Abstract 3517
Background
The role of FDG-PET/CT in the FU of LA-HNSCC is unclear.
Methods
Scan reports of LA-HNSCC patients, having FU-FDG-PET/CT performed 6-18 months after ST/CRT were retrospectively analyzed. Equivocal reports were scored as positive. Excluded were patients with proven recurrence before FU-FDG-PET/CT. The reference standard was the occurrence of a second primary (SP) or a recurrence < 12 months after FU-FDG-PET/CT. Primary endpoints included sensitivity, specificity, positive (PPV) and negative predictive value (NPV) on a patient level.
Results
We identified 73 patients. Primary tumor site: oropharynx: n = 35; 7 larynx: n = 7; hypopharynx: n = 11; oral cavity: n = 4; paranasal sinus: n = 4; unknown: n = 5. Tumor stage (UICC 7): II (T2N0): n = 1; III: n = 9; IV: n = 63. T1: n = 8; T2: n = 20; T3: n = 16; T4: n = 24. N0: n = 10; N1: n = 7; N2: n = 53; N3: n = 2. Patients were treated by CRT (n = 29) or ST (n = 44). A prior FDG-PET/CT at 3 months after end of treatment (EOT) (EOT-FDG-PET/CT) had been performed in 69/73 (60 negative, 6 false and 3 true positive [resected lymph nodes]). FU-FDG-PET/CT in patients without EOT-FDG-PET/CT was true negative in 3 patients and true positive in 1. Median time between EOT and FU-FDG-PET/CT was 12 months (range 6-17). Median FU after FU-FDG-PET/CT was 48 months (range 2-130). Sensitivity, specificity, PPV and NPV were 83% (95% CI 52-98), 87% (95% CI 76-94), 56% (95% CI 31-78) and 96% (95% CI 87-100), respectively. Local recurrences, SP and distant metastases were detected in 5, 1, and 4 patients, respectively. One FU-FDG-PET/CT-detected local recurrence and 1 SP were treated with curative intent. All false-positive patients (n = 8) underwent biopsy (n = 3) or surgery (n = 5). 15 patients (21%) recurred > 12 months after FU-FDG-PET-CT. Median overall survival was 49 (95% CI 29 - 68) and 98 months (95% CI 86-111) in FU-FDG-PET/CT-positive and -negative patients, respectively (p = 0.000196).
Conclusions
FU-FDG-PET/CT in real-life has a high NPV and significant prognostic value. However, false-positive scans induce invasive procedures in a significant fraction of patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5031 - Sarcoidosis-Like Reaction Mimics Progression in patients treated with immune checkpoint inhibitors
Presenter: Sophie Hans
Session: Poster Display session 3
Resources:
Abstract
5650 - Tissue-based activation of mucosal-associated invariant T (MAIT) cells in combination ipilimumab and nivolumab checkpoint inhibitor (CI) colitis.
Presenter: Sarah Sasson
Session: Poster Display session 3
Resources:
Abstract
5944 - Significance of severe immune-related adverse effects (irAE) on patients with advanced tumors treated with immune checkpoint inhibitors being admitted for secondary toxicity: Clinical relevance and next steps
Presenter: Leyre Zubiri
Session: Poster Display session 3
Resources:
Abstract
5989 - Implementation of a dedicated immuno-oncology toxicity service reduces the acute impact of immune-related adverse events
Presenter: Anna Olsson-Brown
Session: Poster Display session 3
Resources:
Abstract
3267 - Cardiotoxic and pro-inflammatory effects induced by the association of immune checkpoint inhibitor Pembrolizumab and Trastuzumab in preclinical models
Presenter: Nicola Maurea
Session: Poster Display session 3
Resources:
Abstract
3417 - Interstitial lung disease associated with immune-checkpoint inhibitors in malignant diseases
Presenter: Akira Yamagata
Session: Poster Display session 3
Resources:
Abstract
2071 - A Phase 1 Study of Intraperitoneal MCY-M11 Anti-Mesothelin CAR for Women with Platinum Resistant High Grade Serous Adenocarcinoma of the Ovary, Primary Peritoneum, or Fallopian Tube, or Subjects with Peritoneal Mesothelioma with Recurrence after Prior Chemotherapy
Presenter: Christina Annunziata
Session: Poster Display session 3
Resources:
Abstract
4935 - Trial in progress: First-in-human study of a novel anti-NY-ESO-1–anti-CD3, TCR-based bispecific (IMCnyeso) as monotherapy in NY-ESO-1/LAGE-1A-positive advanced solid tumors (IMCnyeso-101)
Presenter: Juanita Lopez
Session: Poster Display session 3
Resources:
Abstract
5613 - Nimotuzumab-Cisplatin-Radiation versus Cisplatin-Radiation in HPV negative oropharyngeal cancer
Presenter: Kumar Prabhash
Session: Poster Display session 3
Resources:
Abstract
2576 - Interim analysis of a single arm phase 2 study of adjuvant nivolumab after salvage resection in head and neck squamous cell carcinoma patients previously treated with definitive therapy.
Presenter: Trisha Wise-draper
Session: Poster Display session 3
Resources:
Abstract