Current Evidence on PET Response Assessment to Immunotherapy in Lymphomas

Lopci, Egesta; Meignan, Michel

doi:10.1016/j.cpet.2019.08.011

Cited by 12 publications

(8 citation statements)

References 57 publications

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“…However, they did not observe any instances of pseudoprogression. This observation confirmed a previous analysis of the PET response in these conditions [73].…”

Section: Pet For Assessment Of the Microenvironmentsupporting

confidence: 92%

Current Role of Functional Imaging in the Management of Lymphoma

Cheson

Meignan

2021

Curr Oncol Rep

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Purpose of Review Functional imaging with 18FDG-PET-CT has transformed the staging and response assessment of patients with Hodgkin (HL) and non-Hodgkin lymphoma (NHL). Herein, we review the current role and future directions for functional imaging in the management of patients with lymphoma. Recent Findings Because of its increased sensitivity, PET-CT is the preferred modality for staging of FDG-avid lymphomas. It appears to have a role for interim assessment in patients with HL with adaptive strategies that reduce toxicity in lower risk patients and increase efficacy in those at high risk. Such a role has yet to be demonstrated in other histologies. FDG-PET-CT is also the gold standard for response assessment posttreatment. Newer uses include assessment of total metabolic tumor volume and radiomics in pretreatment prognosis. Summary Whereas PET-CT is more sensitive than other current modalities for staging and response assessment, the future of PET-CT will be in conjunction with other modalities, notably assessment of minimal residual disease and microenvironmental markers to develop risk adaptive strategies to improve the outcome of patients with lymphoma.

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“…However, they did not observe any instances of pseudoprogression. This observation confirmed a previous analysis of the PET response in these conditions [73].…”

Section: Pet For Assessment Of the Microenvironmentsupporting

confidence: 92%

Current Role of Functional Imaging in the Management of Lymphoma

Cheson

Meignan

2021

Curr Oncol Rep

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“…In 1997, the introduction of anti-CD20 monoclonal antibodies (mAbs) such as rituximab which targeted B-cells exclusively to evoke a direct antitumor cytotoxic effect revolutionalized the treatment paradigm for lymphoma. Then, in 2017, the introduction of immune checkpoint inhibitors (ICI) such as anti-PD1 and anti-CTLA4 monoclonal antibodies which stimulates the immune system via T cells appears to be the next promising step in lymphoma management [1][2][3]. Although immunotherapy now is common terminology for the class of drugs that stimulate the immune system to indirectly target cancer cells, conventionally, immunotherapy refers to any therapy that manipulates the immune system such as both anti-CD20 mAbs and new targeted immunotherapy, ICIs, and cell therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the available 18 F-FDG PET criteria, following the introduction of ICIs some modified response assessment criteria were proposed. These criteria were developed based on the observation that some immunomodulatory drugs can alter tumoral glucose metabolism, changing the assumed association between the 18 F-FDG uptake and treatment efficacy observed under conventional chemotherapy [2].…”

Section: Introductionmentioning

confidence: 99%

The value of FDG PET/CT imaging in outcome prediction and response assessment of lymphoma patients treated with immunotherapy: a meta-analysis and systematic review

Kiamanesh

Ayati

Sadeghi

et al. 2022

Eur J Nucl Med Mol Imaging

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Purpose Treatment strategies of lymphoid malignancies have been revolutionized by immunotherapy. Because of the inherent property of Hodgkin lymphoma and some subtypes of non-Hodgkin lymphoma as a highly FDG-avid tumor, functional 18F-FDG PET/CT imaging is already embedded in their routine care. Nevertheless, the question is whether it is still valuable in the context of these tumors being treated with immunotherapy. Herein, we will review the value of 18F-FDG PET/CT imaging lymphoid tumors treated with immunotherapy regimens. Methods A comprehensive literature search of the PubMed database was conducted on the value of the 18F-FDG PET/CT for immunotherapy response monitoring of patients with malignant lymphoma. The articles were considered eligible if they met all of the following inclusion criteria: (a) clinical studies on patients with different types of malignant lymphoma, (b) treatment with anti-CD20 antibodies, immune checkpoint inhibitors or immune cell therapies, (c) and incorporated PET/CT with 18F-FDG as the PET tracer. Results From the initial 1488 papers identified, 91 were ultimately included in our study. In anti-CD20 therapy, the highest pooled hazard ratios (HRs) of baseline, early, and late response monitoring parameters for progression-free survival (PFS) belong to metabolic tumor volume (MTV) (3.19 (95%CI: 2.36–4.30)), maximum standardized uptake value (SUVmax) (3.25 (95%CI: 2.08–5.08)), and Deauville score (DS) (3.73 (95%CI: 2.50–5.56)), respectively. These measurements for overall survival (OS) were MTV (4.39 (95%CI: 2.71–7.08)), DS (3.23 (95%CI: 1.87–5.58)), and DS (3.64 (95%CI: 1.40–9.43)), respectively. Early and late 18F-FDG PET/CT response assessment in immune checkpoint inhibitors (ICI) and immune cell therapy might be an effective tool for prediction of clinical outcome. Conclusion For anti-CD20 therapy of lymphoma, the MTV as a baseline 18F-FDG PET/CT-derived parameter has the highest HRs for PFS and OS. The DS as visual criteria in early and late response assessment has higher HRs for PFS and OS compared to the international harmonization project (IHP) visual criteria in anti-CD20 therapy. Early changes in 18F-FDG PET parameters may be predictive of response to ICIs and cell therapy in lymphoma patients.

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“…Interestingly enough, studies have already been performed in order to determine which metabolic criteria could better define the response of HL to immunotherapy; however, no conclusive data are available to date to define which criteria should be used to assess the PET metabolic response in this setting [52]. Finally, given the capability of [ 18 F]FDG PET/CT to highlight the presence of hypermetabolism related to inflammation, it has also been used to capture the presence of immune-related adverse events (IRAEs) and to correlate them with patients' outcome [53].…”

Section: Pet-based Response To Icpis In Patients With Nsclcmentioning

confidence: 99%

Positron Emission Tomography-Based Response to Target and Immunotherapies in Oncology

et al. 2020

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2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) is a promising tool to support the evaluation of response to either target therapies or immunotherapy with immune checkpoint inhibitors both in clinical trials and, in selected patients, at the single patient’s level. The present review aims to discuss available evidence related to the use of [18F]FDG PET (Positron Emission Tomography) to evaluate the response to target therapies and immune checkpoint inhibitors. Criteria proposed for the standardization of the definition of the PET-based response and complementary value with respect to morphological imaging are commented on. The use of PET-based assessment of the response through metabolic pathways other than glucose metabolism is also relevant in the framework of personalized cancer treatment. A brief discussion of the preliminary evidence for the use of non-FDG PET tracers in the evaluation of the response to new therapies is also provided.

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Current Evidence on PET Response Assessment to Immunotherapy in Lymphomas

Cited by 12 publications

References 57 publications

Current Role of Functional Imaging in the Management of Lymphoma

Current Role of Functional Imaging in the Management of Lymphoma

The value of FDG PET/CT imaging in outcome prediction and response assessment of lymphoma patients treated with immunotherapy: a meta-analysis and systematic review

Positron Emission Tomography-Based Response to Target and Immunotherapies in Oncology

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