Image‐based response assessment during immunotherapy in skin cancer

Abstract

Immune-checkpoint inhibitors and further immunotherapeutic treatment strategies have significantly extended therapy options for melanoma and other skin cancer entities over the last decade. In the context of a broader application of immunotherapeutic approaches, sufficient ways to monitor the course of the disease during therapy are required. Immunotherapies are based on different ways of modulating the immune system. This leads to complex clinical response patterns including pseudoprogression and others, requiring an adaptation of conventional diagnostic imaging tools or the introduction of novel technologies. In this review, current non-invasive imaging approaches for response assessment during immunotherapies in skin cancers as well as their limitations are discussed. To overcome present hurdles, promising alternatives to better address novel imaging features during immunotherapy are depicted giving an outlook on what can be expected in the future.

Pseudo-Progression of Melanoma Treated with Nivolumab/Ipilimumab: A Case Report

“…Regular imaging tests may not help to differentiate between both. Depending on the situation, a PET scan or repeat biopsies can be necessary to confirm whether the apparent growth is due to inflammation or actual disease progression [ 8 ]. While pseudo-progression can be a concerning phenomenon, the clinical evaluation of the patient should be considered when deciding to continue with immunotherapy or to change to an alternative therapy.…”