Complete metabolic response in FDG-PET-CT scan before discontinuation of immune checkpoint inhibitors correlates with long progression-free survival

• Verfasst von: Schank, Timo Emanuel [VerfasserIn]
• Verfasst von: Forschner, Andrea [VerfasserIn]
• Verfasst von: Sachse, Michael Max [VerfasserIn]
• Verfasst von: Dimitrakopoulou-Strauss, Antonia [VerfasserIn]
• Verfasst von: Sachpekidis, Christos [VerfasserIn]
• Verfasst von: Stenzinger, Albrecht [VerfasserIn]
• Verfasst von: Volckmar, Anna-Lena [VerfasserIn]
• Verfasst von: Enk, Alexander [VerfasserIn]
• Verfasst von: Hassel, Jessica C. [VerfasserIn]
• Titel: Complete metabolic response in FDG-PET-CT scan before discontinuation of immune checkpoint inhibitors correlates with long progression-free survival
• Verf.angabe: Timo E. Schank, Andrea Forschner, Michael Max Sachse, Antonia Dimitrakopoulou-Strauss, Christos Sachpekidis, Albrecht Stenzinger, Anna-Lena Volckmar, Alexander Enk and Jessica C. Hassel
• E-Jahr: 2021
• Jahr: 26 May 2021
• Umfang: 11 S.
• Fussnoten: Gesehen am 07.04.2022
• Titel Quelle: Enthalten in: Cancers
• Ort Quelle: Basel : MDPI, 2009
• Jahr Quelle: 2021
• Band/Heft Quelle: 13(2021), 11, Artikel-ID 2616, Seite 1-11
• ISSN Quelle: 2072-6694
• DOI: doi:10.3390/cancers13112616
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: checkpoint inhibitors
• Sach-SW: FDG-PET-CT scan
• Sach-SW: melanoma
• Sach-SW: outcome
• K10plus-PPN: 1798094266

Abstract

Checkpoint inhibitors have revolutionized the treatment of patients with metastasized melanoma. However, it remains unclear when to stop treatment. We retrospectively analyzed 45 patients (median age 64 years; 58% male) with metastasized melanoma from 3 cancer centers that received checkpoint inhibitors and discontinued therapy due to either immune-related adverse events or patient decision after an (18F)2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) combined with a low-dose CT scan (FDG-PET-CT) scan without signs for disease progression. After a median of 21 (range 1-42) months of immunotherapy an FDG-PET-CT scan was performed to evaluate disease activity. In these, 32 patients (71%) showed a complete metabolic response (CMR) and 13 were classified as non-CMR. After a median follow-up of 34 (range 1-70) months, 3/32 (9%) of CMR patients and 6/13 (46%) of non-CMR patients had progressed (p = 0.007). Progression-free survival (PFS), as estimated from the date of last drug administration, was significantly longer among CMR patients than non-CMR (log-rank: p = 0.001; hazard ratio: 0.127; 95% CI: 0.032-0.511). Two-year PFS was 94% among CMR patients and 62% among non-CMR patients. Univariable Cox regression showed that metabolic response was the only parameter which predicted PFS (p = 0.004). Multivariate analysis revealed that metabolic response predicted disease progression (p = 0.008). In conclusion, our findings suggest that patients with CMR in an FDG-PET-CT scan may have a favorable outcome even if checkpoint inhibition is discontinued.