18FDG PET Assessment of Therapeutic Response in Patients with Advanced or Metastatic Melanoma Treated with First-Line Immune Checkpoint Inhibitors
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. 18F-FDG PET/CT Protocol
2.3. Image Analysis
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- PERCIST5 criteria (PET Response Criteria in Solid Tumors): nuclear physicians measured SULpeak on up to 5 metastatic lesions and no more than 2 per organ. The lesions could be different on baseline and follow-up PET/CT. The target lesions had to have a SULpeak greater than the reference threshold defined as follows: on the healthy liver: reference threshold = 1.5* SULmean liver +2* σSULliver; on the metastatic liver: reference threshold = 2* SULmean mediastinum +2* σSULmediastinum. CR was defined as complete resolution of 18F-FDG within measurable target lesion so that it is less than mean liver activity and indistinguishable from surrounding background blood-pool levels. PR was defined as a decrease of more than 30% in the sum of SULpeak. PD was defined as an increase of more than 30% in the sum of SULpeak or the appearance of new lesions. Finally, SD applies to patients who do not fit into the definitions of CR, PR or PD.
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- imPERCIST5 criteria (modified PERCIST criteria for immunotherapy): the analysis of the 5 lesions was performed similarly to PERCIST5, with the difference that the appearance of a new lesion did not lead automatically to PD. Thus, the SULpeak of the new lesion(s) had to be included in the sum of the SULpeak of the 5 hottest tumor lesions, and PD was only defined by an increase of more than 30% in the sum of the SULpeak. New lesion(s) were included in the sum of total SULpeak if they had a SULpeak greater than pre-existing target lesions or if less than 5 target lesions were detected at baseline.
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. PET/CT Acquisitions
3.3. Baseline PET/CT
3.4. Metabolic Response at 3 Months
3.5. Survival Study
3.6. Patients’ Outcome
3.7. Assessment of Adverse Events
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Characteristics | Patients nb (Total = 29) |
---|---|
Gender | |
Female | 14 (48%) |
Male | 15 (52%) |
Type of treatment | |
pembrolizumab | 15 (52%) |
nivolumab | 9 (31%) |
nivolumab + ipilimumab | 5 (17%) |
Breslow (mm) | |
≤1 | 4 |
1, 1–4 | 9 |
>4 | 13 |
Missing data | 3 |
Mutation status | |
BRAF WT/M/NA | 22/7/0 |
NRAS WT/M/NA | 19/9/1 |
Ckit WT/M/NA | 10/2/17 |
ECOG | |
0 | 17 |
1 | 10 |
2 | 2 |
LDH level | |
normal | 19 |
high | 8 |
Missing data | 2 |
Type of primary melanoma | |
cutaneous mucosal | 23 4 |
unknown | 2 |
imPERCIST 5 | |||||
---|---|---|---|---|---|
PERCIST 5 | CR (n) | PR (n) | SD (n) | PD (n) | Total (n) |
CR | 3 | 0 | 0 | 0 | 3 |
PR | 0 | 8 | 0 | 0 | 8 |
SD | 0 | 0 | 4 | 0 | 4 |
PD | 0 | 0 | 6 | 8 | 14 |
Total | 3 | 8 | 10 | 8 | 29 |
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Rivas, A.; Delyon, J.; Martineau, A.; Blanc, E.; Allayous, C.; Da Meda, L.; Merlet, P.; Lebbé, C.; Baroudjian, B.; Vercellino, L. 18FDG PET Assessment of Therapeutic Response in Patients with Advanced or Metastatic Melanoma Treated with First-Line Immune Checkpoint Inhibitors. Cancers 2022, 14, 3190. https://doi.org/10.3390/cancers14133190
Rivas A, Delyon J, Martineau A, Blanc E, Allayous C, Da Meda L, Merlet P, Lebbé C, Baroudjian B, Vercellino L. 18FDG PET Assessment of Therapeutic Response in Patients with Advanced or Metastatic Melanoma Treated with First-Line Immune Checkpoint Inhibitors. Cancers. 2022; 14(13):3190. https://doi.org/10.3390/cancers14133190
Chicago/Turabian StyleRivas, Alexia, Julie Delyon, Antoine Martineau, Estelle Blanc, Clara Allayous, Laetitia Da Meda, Pascal Merlet, Céleste Lebbé, Barouyr Baroudjian, and Laetitia Vercellino. 2022. "18FDG PET Assessment of Therapeutic Response in Patients with Advanced or Metastatic Melanoma Treated with First-Line Immune Checkpoint Inhibitors" Cancers 14, no. 13: 3190. https://doi.org/10.3390/cancers14133190