title: Residual FDG-PET metabolic activity in metastatic melanoma patients with prolonged response to anti-PD-1 therapy.
abstract: 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) scans were performed on 27 patients with unresectable stage IIIC or IV melanoma after prolonged treatment with anti-PD-1 antibodies to examine the hypothesis that patients with prolonged response to treatment may have metabolically inactive lesions by FDG-PET. Scans were performed at a median of 15.2 months (range 12-29 months) after starting treatment. Overall, 15 of 27 (56%) patients had a positive FDG-PET scan. Eight patients with positive scans underwent biopsy; 5 of 8 (62%) were melanoma and 3 of 8 (38%) were immune cell infiltrates. Of the 12 patients with negative FDG-PET scans, six had residual computerized tomography-visible lesions, five have ceased treatment, and none have recurred with follow-up of 6-10 months. Patients with residual metastases after a prolonged period without progression on anti-PD-1 therapy may have metabolically inactive lesions. Isolated metabolically active lesions in clinically well patients may reveal immune cell infiltrates rather than melanoma.
authors.affiliation: Crown Princess Mary Cancer Centre, Sydney, NSW, Australia.|The University of Sydney, Sydney, NSW, Australia.
authors.forename: Benjamin Y
authors.identifier: 0000-0001-8659-5591
authors.initials: BY
authors.lastname: Kong
authors.affiliation: The University of Sydney, Sydney, NSW, Australia.|Melanoma Institute Australia, Sydney, NSW, Australia.|Royal North Shore Hospital, Sydney, NSW, Australia.|Mater Hospital, Sydney, NSW, Australia.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Menzies
authors.affiliation: Department of Nuclear Medicine, Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Catherine A B
authors.initials: CA
authors.lastname: Saunders
authors.affiliation: Melanoma Institute Australia, Sydney, NSW, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Liniker
authors.affiliation: Melanoma Institute Australia, Sydney, NSW, Australia.
authors.forename: Sangeetha
authors.initials: S
authors.lastname: Ramanujam
authors.affiliation: The University of Sydney, Sydney, NSW, Australia.|Melanoma Institute Australia, Sydney, NSW, Australia.|Royal North Shore Hospital, Sydney, NSW, Australia.|Mater Hospital, Sydney, NSW, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Guminski
authors.affiliation: Crown Princess Mary Cancer Centre, Sydney, NSW, Australia.|Melanoma Institute Australia, Sydney, NSW, Australia.|Faculty of Health and Medical Sciences, Macquarie University, Sydney, NSW, Australia.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Kefford
authors.affiliation: The University of Sydney, Sydney, NSW, Australia.|Melanoma Institute Australia, Sydney, NSW, Australia.|Royal North Shore Hospital, Sydney, NSW, Australia.|Mater Hospital, Sydney, NSW, Australia.
authors.forename: Georgina V
authors.initials: GV
authors.lastname: Long
authors.affiliation: Crown Princess Mary Cancer Centre, Sydney, NSW, Australia. matteo.carlino@sydney.edu.au.|The University of Sydney, Sydney, NSW, Australia. matteo.carlino@sydney.edu.au.|Melanoma Institute Australia, Sydney, NSW, Australia. matteo.carlino@sydney.edu.au.
authors.forename: Matteo S
authors.initials: MS
authors.lastname: Carlino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism* / Q000556:secondary; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors*; D019275:Radiopharmaceuticals / Q000378:metabolism*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; anti-PD-1; melanoma; nivolumab; pembrolizumab