89 Zr-DFO-Durvalumab PET/CT Before Durvalumab Treatment in Patients with Recurrent or Metastatic Head and Neck Cancer.

Autor: Verhoeff SR; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands., van de Donk PP; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Aarntzen EHJG; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands., Oosting SF; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Brouwers AH; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Miedema IHC; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Voortman J; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Menke-van der Houven van Oordt WC; Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Boellaard R; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.; Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Vriens D; Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands., Slingerland M; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands., Hermsen R; Department of Nuclear Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands; and., Grunsven IVE; Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands., Heskamp S; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands., van Herpen CML; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Carla.vanherpen@radboudumc.nl.
Jazyk: angličtina
Zdroj: Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2022 Oct; Vol. 63 (10), pp. 1523-1530. Date of Electronic Publication: 2022 May 05.
DOI: 10.2967/jnumed.121.263470
Abstrakt: In this PD-L1 ImagiNg to prediCt durvalumab treatment response in SCCHN (PINCH) study, we performed 89 Zr-DFO-durvalumab (anti-PD-L1 [programmed death ligand 1]) PET/CT in patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) before monotherapy durvalumab treatment. The primary aims were to assess safety and feasibility of 89 Zr-DFO-durvalumab PET imaging and predict disease control rate during durvalumab treatment. Secondary aims were to correlate 89 Zr-DFO-durvalumab uptake to tumor PD-L1 expression, 18 F-FDG uptake, and treatment response of individual lesions. Methods: In this prospective multicenter phase I-II study (NCT03829007), patients with incurable R/M SCCHN underwent baseline 18 F-FDG PET and CT or MRI. Subsequently, PD-L1 PET imaging was performed 5 d after administration of 37 MBq of 89 Zr-DFO-durvalumab. To optimize imaging conditions, dose finding was performed in the first 14 patients. For all patients ( n = 33), durvalumab treatment (1,500 mg/4 wk, intravenously) was started within 1 wk after PD-L1 PET imaging and continued until disease progression or unacceptable toxicity (maximum, 24 mo). CT evaluation was assessed according to RECIST 1.1 every 8 wk. PD-L1 expression was determined by combined positive score on (archival) tumor tissue. 89 Zr-DFO-durvalumab uptake was measured in 18 F-FDG-positive lesions, primary and secondary lymphoid organs, and blood pool. Results: In total, 33 patients with locoregional recurrent ( n = 12) or metastatic SCCHN ( n = 21) were enrolled. 89 Zr-DFO-durvalumab injection was safe. A dose of 10 mg of durvalumab resulted in highest tumor-to-blood ratios. After a median follow-up of 12.6 mo, overall response rate was 26%. The disease control rate at 16 wk was 48%, with a mean duration of 7.8 mo (range, 1.7-21.1). On a patient level, 89 Zr-DFO-durvalumab SUV peak or tumor-to-blood ratio could not predict treatment response (hazard ratio, 1.5 [95% CI, 0.5-3.9; P = 0.45] and 1.3 [95% CI, 0.5-3.3; P = 0.60], respectively). Also, on a lesion level, 89 Zr-DFO-durvalumab SUV peak showed no substantial correlation to treatment response (Spearman ρ, 0.45; P = 0.051). Lesional 89 Zr-DFO-durvalumab uptake did not correlate to PD-L1 combined positive score but did correlate to 18 F-FDG SUV peak (Spearman ρ, 0.391; P = 0.005). Conclusion: PINCH is the first, to our knowledge, PD-L1 PET/CT study in patients with R/M SCCHN and has shown the feasibility and safety of 89 Zr-DFO-durvalumab PET/CT in a multicenter trial. 89 Zr-DFO-durvalumab uptake did not correlate to durvalumab treatment response.
(© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze: MEDLINE
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