FDG PET/CT for assessing tumour response to immunotherapy : Report on the EANM symposium on immune modulation and recent review of the literature

Eur J Nucl Med Mol Imaging. 2019 Jan;46(1):238-250. doi: 10.1007/s00259-018-4171-4. Epub 2018 Oct 5.

Abstract

This paper follows the immunotherapy symposium held during the European Association of Nuclear Medicine (EANM) 2017 Annual Congress. The biological basis of the immune checkpoint inhibitors and the drugs most frequently used for the treatment of solid tumours are reviewed. The issues of pseudoprogression (frequency, timeline), hyperprogression and immune-related side effects are discussed, as well as their implications for patient management. A review of the recent literature on the use of FDG PET for assessment of immunotherapy is presented, and recommendations are provided for assessing tumour response and reporting immune-related side effects with FDG PET based on published data and experts' experience. Representative clinical cases are also discussed.

Keywords: Hyperprogression; Immune checkpoint inhibitors; Immune-related side effects; Immunotherapy; Pseudoprogression; Therapy response.

Publication types

  • Review

MeSH terms

  • Congresses as Topic*
  • Fluorodeoxyglucose F18
  • Humans
  • Immunotherapy*
  • Neoplasms / diagnostic imaging*
  • Neoplasms / therapy
  • Positron Emission Tomography Computed Tomography / methods*
  • Positron Emission Tomography Computed Tomography / standards
  • Practice Guidelines as Topic
  • Radiopharmaceuticals
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18