FDG PET scans as evaluation of clinical response to dendritic cell vaccination in patients with malignant melanoma

2012 ◽  
Vol 62 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Lotte Engell-Noerregaard ◽  
Helle W. Hendel ◽  
Helle H. Johannesen ◽  
Louise Alslev ◽  
Inge Marie Svane
Keyword(s):  
Dendritic Cell ◽  
Malignant Melanoma ◽  
Clinical Response ◽  
Fdg Pet ◽  
Dendritic Cell Vaccination ◽  
Pet Scans

scholarly journals TriMix and tumor antigen mRNA electroporated dendritic cell vaccination plus ipilimumab: link between T-cell activation and clinical responses in advanced melanoma

2020 ◽  
Vol 8 (1) ◽  
pp. e000329 ◽  
Author(s):  
Brenda De Keersmaecker ◽  
Sofie Claerhout ◽  
Javier Carrasco ◽  
Isabelle Bar ◽  
Jurgen Corthals ◽  
...  
Keyword(s):  
T Cell ◽  
Dendritic Cell ◽  
Clinical Response ◽  
T Cell Activation ◽  
Peripheral Blood ◽  
T Cell Responses ◽  
Cd8 T Cell ◽  
Advanced Melanoma ◽  
Dendritic Cell Vaccination ◽  
Cell Responses

BackgroundWe previously reported that dendritic cell-based mRNA vaccination plus ipilimumab (TriMixDC-MEL IPI) results in an encouraging rate of tumor responses in patients with pretreated advanced melanoma. Here, we report the TriMixDC-MEL IPI-induced T-cell responses detected in the peripheral blood.MethodsMonocyte-derived dendritic cells electroporated with mRNA encoding CD70, CD40 ligand, and constitutively active TLR4 (TriMix) as well as the tumor-associated antigens tyrosinase, gp100, MAGE-A3, or MAGE-C2 were administered together with IPI for four cycles. For 18/39 patients, an additional vaccine was administered before the first IPI administration. We evaluated tumor-associated antigen specific T-cell responses in previously collected peripheral blood mononuclear cells, available from 15 patients.ResultsVaccine-induced enzyme-linked immunospot assay responses detected after in vitro T-cell stimulation were shown in 12/15 patients. Immune responses detected in patients with a complete or partial response were significantly stronger and broader, and exhibited a higher degree of multifunctionality compared with responses in patients with stable or progressive disease. CD8+ T-cell responses from patients with an ongoing clinical response, either elicited by TriMixDC-MEL IPI or on subsequent pembrolizumab treatment, exhibited the highest degree of multifunctionality.ConclusionsTriMixDC-MEL IPI treatment results in robust CD8+ T-cell responses in a meaningful portion of stage III or IV melanoma patients, and obviously in patients with a clinical response. The levels of polyfunctional and multiantigen T-cell responses measured in patients with a complete response, particularly in patients evidently cured after 5+ years of follow-up, may provide a benchmark for the level of immune stimulation needed to achieve a durable clinical remission.Trial registration numberNCT01302496.

Malignant melanoma and 18F-FDG-PET: Should the whole body scan include the legs?

2003 ◽  
Vol 42 (04) ◽  
pp. 167-172 ◽  
Author(s):  
M. Weckesser ◽  
Ch. Franzius ◽  
D. Nashan ◽  
O. Schober ◽  
M. Löffler
Keyword(s):  
Malignant Melanoma ◽  
Fdg Pet ◽  
Therapeutic Benefit ◽  
Whole Body ◽  
Examination Time ◽  
Primary Location ◽  
18F Fdg ◽  
Diagnostic Benefit ◽  
Pet Scans

Summary:Aim: 18F-FDG-PET (FDG-PET) is established in staging and follow-up of malignant melanoma. The legs are affected in 10-40% at time of diagnosis even if the primary is at the arms and torso. Imaging including the legs may detect distant manifestations but increases duration of the scan by ~30 min. We intended to disclose the diagnostic benefit of scanning the legs and to evaluate the therapeutic benefit resulting. Patients, Methods: In this retrospective analyse 213 consecutive PET studies of 153 patients with suspected or recent malignant melanoma were re-evaluated for metastastic spread by a blinded investigator. Histopathological follow-up was assessed for confirmation. Results: Suspicious findings at the legs were depicted in 53 patients on 76 occasions. 38/53 showed pathologic uptake in the torso as well. In 15/53 patients it was restricted to the legs. One of them had a hitherto unknown, clinically relevant finding that was not apparent in palpation and inspection. In 6 other patients with primary location at the legs a validation of the positive PET findings was not possible up to now. Conclusion: Metastases and local recurrence of malignant melanoma at the legs were found in 41% of women and 27% of men. However, a long scan does not yield relevant additional data. We found isolated new manifestations at the legs in only 1/153 patients. We recommend performing a long scan only in patients with previous melanoma manifestations restricted to the legs. In all other cases a short scan of the torso and proximal thighs is sufficient. This allows a higher number of PET-scans without loss of diagnostic power and a shorter examination time.

