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e-Poster Display Session

46P - [18F]2-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18FDG-PET/CT) in patients treated with immune checkpoint inhibitors (ICI) for microsatellite instability-high metastatic colorectal cancer (MSI mCRC)

Date

09 Dec 2020

Session

e-Poster Display Session

Topics

Staging and Imaging;  Tumour Immunology;  Immunotherapy

Tumour Site

Colon and Rectal Cancer

Presenters

Thomas Pudlarz

Citation

Annals of Oncology (2020) 31 (suppl_7): S1428-S1440. 10.1016/annonc/annonc391

Authors

T. Pudlarz1, F. Montravers2, M. Garcia-Larnicol3, E. Kempf4, J. Bennouna5

Author affiliations

  • 1 Hôpital Saint-Antoine, Paris/FR
  • 2 Hôpital Tenon, Paris/FR
  • 3 Multidisciplinary Group in Oncology (GERCOR), Paris/FR
  • 4 Assistance Publique - Hopitaux De Paris, Paris/FR
  • 5 CHU du Nantes - Hôtel-Dieu, Nantes/FR
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Abstract 46P

Background

The interest of 18FDG-PET/CT to evaluate ICI efficacy is unclear. We aimed at investigating end-of-treatment 18FDG-PET/CT as well as its relationship with the occurrence of pathological complete response (pCR) for patients with MSI mCRC treated by ICI in resected residual lesions.

Methods

All patients from the multicenter NIPICOL phase II study (NCT03350126) with an end-of-treatment 18FDG-PET/CT were included (cohort A), as well as all ICI-treated MSI mCRC patients from Saint-Antoine hospital (Paris, France) who performed a 18FDG-PET/CT prior to the resection of a residual lesion (cohort B). Patients in NIPICOL study received nivolumab plus ipilimumab for 3 months, then nivolumab alone for a total of 1 year. We defined complete metabolic response (CMR) as the absence of lesions with a standard uptake value maximal (SUVmax) superior to the normal liver SUVmax.

Results

Cohort A: 36 of 57 patients from the NIPICOL study had an end-of-treatment 18FDG-PET/CT with a median delay from the start of ICI of 12.5 month (95%CI = [12.1; 13.2]). All patients achieved a partial response (PR) or a stable disease (SD) according to RECIST1.1 criteria. CMR at the end of treatment was observed in 28/36 cases (78%). 19 of 22 patients with PR (86%) and 9 of 14 patients with SD (64%) had a CMR (p=0.22). With a median follow-up of 10.3 months after the 18FDG-PET/CT, one disese progression was reported, in a patient who did not achieve CMR at the end of treatment. Cohort B: among 10 patients who underwent a 18FDG-PET/CT prior to surgery of residual lesions, 6 had a pCR and 5 patients had a MCR (4 with pCR, 1 with residual tumor cells). Of note, one patient with pCR did not achived MCR. The positive and negative predictive values of 18FDG-PET/CT for pCR were 80.0% (95%CI 28.4-99.5) and 60.0% (95%CI 14.7-94.7), respectively (AUC 0.71).

Conclusions

MCR is frequent in patients with MSI mCRC treated with ICI but does not appear as a suitable tool to predict pCR.

Legal entity responsible for the study

GERCOR.

Funding

Has not received any funding.

Disclosure

D. Tougeron: Honoraria (institution): BMS; Honoraria (institution): MSD oncology. T. Mazard: Research grant/Funding (institution): Roche; Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: Amgen; Honoraria (institution): Sanofi; Honoraria (institution): BMS; Honoraria (institution): Sandoz. B. Chibaudel: Honoraria (institution): Pfizer; Honoraria (institution): Roche; Honoraria (institution): Sanofi; Honoraria (institution): Servier; Honoraria (institution): Bayer; Honoraria (institution): Beigine. M. Svrcek: Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy: Astella; Advisory/Consultancy: MSD Oncology; Advisory/Consultancy: Sanofi; Travel/Accommodation/Expenses: Ventana/Roche. R. Cohen: Honoraria (self), Research grant/Funding (institution): Servier; Honoraria (self): MSD. T. Andre: Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: MSD Oncology; Travel/Accommodation/Expenses: Tesaro. All other authors have declared no conflicts of interest.

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