TY  - JOUR
A1  - Beck, Michael
A1  - Hartwich, Julius
A1  - Eckstein, Markus
A1  - Schmidt, Daniela
A1  - Gostian, Antoniu-Oreste
A1  - Müller, Sarina
A1  - Rutzner, Sandra
A1  - Gaipl, Udo Sebastian
A1  - Müller-von der Grün, Jens
A1  - Illmer, Thomas
A1  - Hautmann, Matthias Günther
A1  - Klautke, Gunther
A1  - Döscher, Johannes
A1  - Brunner, Thomas B.
A1  - Tamaskovics, Bálint
A1  - Hartmann, Arndt
A1  - Iro, Heinrich
A1  - Kuwert, Torsten
A1  - Fietkau, Rainer
A1  - Hecht, Markus
A1  - Semrau, Sabine
T1  - 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
T2  - Annals of nuclear medicine
N2  - 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.
KW  - FDG-PET/CT
KW  - HNSCC
KW  - Head neck cancer
KW  - Immunotherapy
KW  - Induction therapy
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/83557
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-835572
SN  - 1864-6433
N1  - Open Access funding enabled and organized by Projekt DEAL. The trial was funded by AstraZeneca (ESR-16-12356) and was conducted as investigator sponsored trial.
VL  - 36.2022
IS  - 7
SP  - 623
EP  - 633
PB  - Springer Japan
CY  - [Erscheinungsort nicht ermittelbar]
ER  -