18氟脱氧葡萄糖正电子发射断层扫描对一线免疫检查点抑制剂治疗的晚期或转移性黑色素瘤患者治疗反应的评估

18FDG PET Assessment of Therapeutic Response in Patients with Advanced or Metastatic Melanoma Treated with First-Line Immune Checkpoint Inhibitors.

作者信息

Rivas Alexia, Delyon Julie, Martineau Antoine, Blanc Estelle, Allayous Clara, Da Meda Laetitia, Merlet Pascal, Lebbé Céleste, Baroudjian Barouyr, Vercellino Laetitia

机构信息

Department of Nuclear Medicine, AP-HP Saint-Louis Hospital, F-75010 Paris, France.

Department of Dermatology, AP-HP Saint-Louis Hospital, F-75010 Paris, France.

出版信息

Cancers (Basel). 2022 Jun 29;14(13):3190. doi: 10.3390/cancers14133190.

BACKGROUND

Immune checkpoint inhibitors (ICI) are currently the first-line treatment for patients with metastatic melanoma. We investigated the value of positron emission tomography (PET) response criteria to assess the therapeutic response to first-line ICI in this clinical context and explore the potential contribution of total tumor metabolic volume (TMTV) analysis.

METHODS

We conducted a retrospective study in patients treated with first-line ICI for advanced or metastatic melanoma, with 18F-FDG PET/CT performed at baseline and 3 months after starting treatment. Patients' metabolic response was classified according to PERCIST5 and imPERCIST 5 criteria. TMTV was recorded for each examination.

RESULTS

Twenty-nine patients were included. The median overall survival (OS) was 51.2 months (IQR 13.6-not reached), and the OS rate at 2 years was 58.6%. Patients classified as responders (complete and partial response) had a 90.9% 2-year OS rate versus 38.9% for non-responders (stable disease and progressive disease) ( = 0.03), for PERCIST5 and imPERCIST 5 criteria. The median change in metabolic volume was 9.8% (IQR -59-+140%). No significant correlation between OS and changes in TMTV was found.

CONCLUSION

The evaluation of response to immunotherapy using metabolic imaging with PERCIST5 and imPERCIST5 was significantly associated with OS in patients with advanced or metastatic melanoma.

背景

免疫检查点抑制剂（ICI）目前是转移性黑色素瘤患者的一线治疗方法。我们研究了正电子发射断层扫描（PET）反应标准在评估这种临床背景下一线ICI治疗反应中的价值，并探讨了总肿瘤代谢体积（TMTV）分析的潜在作用。

方法

我们对接受一线ICI治疗晚期或转移性黑色素瘤的患者进行了一项回顾性研究，在基线和开始治疗后3个月进行18F-FDG PET/CT检查。根据PERCIST5和imPERCIST 5标准对患者的代谢反应进行分类。每次检查都记录TMTV。

结果

纳入29例患者。中位总生存期（OS）为51.2个月（四分位间距13.6 - 未达到），2年总生存率为58.6%。根据PERCIST5和imPERCIST 5标准，分类为反应者（完全缓解和部分缓解）的患者2年总生存率为90.9%，而非反应者（疾病稳定和疾病进展）为38.9%（P = 0.03）。代谢体积的中位变化为9.8%（四分位间距-59 - +140%）。未发现OS与TMTV变化之间存在显著相关性。