Prognostic 18F-FDG PET biomarkers in metastatic mucosal and cutaneous melanoma treated with immune checkpoint inhibitors targeting PD-1 and CTLA-4.

Autor: Seban RD; Département of Medical Imaging, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France., Moya-Plana A; Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France., Antonios L; Département of Medical Imaging, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France., Yeh R; Department of Radiology, New York Presbyterian Hospital, Columbia University Medical Center, 168th Street, New York, NY, 10039, USA., Marabelle A; Drug Development Department (DITEP), Gustave Roussy, Villejuif, France.; UMR1015, Institut Gustave Roussy, Université Paris Saclay, 94800, Villejuif, France., Deutsch E; Drug Development Department (DITEP), Gustave Roussy, Villejuif, France.; Department of Radiotherapy, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France., Schwartz LH; Department of Radiology, New York Presbyterian Hospital, Columbia University Medical Center, 168th Street, New York, NY, 10039, USA., Gómez RGH; Département d'oncologie CHUV-UNIL, Centre Hospitalier Universitaire Vaudois, Lausanne, VD, CH, Switzerland., Saenger Y; Department of Medicine, Division of Hematology Oncology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA., Robert C; Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France., Ammari S; Département of Medical Imaging, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France., Dercle L; Department of Radiology, New York Presbyterian Hospital, Columbia University Medical Center, 168th Street, New York, NY, 10039, USA. ld2752@cumc.columbia.edu.; UMR1015, Institut Gustave Roussy, Université Paris Saclay, 94800, Villejuif, France. ld2752@cumc.columbia.edu.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2020 Sep; Vol. 47 (10), pp. 2301-2312. Date of Electronic Publication: 2020 Mar 23.
DOI: 10.1007/s00259-020-04757-3
Abstrakt: Purpose: To compare the prognostic value of imaging biomarkers derived from a quantitative analysis of baseline 18F-FDG-PET/CT in patients with mucosal melanoma (Muc-M) or cutaneous melanoma (Cut-M) treated with immune checkpoint inhibitors (ICIs).
Methods: In this retrospective monocentric study, we included 56 patients with non-resectable Muc-M (n = 24) or Cut-M (n = 32) who underwent baseline 18F-FDG-PET/CT before treatment with ICIs between 2011 and 2017. Parameters were extracted from (i) tumoral tissues: SUVmax, SUVmean, TMTV (total metabolic tumor volume), and TLG (total lesion glycolysis) and (ii) lymphoid tissues: BLR (bone marrow-to-liver SUVmax ratio) and SLR (spleen-to-liver SUVmax ratio). Association with survival and response was evaluated using Cox prediction models, Student's t tests, and Spearman's correlation respectively. p < 0.05 was considered significant.
Results: Majority of ICIs were anti-PD1 (92.9%, n = 52/56). All 18F-FDG-PET/CT were positive. Overall (Muc-M to Cut-M), ORR was 33%:42%, DCR was 56%:69%, median follow-up was 25.0:28.9 months, median PFS was 4.7:10.7 months, and median OS was 23.9:28.3 months. In Muc-M, increased tumor SUVmax was associated with shorter OS while it was not correlated with PFS, ORR, or DCR. In Cut-M, increased TMTV and increased BLR were independently associated with shorter OS, shorter PFS, and lower response (ORR, DCR).
Conclusion: While all Muc-M and Cut-M were FDG avid, prognostic imaging biomarkers differed. For Muc-M patients treated with ICI, the only prognostic imaging biomarker was a high baseline maximal glycolytic activity (SUVmax), whereas for Cut-M patients, baseline metabolic tumor burden or bone marrow metabolism was negatively correlated to ICI response duration.
Databáze: MEDLINE
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