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@ARTICLE{Sachpekidis:166490,
      author       = {C. Sachpekidis$^*$ and A. Kopp-Schneider$^*$ and L. Pan$^*$
                      and D. Papamichail$^*$ and U. Haberkorn$^*$ and J. C. Hassel
                      and A. Dimitrakopoulou-Strauss$^*$},
      title        = {{I}nterim [18{F}]{FDG} {PET}/{CT} can predict response to
                      anti-{PD}-1 treatment in metastatic melanoma.},
      journal      = {European journal of nuclear medicine and molecular imaging},
      volume       = {48},
      number       = {6},
      issn         = {1619-7089},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer-Verl.},
      reportid     = {DKFZ-2020-02933},
      pages        = {1932-1943},
      year         = {2021},
      note         = {#EA:E060#LA:E060# / 2021 Jun;48(6):1932-1943},
      abstract     = {In an attempt to identify biomarkers that can reliably
                      predict long-term outcomes to immunotherapy in metastatic
                      melanoma, we investigated the prognostic role of [18F]FDG
                      PET/CT, performed at baseline and early during the course of
                      anti-PD-1 treatment.Twenty-five patients with stage IV
                      melanoma, scheduled for treatment with PD-1 inhibitors, were
                      enrolled in the study (pembrolizumab, n = 8 patients;
                      nivolumab, n = 4 patients; nivolumab/ipilimumab, 13
                      patients). [18F]FDG PET/CT was performed before the start of
                      treatment (baseline PET/CT) and after the initial two cycles
                      of PD-1 blockade administration (interim PET/CT). Seventeen
                      patients underwent also a third PET/CT scan after
                      administration of four cycles of treatment. Evaluation of
                      patients' response by means of PET/CT was performed after
                      application of the European Organization for Research and
                      Treatment of Cancer (EORTC) 1999 criteria and the PET
                      Response Evaluation Criteria for IMmunoTherapy (PERCIMT).
                      Response to treatment was classified into 4 categories:
                      complete metabolic response (CMR), partial metabolic
                      response (PMR), stable metabolic disease (SMD), and
                      progressive metabolic disease (PMD). Patients were further
                      grouped into two groups: those demonstrating metabolic
                      benefit (MB), including patients with SMD, PMR, and CMR, and
                      those demonstrating no MB (no-MB), including patients with
                      PMD. Moreover, patterns of [18F]FDG uptake suggestive of
                      radiologic immune-related adverse events (irAEs) were
                      documented. Progression-free survival (PFS) was measured
                      from the date of interim PET/CT until disease progression or
                      death from any cause.Median follow-up from interim PET/CT
                      was 24.2 months (19.3-41.7 months). According to the EORTC
                      criteria, 14 patients showed MB (1 CMR, 6 PMR, and 7 SMD),
                      while 11 patients showed no-MB (PMD). Respectively, the
                      application of the PERCIMT criteria revealed that 19
                      patients had MB (1 CMR, 6 PMR, and 12 SMD), and 6 of them
                      had no-MB (PMD). With regard to PFS, no significant
                      difference was observed between patients with MB and no-MB
                      on interim PET/CT according to the EORTC criteria (p =
                      0.088). In contrary, according to the PERCIMT criteria,
                      patients demonstrating MB had a significantly longer PFS
                      than those showing no-MB (p = 0.045). The emergence of
                      radiologic irAEs (n = 11 patients) was not associated with a
                      significant survival benefit. Regarding the sub-cohort
                      undergoing also a third PET/CT, 14/17 patients $(82\%)$
                      showed concordant responses and 3/17 $(18\%)$ had a mismatch
                      of response assessment between interim and late
                      PET/CT.PET/CT-based response of metastatic melanoma to PD-1
                      blockade after application of the recently proposed PERCIMT
                      criteria is significantly correlated with PFS. This
                      highlights the potential ability of [18F]FDG PET/CT for
                      early stratification of response to anti-PD-1 agents, a
                      finding with possible significant clinical and financial
                      implications. Further studies including larger numbers of
                      patients are necessary to validate these results.},
      keywords     = {Anti-PD-1 therapy (Other) / EORTC criteria (Other) /
                      Immunotherapy (Other) / Interim [18F]FDG PET/CT (Other) /
                      Metastatic melanoma (Other) / PERCIMT criteria (Other) /
                      Treatment response evaluation (Other)},
      cin          = {E060 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E060-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:33336264},
      doi          = {10.1007/s00259-020-05137-7},
      url          = {https://inrepo02.dkfz.de/record/166490},
}