In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e20554-e20554
Abstract:
e20554 Background: Immunotherapy becomes a standard treatment in non-small-cell lung carcinoma (NSCLC), locally advanced or metastatic, after prior chemotherapy. Because of systemic involvement and heterogeneity of the tumoral disease, methods of assessment are complex and the role of PET-FDG is not well established. The objective of the present study is to describe the results of FDG-PET in the evaluation of patients with NSCLC treated with checkpoint inhibitor (OPDIVO®, Nivolumab) in our academic center. Methods: A retrospective analysis of FDG-PET’s data was performed in 16 patients (performance status: 1), with NSCLC (13 adenocarcinoma, 2 squamous cell carcinoma and 1 large cell neuroendocrine carcinoma) and progression after at least one line of treatment, and treated with Nivolumab. All patients had an FDG-PET before and at 2 months (M2) of treatment. Patients showing progression at M2 had a third PET at M3 to confirm disease progression. Disease responses were assessed according to PERCIST criteria. Patients were considered as responders to Nivolumab treatment, if the treatment was pursued at least 6 months, or as non-responders if the treatment was pursued less than 6 months. Pseudoprogression was defined as a disease progression at M2, which was not confirmed on FDG-PET control at M3. Results: Assessment by FDG-PET after 2 months of treatment showed 8/16 partial metabolic responses (PMR), 6/16 progressive diseases (PD), 1/16 stable disease (SD) and 1/16 complete metabolic response (CMR). Among the patients with PMR, SD or CMR at M2 (n = 10), 90% (9/10) were considered as responders and 10% (1/10) as non-responder. Nivolumab was discontinued in patients with PD. One patient showed a pseudo progression at M2 (PMR at M3), and was eventually classified as non-responder. Conclusions: These results show an association between the metabolic response at M2 and the continuation of the treatment with Nivolumab in NSCLC patients. 90% of patients with early metabolic response showed a sustained response with Nivolumab. FDG-PET could be helpful in the therapeutic strategy of these patients and deserves to be assessed in prospective trials including a cost/benefit evaluation.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.15_suppl.e20554
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
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