PD-L1 PET/CT Imaging with Radiolabeled Durvalumab in Patients with Advanced-Stage Non-Small Cell Lung Cancer

Autor: Adrianus J. de Langen, Danielle J. Vugts, Guus A.M.S. van Dongen, Berlinda J. de Wit–van der Veen, Otto S. Hoekstra, Egbert F. Smit, Frank Johannes Borm, Daniela E. Oprea-Lager, Erik Thunnissen, Ronald Boellaard, Anna-Larissa N. Niemeijer, Jasper Smit, Marc C. Huisman
Přispěvatelé: Intensive care medicine, Radiology and nuclear medicine, ACS - Diabetes & metabolism, Pulmonary medicine, AII - Inflammatory diseases, Amsterdam Neuroscience - Brain Imaging, CCA - Imaging and biomarkers, AII - Cancer immunology, CCA - Cancer biology and immunology, CCA - Cancer Treatment and quality of life, Pathology
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Nuclear Medicine, 63(5), 686-693. Society of Nuclear Medicine Inc.
Smit, J, Borm, F J, Niemeijer, A-L N, Huisman, M C, Hoekstra, O S, Boellaard, R, Oprea-Lager, D E, Vugts, D J, van Dongen, G A M S, de Wit-van der Veen, B J, Thunnissen, E, Smit, E F & de Langen, A J 2022, ' PD-L1 PET/CT Imaging with Radiolabeled Durvalumab in Patients with Advanced-Stage Non-Small Cell Lung Cancer ', Journal of Nuclear Medicine, vol. 63, no. 5, pp. 686-693 . https://doi.org/10.2967/jnumed.121.262473
Journal of Nuclear Medicine, 63(5), 686-693. SOC NUCLEAR MEDICINE INC
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 63(5), 686-693
ISSN: 0161-5505
Popis: Background: Better biomarkers are needed to predict treatment outcome in NSCLC patients treated with anti PD-(L)1 checkpoint inhibitors. PD-L1 immunohistochemistry has limited predictive value, possibly due to tumor heterogeneity of PD-L1 expression. Noninvasive PD-L1 imaging using 89Zr-durvalumab might provide a better reflection of tumor PD-L1 expression and can therefore support treatment decision making. Patients and Methods: NSCLC patients eligible for second line immunotherapy treatment were enrolled. Patients received two injections of 89Zr-durvalumab; one without a preceding dose of unlabeled durvalumab (‘tracer dose only’) and one with a preceding dose of 750 mg durvalumab, directly prior to tracer injection. Up to four PET/CT scans were obtained after tracer injection. Post-imaging acquisition, patients were treated with 750mg durvalumab every two weeks. Tracer biodistribution and tumor uptake were visually assessed and quantified as standardized uptake value (SUV) and both imaging acquisitions were compared. Tumor tracer uptake was correlated with PD-L1 expression and clinical outcome, defined as treatment response to durvalumab treatment. Results: Thirteen patients were included and ten completed all scheduled PET scans. No tracer related adverse events were observed and all patients started durvalumab treatment. Biodistribution analysis showed 89Zr-durvalumab accumulation in the blood pool, liver and spleen. Serial imaging showed that image acquisition 120 hours post injection delivered the best tumor to blood pool ratio. Most tumor lesions were visualized with the tracer-dose only versus the co-injection imaging acquisition (25% vs 13.5% of all lesions). Uptake heterogeneity was observed within (range SUVpeak 0.2 to 15.1) and between patients. Tumor uptake was higher in patients with treatment response or stable disease, compared to patients with disease progression according to RECIST 1.1. However, this difference was not statistically significant (median SUVpeak 4.9 vs 2.4, P = 0.06). SUVpeak correlated better with the combined tumor and immune cell PD-L1 score than with PD-L1 expression on tumor cells, although both were not statistically significant (P = 0.06 and P = 0.93, respectively). Conclusion:89Zr-durvalumab was safe without any tracer related adverse events and more tumor lesions were visualized using the tracer dose only imaging acquisition. 89Zr-durvalumab tumor uptake was higher in patients with response to durvalumab treatment, but did not correlate with tumor PD-L1 IHC.
Databáze: OpenAIRE
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