Treatment Monitoring of Immunotherapy and Targeted Therapy using 18 F-FET PET in Patients with Melanoma and Lung Cancer Brain Metastases: Initial Experiences

Medientyp: E-Artikel

Titel: Treatment Monitoring of Immunotherapy and Targeted Therapy using 18 F-FET PET in Patients with Melanoma and Lung Cancer Brain Metastases: Initial Experiences

Beteiligte: Galldiks, Norbert [Verfasser:in]; Abdulla, Diana SY [Verfasser:in]; Landsberg, Jennifer [Verfasser:in]; Lohmann, Philipp [Verfasser:in]; Ceccon, Garry [Verfasser:in]; Baues, Christian [Verfasser:in]; Trommer, Maike [Verfasser:in]; Celik, Eren [Verfasser:in]; Ruge, Maximilian I [Verfasser:in]; Kocher, Martin [Verfasser:in]; Marnitz, Simone [Verfasser:in]; Fink, Gereon R [Verfasser:in]; Scheffler, Matthias [Verfasser:in]; Tonn, Joerg-Christian [Verfasser:in]; Weller, Michael [Verfasser:in]; Langen, Karl-Josef [Verfasser:in]; Wolf, Jürgen [Verfasser:in]; Mauch, Cornelia [Verfasser:in]; Wolpert, Fabian [Verfasser:in]; Werner, Jan-Michael [Verfasser:in]; Huellner, Martin W [Verfasser:in]; Stoffels, Gabriele [Verfasser:in]; Schweinsberg, Viola [Verfasser:in]; Schlaak, Max [Verfasser:in];

Erschienen: Soc., 2021

Sprache: Englisch

DOI: https://doi.org/10.2967/jnumed.120.248278

ISSN: 0022-3123; 1535-5667; 0097-9058; 0161-5505; 2159-662X

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Beschreibung: We investigated the value of O-(2-18F-fluoroethyl)-l-tyrosine (18F-FET) PET for treatment monitoring of immune checkpoint inhibition (ICI) or targeted therapy (TT) alone or in combination with radiotherapy in patients with brain metastasis (BM) since contrast-enhanced MRI often remains inconclusive. Methods: We retrospectively identified 40 patients with 107 BMs secondary to melanoma (n = 29 with 75 BMs) or non–small cell lung cancer (n = 11 with 32 BMs) treated with ICI or TT who had 18F-FET PET (n = 60 scans) for treatment monitoring from 2015 to 2019. Most patients (n = 37; 92.5%) had radiotherapy during the course of the disease. In 27 patients, 18F-FET PET was used to differentiate treatment-related changes from BM relapse after ICI or TT. In 13 patients, 18F-FET PET was performed for response assessment to ICI or TT using baseline and follow-up scans (median time between scans, 4.2 mo). In all lesions, static and dynamic 18F-FET PET parameters were obtained (i.e., mean tumor-to-brain ratios [TBR], time-to-peak values). Diagnostic accuracies of PET parameters were evaluated by receiver-operating-characteristic analyses using the clinical follow-up or neuropathologic findings as a reference. Results: A TBR threshold of 1.95 differentiated BM relapse from treatment-related changes with an accuracy of 85% (P = 0.003). Metabolic responders to ICI or TT on 18F-FET PET had a significantly longer stable follow-up (threshold of TBR reduction relative to baseline, ≥10%; accuracy, 82%; P = 0.004). Furthermore, at follow-up, time to peak in metabolic responders increased significantly (P = 0.019). Conclusion: 18F-FET PET may add valuable information for treatment monitoring in BM patients treated with ICI or TT.

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