FDG-PET/CT imaging for evaluating durable responses to immune check point inhibitors in patients with advanced cutaneous squamous cell carcinoma

Cancer Imaging. 2021 Oct 13;21(1):57. doi: 10.1186/s40644-021-00426-2.

Abstract

Background: The role of FDG-PET/CT imaging in assessing response to immunotherapy in advanced cutaneous squamous cell carcinoma (CSCC) is unknown. This study compared complete metabolic response (CMR) rates by FDG-PET and RECIST1.1 via CT or MRI in patients on cemiplimab for > 10 months.

Methods: This was a single-centre retrospective study of 15 patients treated with cemiplimab for advanced CSCC who had CT/MRI and FDG-PET/CT at > 10 months to assess metabolic treatment response. The median age was 73 years (range 55-84) and 93% were male. RECIST1.1 and PERCIST1.0 tumor responses were evaluated by blinded readers.

Results: Seventy-three percent (11/15) (95%CI 44.9, 92.2%) achieved a CMR on PET. Of these 11, on RECIST1.1 there was one complete response, 9 partial responses and one stable disease.

Conclusions: In patients on cemiplimab for > 10 months, there was discordance between CR rates on FDG-PET versus RECIST1.1. FDG-PET/CT may have utility for clarifying depth of response in patients treated with immunotherapy for CSCC.

Keywords: Cutaneous cancer; FDG-PET; Immunotherapy; PERCIST1.0; RECIST1.1.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immunotherapy / methods
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography / methods*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Retrospective Studies
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18