Dendritic cell vaccination in melanoma patients: Update and subgroup analysis of clinical response to post-vaccine treatment

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9042-9042
Author(s):  
L. Ridolfi ◽  
L. Fiammenghi ◽  
M. Petrini ◽  
A. M. Granato ◽  
V. Ancarani ◽  
...  
Keyword(s):  
Dendritic Cell ◽  
Clinical Response ◽  
Metastatic Melanoma ◽  
B Cell Lymphoma ◽  
Delayed Type Hypersensitivity ◽  
Dendritic Cell Vaccination ◽  
Autologous Tumor ◽  
Mixed Response ◽  
Vaccine Treatment ◽  
Melanoma Patients

9042 Background: Dendritic cells (DCs) play a crucial role in the interplay between innate and adaptive immune response towards cancer. The combination of immunotherapies with standard treatments for cancer could represent a further chance for advanced melanoma patients. In the literature, higher response rates than those normally obtained have been reported after second-line chemotherapy in patients with non small cell lung cancer pre-treated with vaccines and in patients with follicular B-cell lymphoma vaccinated with an anti-idiotype vaccine whilst in remission. On the basis of this data, we reviewed and updated the clinical results of our dendritic cell based vaccine clinical trial in stage IV melanoma patients. Methods: From December 2002 to 2007, 24 pre-treated metastatic melanoma patients were vaccinated with mature DCs (mDCs) pulsed with autologous tumor lysate (ATL) and keyhole limpet hemocyanin (KLH) followed by a 5-day treatment with low-dose subcutaneous Interleukin-2. Results: We observed 2 complete response (CR), 2 mixed response (MR), 5 partial response (PR), 4 stable disease (SD) and 11 progressive disease (PD) (overall response (OS) 37.5%; clinical benefit 54.1%). All 13 responders had delayed-type hypersensitivity (DTH) positivity to KLH, of whom 10 also showed positivity to the lysate. Eleven (45.8%) of the 24 patients underwent further lines of treatment (5 chemotherapy [CT], 3 surgery [S], 4 biotherapy, 2 radiotherapy [RT] and 4 biochemotherapy [BioCT]) after stopping vaccination (8 due to progression and 3, in SD, because all of their lysate had been used). Of these 11 patients, 2 obtained CR (1 RT, 1 S), 5 PR (3 BioCT, 2 S) for an OR of 63.6%, 1 SD (BioCT) and 3 showed PD as the best response to subsequent therapies, with a median OS of 30 months (range 16–52). Of the 3 SD patients who were forced to stop vaccine treatment, 1 had CR following RT and 2 progressed. Conclusions: Metastatic melanoma responds poorly to standard therapy, in particular after first-line treatment. Vaccination could enhance clinical response to subsequent third- or fourth-line therapies, thus prolonging overall survival. No significant financial relationships to disclose.

Review of clinical studies on dendritic cell-based vaccination of patients with malignant melanoma: assessment of correlation between clinical response and vaccine parameters

2008 ◽  
Vol 58 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Lotte Engell-Noerregaard ◽  
Troels Holz Hansen ◽  
Mads Hald Andersen ◽  
Per thor Straten ◽  
Inge Marie Svane
Keyword(s):  
Dendritic Cell ◽  
Malignant Melanoma ◽  
Clinical Response ◽  
Clinical Studies

FDG-PET Scans Find Secondary Infections

2005 ◽  
Vol 38 (19) ◽  
pp. 83
Author(s):  
PAM HARRISON
Keyword(s):  
Fdg Pet ◽  
Secondary Infections ◽  
Pet Scans

The therapeutic impact of 18F-FDG whole body PET

2005 ◽  
Vol 44 (01) ◽  
pp. 8-14 ◽  
Author(s):  
B. Dietl ◽  
J. Marienhagen
Keyword(s):  
Fdg Pet ◽  
Diagnostic Information ◽  
Whole Body ◽  
Therapeutic Concept ◽  
Therapeutic Impact ◽  
Additional Diagnostic Information ◽  
Therapeutic Decisions ◽  
Target Volumes ◽  
18F Fdg ◽  
Pet Scans

