Journal Article

FZJ-2021-00862

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Treatment Monitoring of Immunotherapy and Targeted Therapy using 18 F-FET PET in Patients with Melanoma and Lung Cancer Brain Metastases: Initial Experiences

Galldiks, N. (Corresponding author)FZJ* ; Abdulla, D. S. ; Scheffler, M. ; Wolpert, F. ; Werner, J.-M. ; Huellner, M. W. ; Stoffels, G.FZJ* ; Schweinsberg, V. ; Schlaak, M. ; Kreuzberg, N. ; Landsberg, J. ; Lohmann, P.FZJ* ; Ceccon, G. ; Baues, C. ; Trommer, M. ; Celik, E. ; Ruge, M. I. ; Kocher, M.FZJ* ; Marnitz, S. ; Fink, G. R.FZJ* ; Tonn, J.-C. ; Weller, M. ; Langen, K.-J.FZJ* ; Wolf, J. ; Mauch, C.

2021
Soc. New York, NY

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Please use a persistent id in citations: http://hdl.handle.net/2128/27586  doi:10.2967/jnumed.120.248278

Abstract: 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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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)
2. Physik der Medizinischen Bildgebung (INM-4)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2021

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Database coverage:
; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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