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Molecular response assessment with immune adaptive positron emission tomography response criteria in solid tumors in lung cancer patients treated with nivolumab: Is it better than immune response evaluation criteria in solid tumors?


1 Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
2 Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
3 Department of Medical Oncology, Homi Bhaba Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
4 Department of Radiology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
5 Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
6 Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

Correspondence Address:
Manoj Gupta,
Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, Sector 5 Rohini, New Delhi - 110 085
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.wjnm_58_21

We compared the immune response evaluation criteria in solid tumors (iRECIST) to immune adaptive positron emission tomography response criteria in solid tumors (imPERCIST) in lung cancer patients treated with nivolumab. Twenty lung cancer patients underwent fluorodeoxyglucose positron emission tomography/computed tomography scan at baseline (PET-0) and after 4 cycles (PET-1) and 6–8 cycles (PET-2) of nivolumab were included. Kappa coefficient (κ) was derived to see the level of agreement in two response criteria. Progression-free survival (PFS) curves were computed by the Kaplan–Meier method and compared with the log-rank test. Univariate and multivariate regression for the percentage change in the sum of diameters (SoD), standard uptake value maximum, sum of metabolic tumor volume (SoMTV), and sum of total lesion glycolysis (SoTLG) was computed. P < 0.05 was considered statistically significant. Kappa coefficient showed a substantial level of agreement (κ = 0.769) in two response criteria. The mean PFS in partial response, stable disease, and progressive disease patients in iRECIST and imPERCIST was 27.3, 17.7, 4.2 and 23.3, 18.8, 3.8 months, respectively. The Kaplan–Meier method with the log-rank test showed a significant difference in PFS on intracomparison within both criteria, however, it was not significant on intercomparison. On univariate analysis, the percentage change in SoD, SoMTV, and SoTLG was significant, however, on multivariate analysis, only percentage change in SoD was a significant predictor. We concluded that imPERCIST was equally effective as currently recommended criteria iRECIST for response evaluation of nivolumab in lung cancer patients.


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    -  Gupta M
    -  Choudhury PS
    -  Jain P
    -  Sharma M
    -  Babu Koyyala VP
    -  Goyal S
    -  Agarwal C
    -  Jajodia A
    -  Pasricha S
    -  Sharma A
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