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NSCLC, metastatic

4467 - Whole body PD-1 and PD-L1 PET in pts with NSCLC

Date

10 Sep 2017

Session

NSCLC, metastatic

Presenters

Anna-Larissa Niemeijer

Citation

Annals of Oncology (2017) 28 (suppl_5): v460-v496. 10.1093/annonc/mdx380

Authors

A. Niemeijer1, E. Smit1, I. Bahce1, O. Hoekstra2, M. Huisman2, G.A. van Dongen2, B. Windhorst2, N. Hendrikse3, A.J. Poot2, D. Vugts2, D.K. Leung4, W. Hayes4, R.A. Smith4, L.M. Wilson4, E. Thunnissen5, J. De Langen1

Author affiliations

  • 1 Pulmonary Diseases, Vrije University Medical Centre (VUMC), 1081 HV - Amsterdam/NL
  • 2 Radiology And Nuclear Medicine, Vrije University Medical Centre (VUMC), 1081 HV - Amsterdam/NL
  • 3 Clinical Pharmacology & Pharmacy & Radiology And Nuclear Medicine, Vrije University Medical Centre (VUMC), 1081 HV - Amsterdam/NL
  • 4 Imaging, Bristol-Myers Squibb, Princeton/US
  • 5 Pathology, Vrije University Medical Centre (VUMC), 1081 HV - Amsterdam/NL
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Resources

Abstract 4467

Background

Tumor PD-L1 IHC relates moderately with treatment outcome following anti-PD1 therapy in pts with NSCLC and single biopsies do not account for tumor heterogeneity. Aim: 1. Assess safety of the PET procedures. 2. Quantify 89Zirconium-labeled nivolumab (89Zr-nivo) and 18F-labeled BMS-986192 (18F-PD-L1) uptake. 3. Assess tracer uptake heterogeneity. 4. Correlate tracer uptake with PD-1/PD-L1 IHC in tumor, stroma and with treatment outcome.

Methods

NSCLC pts eligible for treatment with nivolumab were included. Pts received whole body 18F-PD-L1 and 89Zr-nivo PET scans. Baseline tumor biopsy was required to assess PD-(L)1 IHC status (28.8 assay). SUVpeak was calculated for delineable lesions and correlated to PD-(L)1 IHC and response after 12 wks of nivolumab treatment.

Results

10 pts (3 ≥50%, 5 ≥1%, 5 negative by PD-L1 IHC) were enrolled and 37 lesions analysed. No toxicity related to radiotracer was observed. Tumor uptake of both tracers was visualized in all pts, but not in all lesions. Tracer uptake varied among pts with mean 18F-PD-L1 SUVpeak 4.6, range 0.5 - 14.4 and mean 89Zr-nivo SUVpeak 5.0, range 1.6 – 11 (p = 0.03) and within pts with mean SUVpeak difference 3.6-fold (±2.1) and 2.4-fold (±0.77) between lesions for 18F-PD-L1 and 89Zr-nivo, respectively. For lesions with ≥50% PD-L1 IHC, mean 18F-PD-L1 SUVpeak was 8.0 (±4.7) as compared to 3.5 (±1.6) for lesions with

Conclusions

1. PET-imaging with both tracers is safe and feasible, with good tumor-to-normal tissue contrast. 2. Tumor uptake showed heterogeneity among pts and among tumors within pts. 3. Pts with ≥50% tumor PD-L1 expression showed higher 18F-PD-L1 uptake. 4. Pts with high PD-1 expression showed higher 89Zr-nivo uptake, and pts with PR demonstrated higher 18F-PD-L1 and 89Zr-nivo tracer uptake than pts with PD/SD, although these are without statistical significance which may be due to the small dataset.

Clinical trial identification

EUDRA-CT-number: 2015‐004760‐11

Legal entity responsible for the study

Joop de Langen

Funding

Bristol-Myers Squibb

Disclosure

E. Smit: Has an advisory role at Lilly. Received research funding from Company: Boehringer Ingelheim, Bayer, Roche/Genentech and AstraZeneca (paid to institution). D.K. Leung, R.A. Smith, L.M. Wilson, W. Hayes: Is employed at BMS and owns stock and/or other ownership interests in BMS. All other authors have declared no conflicts of interest.

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