Physiologic colonic fluorine-18-fluorodeoxyglucose uptake may predict response to immunotherapy in patients with metastatic melanoma

Ben Boursi*, Thomas J. Werner, Saeid Gholami, Ofer Margalit, Erez Baruch, Gal Markel, Yael Eshet, Sina Houshmand, Einat Shacham-Shmueli, Tara C. Mitchell, Ronac Mamtani, Abass Alavi, Yu Xiao Yang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The gut microbiota impacts response to immunotherapy in cancer patients. We sought to evaluate the role of physiologic colonic fluorine-18-fluorodeoxyglucose (18F-FDG) uptake, a test that was recently shown to reflect colonic bacterial load, as a possible predictor for response to immunotherapy. We carried out a retrospective study in metastatic melanoma patients who received the immune checkpoint inhibitor ipilimumab as first-line therapy. All patients underwent an 18F-FDG PET scan before treatment initiation. The primary outcome was defined as response to treatment according to the RECIST criteria. Regions of interest were drawn on each transaxial slice around the outer boundaries of the colon. Uptake was measured using maximum and mean standardized uptake value (SUV). A nonparametric test was used to compare SUV between response groups. The study included 14 melanoma patients, of whom two (14.3%) achieved a complete response (CR) following treatment, eight (57.1%) achieved a partial response (PR), and four (28.6%) developed progressive disease (PD). The mean SUVmax was 1.33±0.04, 2.2±0.46, and 3.33±2.67 for individuals with CR, PR, and PD, respectively. The difference between individuals with CR and those without CR (PR or PD) in total colonic SUVmax was statistically significant (P=0.03). Thus, physiologic colonic 18F-FDG uptake may predict CR to immunotherapy in metastatic melanoma patients.

Original languageEnglish
Pages (from-to)318-321
Number of pages4
JournalMelanoma Research
Volume29
Issue number3
DOIs
StatePublished - 1 Jun 2019

Keywords

  • F-FDG PET CT
  • immunotherapy
  • melanoma
  • physiologic colonic uptake
  • response

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