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@ARTICLE{Sachpekidis:136038,
author = {C. Sachpekidis$^*$ and H. N. M. A. Anwar$^*$ and J. Winkler
and A. Kopp-Schneider$^*$ and L. Larribere$^*$ and U.
Haberkorn$^*$ and J. C. Hassel and A.
Dimitrakopoulou-Strauss$^*$},
title = {{T}he role of interim 18{F}-{FDG} {PET}/{CT} in prediction
of response to ipilimumab treatment in metastatic melanoma.},
journal = {European journal of nuclear medicine and molecular imaging},
volume = {45},
number = {8},
issn = {1619-7089},
address = {Heidelberg [u.a.]},
publisher = {Springer-Verl.},
reportid = {DKFZ-2018-00737},
pages = {1289 - 1296},
year = {2018},
abstract = {The aim of the present study was to assess the value of
interim 18F-FDG PET/CT performed after the first two cycles
of ipilimumab treatment in the prediction of the final
clinical response to this type of immunotherapy.The study
group comprised 41 patients with unresectable metastatic
melanoma scheduled for ipilimumab therapy. Whole-body
18F-FDG PET/CT was performed before the start of ipilimumab
treatment (baseline PET/CT) and after the initial two cycles
of ipilimumab treatment (interim PET/CT). Evaluation of
patient response to treatment was based on the European
Organization for Research and Treatment of Cancer (EORTC)
1999 criteria for PET as well as the recently proposed PET
Response Evaluation Criteria for Immunotherapy (PERCIMT).
The patients' best clinical response, assessed at a median
of 21.4 months (range 6.3-41.9 months) was used as
reference.According to their best clinical response, the
patients were divided into two groups: those showing
clinical benefit (CB) including stable disease, partial
response and complete response (31 patients), and those
showing no clinical benefit (no-CB including progressive
disease (10 patients). According to the EORTC criteria,
interim PET/CT demonstrated progressive metabolic disease
(PMD) in 20 patients, stable metabolic disease (SMD) in 11
patients, partial metabolic response (PMR) in 8 patients,
and complete metabolic response (CMR) in 2 patients.
According to the PERCIMT, interim PET/CT demonstrated PMD in
9 patients, SMD in 24 patients, PMR in 6 patients and CMR in
2 patients. On the basis of the interim PET, the patients
were divided in a similar manner to the division according
to clinical response into those showing metabolic benefit
(MB) including SMD, PMR and CMR, and those showing no
metabolic benefit (no-MB) including PMD. According to this
dichotomization, the EORTC criteria showed a sensitivity
(correctly predicting CB) of $64.5\%,$ a specificity
(correctly predicting no-CB) of $90.0\%,$ a positive
predictive value (PPV) of $95.2\%,$ a negative predictive
value (NPV) of $45.0\%$ and an accuracy of $70.7\%$ in
predicting best clinical response. The PERCIMT showed a
sensitivity of $93.6\%,$ a specificity of $70.0\%,$ a PPV of
$90.6\%,$ a NPV of $77.8\%$ and an accuracy of $87.8\%.$ The
McNemar test showed that the PERCIMT had a significantly
higher sensitivity than EORTC criteria (p = 0.004),
while there was no significant difference in specificity
(p = 0.5). The agreement between the two sets of
criteria was poor (McNemar test p = 0.001, and
accordingly kappa = 0.46).The application of the
recently proposed PERCIMT to interim 18F-FDG PET/CT provides
a more sensitive predictor of final clinical response to
immunotherapy than the application of the EORTC criteria in
patients with metastatic melanoma.},
cin = {E060 / C060 / G300},
ddc = {610},
cid = {I:(DE-He78)E060-20160331 / I:(DE-He78)C060-20160331 /
I:(DE-He78)G300-20160331},
pnm = {315 - Imaging and radiooncology (POF3-315)},
pid = {G:(DE-HGF)POF3-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:29478079},
doi = {10.1007/s00259-018-3972-9},
url = {https://inrepo02.dkfz.de/record/136038},
}