Erschienen in:
21.08.2017 | Original Article
Metabolic activity by 18F–FDG-PET/CT is predictive of early response after nivolumab in previously treated NSCLC
verfasst von:
Kyoichi Kaira, Tetsuya Higuchi, Ichiro Naruse, Yukiko Arisaka, Azusa Tokue, Bolag Altan, Satoshi Suda, Akira Mogi, Kimihiro Shimizu, Noriaki Sunaga, Takeshi Hisada, Shigehisa Kitano, Hideru Obinata, Takehiko Yokobori, Keita Mori, Masahiko Nishiyama, Yoshihito Tsushima, Takayuki Asao
Erschienen in:
European Journal of Nuclear Medicine and Molecular Imaging
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Ausgabe 1/2018
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Abstract
Background
Nivolumab, an anti-programmed death-1 (PD-1) antibody, is administered in patients with previously treated non-small cell lung cancer. However, little is known about the established biomarker predicting the efficacy of nivolumab. Here, we conducted a preliminary study to investigate whether 18F–FDG-PET/CT could predict the therapeutic response of nivolumab at the early phase.
Methods
Twenty-four patients were enrolled in this study. 18F–FDG-PET/CT was carried out before and 1 month after nivolumab therapy. SUVmax, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were calculated. Immunohistochemical analysis of PD-L1 expression and tumour-infiltrating lymphocytes was conducted.
Results
Among all patients, a partial metabolic response to nivolumab was observed in 29% on SUVmax, 25% on MTV, and 33% on TLG, whereas seven (29%) patients achieved a partial response (PR) based on RECIST v1.1. The predictive probability of PR (100% vs. 29%, p = 0.021) and progressive disease (100% vs. 22.2%, p = 0.002) at 1 month after nivolumab initiation was significantly higher in 18F–FDG on PET/CT than in CT scans. Multivariate analysis confirmed that 18F–FDG uptake after administration of nivolumab was an independent prognostic factor. PD-L1 expression and nivolumab plasma concentration could not precisely predict the early therapeutic efficacy of nivolumab.
Conclusion
Metabolic response by 18F–FDG was effective in predicting efficacy and survival at 1 month after nivolumab treatment.