Summary Aims: An explorative analysis of the diagnostic as well as therapeutic impact of 18F-FDG whole body PET on patients with various tumours in the setting of an university hospital radiation therapy was performed. Patients and methods: 222 FDG PET investigations (148 initial stagings, 74 restagings) in 176 patients with diverse tumour entities (37 lung carcinoma, 15 gastrointestinal tumours, 38 head and neck cancer, 30 lymphoma, 37 breast cancer, 19 sarcoma and 16 other carcinomas) were done. All PET scans were evaluated in an interdisciplinary approach and consecutively confirmed by other imaging modalities or biopsy. Unconfirmed PET findings were ignored. Proportions of verified PET findings, additional diagnostic information (diagnostic impact) and changes of the therapeutic concept intended and documented before PET with special emphasis on radiooncological decisions (therapeutic impact) were analysed. Results: 195/222 (88%) FDG-PET findings were verified, 104/222 (47%) FDG-PET scans yielded additional diagnostic information (38 distant, 30 additional metastasis, 11 local recurrencies, 10 primary tumours and 15 residual tumours after chemoptherapy). The results of 75/222 (34%) scans induced changes in cancer therapy and those of 58/222 (26%) scans induced modifications of radiotherapeutic treatment plan (esp. target volumes). Conclusion: 18F-FDG whole body PET is a valuable diagnostic tool for therapy planning in radiooncology with a high impact on therapeutic decisions in initial staging as well as in restaging. Especially in a curative setting it should be used for definition of target volumes.

scholarly journals Tumor response evaluation in patients with malignant melanoma undergoing immune checkpoint inhibitor therapy and prognosis prediction using 18F-FDG PET/CT: multicenter study for comparison of EORTC, PERCIST, and imPERCIST

2021 ◽  
Author(s):  
Kazuhiro Kitajima ◽  
Tadashi Watabe ◽  
Masatoyo Nakajo ◽  
Mana Ishibashi ◽  
Hiromitsu Daisaki ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Malignant Melanoma ◽  
Fdg Pet ◽  
Immune Checkpoint Inhibitor ◽  
Metabolic Response ◽  
Checkpoint Inhibitor ◽  
Response Evaluation ◽  
Pet Ct ◽  
Melanoma Patients ◽  
Fdg Pet Ct

Abstract Objective In malignant melanoma patients treated with immune checkpoint inhibitor (ICI) therapy, three different FDG-PET criteria, European Organization for Research and Treatment of Cancer (EORTC), PET Response Criteria in Solid Tumors (PERCIST), immunotherapy-modified PERCIST (imPERCIST), were compared regarding response evaluation and prognosis prediction using standardized uptake value (SUV) harmonization of results obtained with various PET/CT scanners installed at different centers. Materials and methods Malignant melanoma patients (n = 27) underwent FDG-PET/CT examinations before and again 3 to 9 months after therapy initiation (nivolumab, n = 21; pembrolizumab, n = 6) with different PET scanners at five hospitals. EORTC, PERCIST, and imPERCIST criteria were used to evaluate therapeutic response, then concordance of the results was assessed using Cohen’s κ coefficient. Log-rank and Cox methods were employed to determine progression-free (PFS) and overall (OS) survival. Results Complete metabolic response (CMR)/partial metabolic response (PMR)/stable metabolic disease (SMD)/progressive metabolic disease (PMD) with harmonized EORTC, PERCIST, and imPERCIST was seen in 3/5/4/15, 4/5/3/15, and 4/5/5/13 patients, respectively. Nearly perfect concordance between each pair of criteria was noted (κ = 0.939–0.972). Twenty patients showed progression and 14 died from malignant melanoma after a median 19.2 months. Responders (CMR/PMR) showed significantly longer PFS and OS than non-responders (SMD/PMD) (harmonized EORTC: p < 0.0001 and p = 0.011; harmonized PERCIST: p < 0.0001 and p = 0.0012; harmonized imPERCIST: p < 0.0001 and p = 0.0012, respectively). Conclusions All harmonized FDG-PET criteria (EORTC, PERCIST, imPERCIST) showed accuracy for response evaluation of ICI therapy and prediction of malignant melanoma patient prognosis. Additional studies to determine their value in larger study populations will be necessary.

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