F18-FDG PET/CT imaging early predicts pathologic complete response to induction chemoimmunotherapy of locally advanced head and neck cancer: preliminary single-center analysis of the checkrad-cd8 trial

URN to cite this document:

urn:nbn:de:bvb:355-epub-576282 Copy

DOI to cite this document:

10.5283/epub.57628 Copy

Beck, M. ; Hartwich, J. ; Eckstein, M. ; Schmidt, D. ; Gostian, A. O. ; Müller, S. ; Rutzner, S. ; Gaipl, U. S. ; von der Grün, J. ; Illmer, T. ; Hautmann, M. G. ; Klautke, G. ; Döscher, J. ; Brunner, T. ; Tamaskovics, B. ; Hartmann, A. ; Iro, H. ; Kuwert, T. ; Fietkau, R. ; Hecht, M. ; Semrau, S.

License: Creative Commons Attribution 4.0 PDF - Published Version (1MB)

Date of publication of this fulltext: 29 Feb 2024 13:01

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Details

Item type:	Article
Open Access Type:	DEAL (Springer) - Non UR
Journal or Publication Title:	Annals of Nuclear Medicine
Publisher:	Springer
Place of Publication:	NEW YORK
Volume:	36
Number of Issue or Book Chapter:	7
Page Range:	pp. 623-633
Date:	10 May 2022
Institutions:	Medicine > Lehrstuhl für Strahlentherapie
Identification Number:	Value Type 10.1007/s12149-022-01744-6 DOI
Keywords:	SQUAMOUS-CELL CARCINOMA; LUNG-CANCER; FDG-PET/CT; IMMUNOTHERAPY; CHEMOTHERAPY; CHEMORADIATION; THERAPY; SURGERY; Immunotherapy; HNSCC; Head neck cancer; FDG-PET; CT; Induction therapy
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	57628

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Abstract

Aim In the CheckRad-CD8 trial patients with locally advanced head and neck squamous cell cancer are treated with a single cycle of induction chemo-immunotherapy (ICIT). Patients with pathological complete response (pCR) in the re-biopsy enter radioimmunotherapy. Our goal was to study the value of F-18-FDG PET/CT in the prediction of pCR after induction therapy. Methods Patients treated ...

Abstract

Aim
In the CheckRad-CD8 trial patients with locally advanced head and neck squamous cell cancer are treated with a single cycle of induction chemo-immunotherapy (ICIT). Patients with pathological complete response (pCR) in the re-biopsy enter radioimmunotherapy. Our goal was to study the value of F-18-FDG PET/CT in the prediction of pCR after induction therapy.

Methods
Patients treated within the CheckRad-CD8 trial that additionally received FDG- PET/CT imaging at the following two time points were included: 3–14 days before (pre-ICIT) and 21–28 days after (post-ICIT) receiving ICIT. Tracer uptake in primary tumors (PT) and suspicious cervical lymph nodes (LN +) was measured using different quantitative parameters on EANM Research Ltd (EARL) accredited PET reconstructions. In addition, mean FDG uptake levels in lymphatic and hematopoietic organs were examined. Percent decrease (Δ) in FDG uptake was calculated for all parameters. Biopsy of the PT post-ICIT acquired after FDG-PET/CT served as reference. The cohort was divided in patients with pCR and residual tumor (ReTu).

Results
Thirty-one patients were included. In ROC analysis, ΔSUVmax PT performed best (AUC = 0.89) in predicting pCR (n = 17), with a decline of at least 60% (sensitivity, 0.77; specificity, 0.93). Residual SUVmax PT post-ICIT performed best in predicting ReTu (n = 14), at a cutpoint of 6.0 (AUC = 0.91; sensitivity, 0.86; specificity, 0.88). Combining two quantitative parameters (ΔSUVmax ≥ 50% and SUVmax PT post-ICIT ≤ 6.0) conferred a sensitivity of 0.81 and a specificity of 0.93 for determining pCR. Background activity in lymphatic organs or uptake in suspected cervical lymph node metastases lacked significant predictive value.

Conclusion
FDG-PET/CT can identify patients with pCR after ICIT via residual FDG uptake levels in primary tumors and the related changes compared to baseline. FDG-uptake in LN + had no predictive value.

Trial registry
ClinicalTrials.gov identifier: NCT03426657.

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Metadata last modified: 22 Apr 2024 07:15

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