>Enterocolitis</topic><topic>Fluorodeoxyglucose F18</topic><topic>Health services</topic><topic>Humans</topic><topic>Imaging</topic><topic>Immune checkpoint inhibitors</topic><topic>Immune response</topic><topic>Immune system</topic><topic>Immunity</topic><topic>Immunotherapy</topic><topic>Ipilimumab - adverse effects</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melanoma</topic><topic>Melanoma - diagnostic imaging</topic><topic>Melanoma - drug therapy</topic><topic>Metabolic disorders</topic><topic>Metabolic response</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Monitoring</topic><topic>Monoclonal antibodies</topic><topic>Nivolumab - therapeutic use</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Oncology – General</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Radiology</topic><topic>Radiology, Nuclear Medicine & Medical Imaging</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Solid tumors</topic><topic>Targeted cancer therapy</topic><topic>Telemedicine</topic><topic>Tomography</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iravani, Amir</creatorcontrib><creatorcontrib>Osman, Medhat M.</creatorcontrib><creatorcontrib>Weppler, Alison M.</creatorcontrib><creatorcontrib>Wallace, Roslyn</creatorcontrib><creatorcontrib>Galligan, Anna</creatorcontrib><creatorcontrib>Lasocki, Arian</creatorcontrib><creatorcontrib>Hunter, Morgan O.</creatorcontrib><creatorcontrib>Akhurst, Tim</creatorcontrib><creatorcontrib>Hofman, Michael S.</creatorcontrib><creatorcontrib>Lau, Peter K. H.</creatorcontrib><creatorcontrib>Kee, Damien</creatorcontrib><creatorcontrib>Au-Yeung, George</creatorcontrib><creatorcontrib>Sandhu, Shahneen</creatorcontrib><creatorcontrib>Hicks, Rodney J.</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iravani, Amir</au><au>Osman, Medhat M.</au><au>Weppler, Alison M.</au><au>Wallace, Roslyn</au><au>Galligan, Anna</au><au>Lasocki, Arian</au><au>Hunter, Morgan O.</au><au>Akhurst, Tim</au><au>Hofman, Michael S.</au><au>Lau, Peter K. H.</au><au>Kee, Damien</au><au>Au-Yeung, George</au><au>Sandhu, Shahneen</au><au>Hicks, Rodney J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>FDG PET/CT for tumoral and systemic immune response monitoring of advanced melanoma during first-line combination ipilimumab and nivolumab treatment</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><stitle>EUR J NUCL MED MOL I</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>47</volume><issue>12</issue><spage>2776</spage><epage>2786</epage><pages>2776-2786</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Purpose
We aimed to investigate the role of FDG-PET/CT in monitoring of response and immune-related adverse events (irAEs) following first-line combination-immune checkpoint inhibitor (combination-ICI) therapy for advanced melanoma.
Methods
We retrospectively reviewed outcomes in patients who had (1) first-line nivolumab plus ipilimumab; (2) pre- and post-treatment FDG-PET/CT scans (pre-FDG-PET/CT and post-FDG-PET/CT) within 2 and 4 months of starting ICI, respectively; and (3) at least one lesion assessable by PET response criteria in solid tumors (PERCIST). Extracranial response was monitored by 3 monthly FDG-PET/CT. Whole-body metabolic tumor volume (wbMTV) was measured pre- and post-treatment and correlated with outcome. FDG-PET/CT manifestations of irAE were defined as new increased non-tumoral uptake on post-FDG-PET/CT and were correlated with clinical presentation.
Results
Thirty-one consecutive patients, median age 60 years (range, 30–78), were identified from 2016 to 2018. The median number of combination-ICI cycles to the first post-FDG-PET/CT response assessment was 3 (interquartile range (IQR), 2–4). The best-overall responses were complete metabolic response (CMR) in 25 (80%), partial metabolic response (PMR) in 3 (10%), and progressive metabolic disease (PMD) in 3 (10%) patients. Patients with PMD had significantly higher pre-treatment wbMTV (
p
= 0.009). At a median follow-up of 21.5 months, 26 (84%) patients were alive with median progression-free and overall survival not reached. Secondary progression occurred in 9/31 (29%) patients at a median of 8.2 months (IQR, 6.9–15.5), of those majority (78%) was detected by FDG-PET/CT. Of 36 findings on post-FDG-PET/CT suggestive of irAE, 29 (80%) had clinical confirmation. In 3 (7%), the FDG-PET/CT findings preceded clinical presentation. The most common FDG-PET/CT detectable irAEs were endocrinopathies (36%) and enterocolitis (35%).
Conclusion
FDG-PET/CT response evaluation predicts the long-term outcome of patients treated with first-line combination-ICIs. Long-term treatment response monitoring for detection of extracranial secondary progression is feasible by FDG-PET/CT. Beyond response assessment, FDG-PET/CT frequently detects clinically relevant irAEs, which may involve multiple systems contemporaneously or at various time-points and may precede clinical diagnosis.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32338306</pmid><doi>10.1007/s00259-020-04815-w</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1273-5835</orcidid><orcidid>https://orcid.org/0000-0003-2656-8393</orcidid><orcidid>https://orcid.org/0000-0002-4685-1666</orcidid><orcidid>https://orcid.org/0000-0002-8660-4475</orcidid><orcidid>https://orcid.org/0000-0001-8622-159X</orcidid><orcidid>https://orcid.org/0000-0003-1071-7956</orcidid><orcidid>https://orcid.org/0000-0002-3344-6178</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1619-7070 |
| ispartof | European journal of nuclear medicine and molecular imaging, 2020-11, Vol.47 (12), p.2776-2786 |
| issn | 1619-7070 1619-7089 |
| language | eng |
| recordid | cdi_proquest_journals_2579873676 |
| source | MEDLINE; SpringerNature Journals; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Adverse events Cardiology Computed tomography Endocrine disorders Enterocolitis Fluorodeoxyglucose F18 Health services Humans Imaging Immune checkpoint inhibitors Immune response Immune system Immunity Immunotherapy Ipilimumab - adverse effects Life Sciences & Biomedicine Medicine Medicine & Public Health Melanoma Melanoma - diagnostic imaging Melanoma - drug therapy Metabolic disorders Metabolic response Metabolism Middle Aged Monitoring Monoclonal antibodies Nivolumab - therapeutic use Nuclear Medicine Oncology Oncology – General Original Article Orthopedics Patients Positron emission Positron emission tomography Positron Emission Tomography Computed Tomography Radiology Radiology, Nuclear Medicine & Medical Imaging Retrospective Studies Science & Technology Solid tumors Targeted cancer therapy Telemedicine Tomography Treatment Outcome Tumors |
| title | FDG PET/CT for tumoral and systemic immune response monitoring of advanced melanoma during first-line combination ipilimumab and nivolumab treatment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-11T16%3A30%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_webof&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=FDG%20PET/CT%20for%20tumoral%20and%20systemic%20immune%20response%20monitoring%20of%20advanced%20melanoma%20during%20first-line%20combination%20ipilimumab%20and%20nivolumab%20treatment&rft.jtitle=European%20journal%20of%20nuclear%20medicine%20and%20molecular%20imaging&rft.au=Iravani,%20Amir&rft.date=2020-11-01&rft.volume=47&rft.issue=12&rft.spage=2776&rft.epage=2786&rft.pages=2776-2786&rft.issn=1619-7070&rft.eissn=1619-7089&rft_id=info:doi/10.1007/s00259-020-04815-w&rft_dat=%3Cproquest_webof%3E2579873676%3C/proquest_webof%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2579873676&rft_id=info:pmid/32338306&rfr_iscdi=true |