1. Early Reassessment of Total Metabolic Tumor Volume on FDG-PET/CT in Advanced Melanoma Patients Treated with Pembrolizumab Predicts Long-Term Outcome
- Author
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Bart Neyns, Marleen Keyaerts, Sim Vermeulen, Gil Awada, Hendrik Everaert, Nuclear Medicine, Faculty of Medicine and Pharmacy, Laboratory of Molecular and Medical Oncology, Clinical sciences, Internal Medicine, Supporting clinical sciences, Medical Imaging, and Medical Oncology
- Subjects
Oncology ,medicine.medical_specialty ,PET/CT ,Pembrolizumab ,Antibodies, Monoclonal, Humanized ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Fluorodeoxyglucose F18 ,Internal medicine ,Positron Emission Tomography Computed Tomography ,medicine ,melanoma ,Humans ,Adverse effect ,RC254-282 ,Advanced melanoma ,Retrospective Studies ,PET-CT ,business.industry ,Melanoma ,Therapeutic effect ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Metabolic tumor volume ,medicine.disease ,Tumor Burden ,Radiology Nuclear Medicine and imaging ,030220 oncology & carcinogenesis ,oncology ,Biomarker (medicine) ,business - Abstract
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.
- Published
- 2021