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The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria

PURPOSE: To investigate the prognostic value of [(18)F]FDG PET/CT as part of response monitoring in metastatic melanoma patients treated with immune checkpoint inhibitors (ICIs). METHODS: Sixty-seven patients underwent [(18)F]FDG PET/CT before start of treatment (baseline PET/CT), after two cycles (...

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Autores principales: Sachpekidis, Christos, Weru, Vivienn, Kopp-Schneider, Annette, Hassel, Jessica C., Dimitrakopoulou-Strauss, Antonia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317882/
https://www.ncbi.nlm.nih.gov/pubmed/37099131
http://dx.doi.org/10.1007/s00259-023-06243-y
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author Sachpekidis, Christos
Weru, Vivienn
Kopp-Schneider, Annette
Hassel, Jessica C.
Dimitrakopoulou-Strauss, Antonia
author_facet Sachpekidis, Christos
Weru, Vivienn
Kopp-Schneider, Annette
Hassel, Jessica C.
Dimitrakopoulou-Strauss, Antonia
author_sort Sachpekidis, Christos
collection PubMed
description PURPOSE: To investigate the prognostic value of [(18)F]FDG PET/CT as part of response monitoring in metastatic melanoma patients treated with immune checkpoint inhibitors (ICIs). METHODS: Sixty-seven patients underwent [(18)F]FDG PET/CT before start of treatment (baseline PET/CT), after two cycles (interim PET/CT) and after four cycles of ICIs administration (late PET/CT). Metabolic response evaluation was based on the conventional EORTC and PERCIST criteria, as well as the newly introduced, immunotherapy-modified PERCIMT, imPERCIST5 and iPERCIST criteria. Metabolic response to immunotherapy was classified according to four response groups (complete metabolic response [CMR], partial metabolic response [PMR], stable metabolic disease [SMD], progressive metabolic disease [PMD]), and further dichotomized by response rate (responders = [CMR] + [PMR] vs. non-responders = [PMD] + [SMD]), and disease control rate (disease control = [CMR] + [PMR] + [SMD] vs. [PMD]). The spleen-to-liver SUV ratios (SLR(mean), SLR(max)) and bone marrow-to-liver SUV ratios (BLR(mean), BLR(max)) were also calculated. The results of PET/CT were correlated with patients’ overall survival (OS). RESULTS: Median patient follow up [95% CI] was 61.5 months [45.3 – 66.7 months]. On interim PET/CT, the application of the novel PERCIMT demonstrated significantly longer survival for metabolic responders, while the rest criteria revealed no significant survival differences between the different response groups. Respectively on late PET/CT, both a trend for longer OS and significantly longer OS were observed in patients responding to ICIs with metabolic response and disease control after application of various criteria, both conventional and immunotherapy-modified. Moreover, patients with lower SLR(mean) values demonstrated significantly longer OS. CONCLUSION: In patients with metastatic melanoma PET/CT-based response assessment after four ICIs cycles is significantly associated with OS after application of different metabolic criteria. The prognostic performance of the modality is also high after the first two ICIs cycles, especially with employment of novel criteria. In addition, investigation of spleen glucose metabolism may provide further prognostic information. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-023-06243-y.
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spelling pubmed-103178822023-07-05 The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria Sachpekidis, Christos Weru, Vivienn Kopp-Schneider, Annette Hassel, Jessica C. Dimitrakopoulou-Strauss, Antonia Eur J Nucl Med Mol Imaging Original Article PURPOSE: To investigate the prognostic value of [(18)F]FDG PET/CT as part of response monitoring in metastatic melanoma patients treated with immune checkpoint inhibitors (ICIs). METHODS: Sixty-seven patients underwent [(18)F]FDG PET/CT before start of treatment (baseline PET/CT), after two cycles (interim PET/CT) and after four cycles of ICIs administration (late PET/CT). Metabolic response evaluation was based on the conventional EORTC and PERCIST criteria, as well as the newly introduced, immunotherapy-modified PERCIMT, imPERCIST5 and iPERCIST criteria. Metabolic response to immunotherapy was classified according to four response groups (complete metabolic response [CMR], partial metabolic response [PMR], stable metabolic disease [SMD], progressive metabolic disease [PMD]), and further dichotomized by response rate (responders = [CMR] + [PMR] vs. non-responders = [PMD] + [SMD]), and disease control rate (disease control = [CMR] + [PMR] + [SMD] vs. [PMD]). The spleen-to-liver SUV ratios (SLR(mean), SLR(max)) and bone marrow-to-liver SUV ratios (BLR(mean), BLR(max)) were also calculated. The results of PET/CT were correlated with patients’ overall survival (OS). RESULTS: Median patient follow up [95% CI] was 61.5 months [45.3 – 66.7 months]. On interim PET/CT, the application of the novel PERCIMT demonstrated significantly longer survival for metabolic responders, while the rest criteria revealed no significant survival differences between the different response groups. Respectively on late PET/CT, both a trend for longer OS and significantly longer OS were observed in patients responding to ICIs with metabolic response and disease control after application of various criteria, both conventional and immunotherapy-modified. Moreover, patients with lower SLR(mean) values demonstrated significantly longer OS. CONCLUSION: In patients with metastatic melanoma PET/CT-based response assessment after four ICIs cycles is significantly associated with OS after application of different metabolic criteria. The prognostic performance of the modality is also high after the first two ICIs cycles, especially with employment of novel criteria. In addition, investigation of spleen glucose metabolism may provide further prognostic information. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-023-06243-y. Springer Berlin Heidelberg 2023-04-26 2023 /pmc/articles/PMC10317882/ /pubmed/37099131 http://dx.doi.org/10.1007/s00259-023-06243-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Sachpekidis, Christos
Weru, Vivienn
Kopp-Schneider, Annette
Hassel, Jessica C.
Dimitrakopoulou-Strauss, Antonia
The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
title The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
title_full The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
title_fullStr The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
title_full_unstemmed The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
title_short The prognostic value of [(18)F]FDG PET/CT based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
title_sort prognostic value of [(18)f]fdg pet/ct based response monitoring in metastatic melanoma patients undergoing immunotherapy: comparison of different metabolic criteria
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317882/
https://www.ncbi.nlm.nih.gov/pubmed/37099131
http://dx.doi.org/10.1007/s00259-023-06243-y
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