Predictive value of baseline [18f]fdg pet/ct for response to systemic therapy in patients with advanced melanoma

Virginia Liberini, Marco Rubatto, Riccardo Mimmo, Roberto Passera, Francesco Ceci, Paolo Fava, Luca Tonella, Giulia Polverari, Adriana Lesca, Marilena Bellò, Vincenzo Arena, Simone Ribero, Pietro Quaglino, Désirée Deandreis

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aim: To evaluate the association between baseline [18F]FDG-PET/CT tumor burden parameters and disease progression rate after first-line target therapy or immunotherapy in advanced melanoma patients. Materials and Methods: Forty four melanoma patients, who underwent [18F]FDG-PET/CT before first-line target therapy (28/44) or immunotherapy (16/44), were retrospectively analyzed. Whole-body and per-district metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated. Therapy response was assessed according to RECIST 1.1 on CT scan at 3 (early) and 12 (late) months. PET parameters were compared using the Mann–Whitney test. Optimal cut-offs for predicting progression were defined using the ROC curve. PFS and OS were studied using Kaplan–Meier analysis. Results: Median (IQR) MTVwb and TLGwb were 13.1 mL and 72.4, respectively. Non-responder patients were 38/44, 26/28 and 12/16 at early evaluation, and 33/44, 21/28 and 12/16 at late evaluation in the whole-cohort, target, and immunotherapy subgroup, respectively. At late evaluation, MTVbone and TLGbone were higher in non-responders compared to responder patients (all p < 0.037) in the whole-cohort and target subgroup and MTVwb and TLGwb (all p < 0.022) in target subgroup. No significant differences were found for the immunotherapy subgroup. No metabolic parameters were able to predict PFS. Controversially, MTVlfn, TLGlfn, MTVsoft + lfn, TLGsoft + lfn, MTVwb and TLGwb were significantly associated (all p < 0.05) with OS in both the whole-cohort and target therapy subgroup. Conclusions: Higher values of whole-body and bone metabolic parameters were correlated with poorer outcome, while higher values of whole-body, lymph node and soft tissue metabolic parameters were correlated with OS.

Original languageEnglish
Article number4994
JournalJournal of Clinical Medicine
Volume10
Issue number21
DOIs
Publication statusPublished - Nov 1 2021

Keywords

  • BRAF
  • CTLA-4
  • Immune checkpoint inhibitors
  • Immunotherapy
  • Melanoma
  • MET
  • PD-1
  • PD-L1
  • Target therapy
  • [18F]FDG PET/CT

ASJC Scopus subject areas

  • Medicine(all)

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