Can benign lymphoid tissue changes in 18F-FDG PET/CT predict response to immunotherapy in metastatic melanoma?
Can benign lymphoid tissue changes in 18F-FDG PET/CT predict response to immunotherapy in metastatic melanoma?
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DOI：
10.1007/s00262-018-2279-9
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发表时间：
2019-02-01
影响因子：
5.8
通讯作者：
Dimitrakopoulou-Strauss, Antonia
中科院分区：
文献类型：
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作者：
Sachpekidis, Christos;Larribere, Lionel;Dimitrakopoulou-Strauss, Antonia
背景：免疫相关不良事件（irAE）与免疫治疗的临床获益之间存在相关性。我们回顾性评价了通过F-18-FDG PET/CT淋巴组织的变化，在纵隔/肺门淋巴结和脾脏中的ipilimumab管理在metastatic melanoma. Methods一个总的41例患者不可切除的转移性黑色素瘤进行F-18-FDG PET/CT开始ipilimumab（基线PET/CT），两个周期后（中期PET/CT）和治疗结束时（晚期PET/CT）。数据分析集中于纵隔/肺门淋巴结和脾脏。结果根据BCR标准，31例患者病情控制（DC），10例患者病情进展（PD）。纵隔/肺门淋巴结评价显示，在中期或晚期PET/CT中，共有4例患者（10%）表现出"结节样淋巴结病"作为治疗反应（LN阳性）。所有LN阳性患者对易普利姆玛有DC应答。另一方面，DC和PD组之间的半定量和定量的F-18-FDG PET脾脏相关参数在基线和作为对treatment的反应没有显着差异detected.Conclusion根据我们的研究结果，10%的患者在中期或晚期PET/CT显示“结节样淋巴结病”作为对治疗的反应。所有这些患者均显示疾病控制，这意味着结节样淋巴结病的出现与抗CTLA-4治疗的临床益处之间存在关系。另一方面，脾脏的定量F-18-FDG PET分析在预测易普利姆玛的临床益处方面表现不佳。
Background An association between immune-related adverse events (irAEs) caused by immunotherapeutic agents and the clinical benefit of immunotherapy has been suggested. We retrospectively evaluated by means of F-18-FDG PET/CT lymphoid tissue changes in the mediastinal/hilar lymph nodes and the spleen in response to ipilimumab administration in metastatic melanoma.Methods A total of 41 patients with unresectable metastatic melanoma underwent F-18-FDG PET/CT before the start of ipilimumab (baseline PET/CT), after two cycles (interim PET/CT) and at the end of treatment (late PET/CT). Data analysis was focused on the mediastinal/hilar lymph nodes and the spleen. The patients' best clinical response (BCR) was used as reference.Results According to the BCR reference, 31 patients showed disease control (DC) and 10 patients showed progressive disease (PD). Mediastinal/hilar lymph node evaluation revealed that in total 4 patients in the interim or late PET/CT (10%) demonstrated a 'sarcoid-like lymphadenopathy' as response to treatment (LN-positive). All LN-positive patients responded to ipilimumab with DC. On the other hand, no significant differences between the DC and PD groups regarding both semi-quantitative and quantitative F-18-FDG PET spleen-related parameters at baseline and as response to treatment were detected.Conclusion Based on our findings, 10% patients in the interim or late PET/CT showed 'sarcoid-like lymphadenopathy' as response to treatment. All these patients showed disease control, implying a relation between the appearance of sarcoid-like lymphadenopathy and the clinical benefit of anti-CTLA-4 therapy. On the other hand, quantitative F-18-FDG PET analysis of the spleen showed a poor performance in predicting clinical benefit to ipilimumab.