Laurent Dercle1,2,3, Romain-David Seban2, Julien Lazarovici4,5, Lawrence H Schwartz3, Roch Houot6, Samy Ammari2, Alina Danu4,5, Véronique Edeline7, Aurélien Marabelle8,9, Vincent Ribrag4,5, Jean-Marie Michot4,5,9. 1. Gustave Roussy, Université Paris-Saclay, Inserm, Villejuif, France laurent.dercle@gmail.com. 2. Gustave Roussy, Université Paris-Saclay, Département d'imagerie médicale, Villejuif, France. 3. Department of Radiology, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York. 4. Department of Medicine Oncology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France. 5. Gustave Roussy, Université Paris-Saclay, Département d'hématologie, Villejuif, France. 6. CHU Rennes, Service Hematologie Clinique, Rennes, France. 7. Department of Imaging, Institut Curie R. Huguenin Hospital, Saint-Cloud, France; and. 8. Gustave Roussy, Université Paris-Saclay, Inserm, Villejuif, France. 9. Drug Development Department, Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
Abstract
The response evaluation criteria in patients with Hodgkin lymphoma (HL) were designed for the assessment of chemotherapy and targeted molecular agents. We investigated the accuracy of 3-mo 18F-FDG PET/CT for the identification of HL patients responding to immune-checkpoint blockade by anti-programmed death 1 antibodies (anti-PD1). We also reported the frequency of new immune patterns of response and progression. Methods: Retrospectively, we recruited consecutive HL patients treated by anti-PD1 (pembrolizumab or nivolumab) at Gustave Roussy from 2013 to 2015. 18F-FDG PET/CT and contrast-enhanced CT scans were acquired every 3 mo. We recorded the best overall response according to the International Harmonization Project Cheson 2014 criteria and LYmphoma Response to Immunomodulatory therapy Criteria (LYRIC) (2016 revised criteria). Patients achieving an objective response at any time during the anti-PD1 treatment were classified as responders. Results: Sixteen relapsed or refractory classic HL patients were included. The median age was 39 y (age range, 19-69 y). The median previous lines of therapy was 6 (range, 3-13). The mean follow-up was 22.6 mo. Nine of 16 patients (56%) achieved an objective response. Two deaths occurred due to progressive disease at 7 mo. 18F-FDG PET/CT detected all responders at 3 mo and reclassified best overall response in 5 patients compared with CT alone. A decrease in tumor metabolism and volume (SUVmean, metabolic tumor volume) and increase in healthy splenic metabolism at 3 mo were observed in responders (area under the curve > 0.85, P < 0.04). Five of 16 patients (31%) displayed new imaging patterns related to anti-PD1; we observed 2 transient progressions consistent with indeterminate response according to the LYRIC (2016) (IR2b at 14 mo and IR3 at 18 mo) and 3 patients with new lesions associated with immune-related adverse events. Conclusion: Three-month 18F-FDG PET/CT scans detected HL patients responding to anti-PD1. New patterns were encountered in 31% of patients, emphasizing the need for further evaluation in larger series and close collaboration between imaging and oncology specialists on a per-patient basis.
The response evaluation criteria in patients with Hodgkin lymphoma (HL) were designed for the assessment of chemotherapy and targeted molecular agents. We investigated the accuracy of 3-mo 18F-FDG PET/CT for the identification of HL patients responding to immune-checkpoint blockade by anti-programmed death 1 antibodies (anti-PD1). We also reported the frequency of new immune patterns of response and progression. Methods: Retrospectively, we recruited consecutive HL patients treated by anti-PD1 (pembrolizumab or nivolumab) at Gustave Roussy from 2013 to 2015. 18F-FDG PET/CT and contrast-enhanced CT scans were acquired every 3 mo. We recorded the best overall response according to the International Harmonization Project Cheson 2014 criteria and LYmphoma Response to Immunomodulatory therapy Criteria (LYRIC) (2016 revised criteria). Patients achieving an objective response at any time during the anti-PD1 treatment were classified as responders. Results: Sixteen relapsed or refractory classic HL patients were included. The median age was 39 y (age range, 19-69 y). The median previous lines of therapy was 6 (range, 3-13). The mean follow-up was 22.6 mo. Nine of 16 patients (56%) achieved an objective response. Two deaths occurred due to progressive disease at 7 mo. 18F-FDG PET/CT detected all responders at 3 mo and reclassified best overall response in 5 patients compared with CT alone. A decrease in tumor metabolism and volume (SUVmean, metabolic tumor volume) and increase in healthy splenic metabolism at 3 mo were observed in responders (area under the curve > 0.85, P < 0.04). Five of 16 patients (31%) displayed new imaging patterns related to anti-PD1; we observed 2 transient progressions consistent with indeterminate response according to the LYRIC (2016) (IR2b at 14 mo and IR3 at 18 mo) and 3 patients with new lesions associated with immune-related adverse events. Conclusion: Three-month 18F-FDG PET/CT scans detected HL patients responding to anti-PD1. New patterns were encountered in 31% of patients, emphasizing the need for further evaluation in larger series and close collaboration between imaging and oncology specialists on a per-patient basis.
Authors: Randy Yeh; Megan H Trager; Emanuelle M Rizk; Grace G Finkel; Luke W Barker; Richard D Carvajal; Larisa J Geskin; Gary K Schwartz; Lawrence Schwartz; Laurent Dercle; Yvonne M Saenger Journal: Clin Nucl Med Date: 2020-04 Impact factor: 7.794
Authors: Romain-David Seban; John S Nemer; Aurélien Marabelle; Randy Yeh; Eric Deutsch; Samy Ammari; Antoine Moya-Plana; Fatima-Zohra Mokrane; Robyn D Gartrell; Grace Finkel; Luke Barker; Amélie E Bigorgne; Lawrence H Schwartz; Yvonne Saenger; Caroline Robert; Laurent Dercle Journal: Eur J Nucl Med Mol Imaging Date: 2019-07-25 Impact factor: 9.236
Authors: Laetitia Vercellino; Dorine de Jong; Roberta di Blasi; Salim Kanoun; Ran Reshef; Lawrence H Schwartz; Laurent Dercle Journal: Front Oncol Date: 2021-05-28 Impact factor: 6.244