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Mini Oral - Non-metastatic NSCLC and other thoracic malignancies

1896MO - Volumetric PET response assessment outperforms conventional criteria in patients receiving high-dose pembrolizumab for malignant mesothelioma

Date

18 Sep 2020

Session

Mini Oral - Non-metastatic NSCLC and other thoracic malignancies

Presenters

Daniel C. Christoph

Citation

Annals of Oncology (2020) 31 (suppl_4): S1018-S1025. 10.1016/annonc/annonc292

Authors

D.C.C. Christoph1, F. Barbato2, M. Chodyla3, W.P. Fendler2, L. Kessler2, K.L. Pomykala4, M. Metzenmacher1, F. Krefting5, T. Hager6, K. Herrmann7, J. Ferdinandus2

Author affiliations

  • 1 Medical Oncology / Hematology Department, University Hospital Essen Westdeutsches Tumorzentrum, 45147 - Essen/DE
  • 2 Department Of Nuclear Medicine, University Hospital Essen Westdeutsches Tumorzentrum, 45147 - Essen/DE
  • 3 Department Of Radiology, University Hospital Essen Westdeutsches Tumorzentrum, 45147 - Essen/DE
  • 4 Department Of Radiology, University of California, 90095 - Los Angeles/US
  • 5 Department Of Dermatology, University Hospital Essen Westdeutsches Tumorzentrum, 45147 - Essen/DE
  • 6 Department Of Pathology, University Hospital Essen Westdeutsches Tumorzentrum, 45147 - Essen/DE
  • 7 Nuclear Medicine, University Hospital Essen Westdeutsches Tumorzentrum, 45147 - Essen/DE
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Resources

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Abstract 1896MO

Background

Fixed-dose pembrolizumab (200 mg abs., d1, q3w) for the treatment of malignant pleural mesothelioma did not result in survival benefit in the phase 3 PROMISE-meso trial compared to 2nd-line chemotherapy. Due to lack of validated imaging response criteria, responder-subgroups with potential survival benefit have not yet been identified. Here, we administered high-dose pembrolizumab (10 mg/kg, d1, q2w) considering the KEYNOTE-028 trial and assessed the prognostic value of PET metabolic response in patients with chemotherapy-resistant malignant mesothelioma of the pleura or peritoneum.

Methods

Data from 27 patients with baseline and follow-up 18F-FDG PET/CT imaging were retrospectively analyzed. RECIST v1.1, mRECIST, PERCISTSULpeak and PERCISTMTV were used separately to categorize responders in CT and PET imaging studies. Progression-free survival (PFS) and overall survival (OS) of responders were compared to non-responders using Kaplan-Meier and log-rank analyses. Programmed Cell Death Protein 1 (PD-L1) expression status was assessed and its association with outcome was investigated.

Results

27 patients had 18F-FDG-PET/CT imaging at baseline and after at least 4 cycles pembrolizumab. Median PFS and OS were 3.4 and 15.1 months, respectively. Response rates were 7%, 7%, 30%, and 30% based on RECIST v1.1, mRECIST, PERCISTSULpeak, and PERCISTMTV response criteria, respectively. Response according to PERCISTMTV predicted prolonged OS or PFS (p < 0.01), whereas all other imaging criteria and PD-L1 expression did not.

Conclusions

18F-FDG PET metabolic volume response predicts survival in patients with malignant mesothelioma receiving high-dose pembrolizumab. These results should prompt inclusion of PET response assessment in future phase 3 clinical trials.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

PD Dr. med. Daniel C. Christoph.

Funding

Has not received any funding.

Disclosure

D.C.C. Christoph: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Bayer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Boehringer Ingelheim; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bristol-Myers Squibb; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Chugai; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Merck, Sharp & Dohme; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Novartis; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Roche; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Takeda. W.P. Fendler: Advisory/Consultancy: BTG; Advisory/Consultancy: Endocyte; Advisory/Consultancy: Ipsen; Honoraria (self): RadioMedix. L. Kessler: Honoraria (self): Sanofi. M. Metzenmacher: Honoraria (self): Boehringer Ingelheim; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Merck, Sharp & Dohme; Honoraria (self): Roche; Honoraria (self): Takeda. T. Hager: Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Chugai; Honoraria (self): Merck, Sharp & Dohme; Honoraria (self): Roche. K. Herrmann: Non-remunerated activity/ies: ABX; Honoraria (self): Adacap; Honoraria (self): Amgen; Honoraria (self): Bayer; Honoraria (self), Research grant/Funding (institution): BTG; Honoraria (self): Curium; Honoraria (self): Endocyte; Honoraria (self): GE Healthcare; Honoraria (self): Ipsen; Honoraria (self): Novartis; Honoraria (self): Siemens Healthineers; Honoraria (self): Sirtex, Honoraria (self), Non-remunerated activity/ies: Sofie Biosciences; Honoraria (self): ymabs. All other authors have declared no conflicts of interest.

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