In a nutshell
This study aimed to investigate if 18F-FDG PET/CT (ePET1) imaging can predict overall survival in patients with relapsed or unresponsive (refractory) Hodgkin lymphoma who have been treated with nivolumab.
This study concluded that ePET1 assessment can predict overall survival in these patients.
Some background
Nivolumab (Opdivo) and pembrolizumab (Keytruda) are a type of treatment called anti-PD-1 monoclonal antibodies (anti PD-1 mAbs). Both treatments have shown good response rates in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (HL).
18F-FDG PET/CT (ePET1) imaging can be used to detect various cancers. It can also be used to determine the stage of cancer and detect recurrence of cancer. It also allows the monitoring of response to treatment. Prognostic factors are measurements at the time of diagnosis that are associated with overall survival (OS).
It was unknown if there was a prognostic factor for OS associated with nivolumab and pembrolizumab in R/R HL.
Methods & findings
This study involved 45 patients with R/R HL who were treated with nivolumab. These patients were involved in 2 previous trials (Lugano and LYRIC). The ePET1 at an average of 2 months after nivolumab treatment was measured.
24% of patients died after an average follow up of 21.2 months.
Patients were classified at ePET1 according to 4 categories: complete metabolic response (CMR), partial metabolic response (PMR), no metabolic response (NMR), or progressive metabolic response (PMR). 29% of patients were in CMR. 36% of patients were in PMD. 9% of patients were in NMR. 27% of patients were in PMR.
Survival without cancer growing or spreading (progression-free survival; PFS) was significantly higher in CMR-patients (26.3 months) compared to PMR patients (11.7 months), and PMR-patients (2.5 months).
The bottom line
This study concluded that in R/R HL patients treated with nivolumab, ePET1 assessment predicts survival. It was also concluded that ePET1 allows risk-assessment and may be used to develop risk-adapted strategies.
The fine print
This was a small study based on medical records. Further larger studies are needed for stronger evidence.
What’s next?
Consult your physician about 18F-FDG PET/CT (ePET1) imaging.
Published By :
Journal of nuclear medicine: official publication of the Society of Nuclear Medicine
Date :
Oct 18, 2019
