Complete metabolic response in patients with advanced nonsmall cell lung cancer with prolonged response to immune checkpoint inhibitor therapy.

Immunotherapy is the new standard of care in advanced nonsmall cell lung cancer (NSCLC). Recently published data show that treatment discontinuation after 12 months of nivolumab treatment is associated with shorter survival. Therefore, the ideal duration of immunotherapy remains unclear, and finding markers of beneficial outcomes is of great importance. Here, we determine the proportion of complete metabolic responses (CMR) in patients who have not progressed after 24 months of immunotherapy. This is a retrospective analysis of 45 patients with positron emission tomography using 2-[18F]fluoro-2-deoxy-D-glucose imaging for assessment of residual metabolic activity after at least 24 months. CMR was defined as uptake in tumor lesions below background levels, using mediastinum as a reference. After a minimum of 24 months of palliative immunotherapy for NSCLC, CMR occurred in almost two thirds of patients. Potentially, achievement of CMR might identify patients, for whom palliative immunotherapy may be safely discontinued.

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© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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Competing interests: MM reports personal fees from Boehringer-Ingelheim, Bristol-Myers Squibb, MSD Sharp & Dohme, Roche and Takeda. LK is a consultant for AAA and BTG and received fees from Sanofi, all outside of the submitted work. LU is a speaker for Bayer Healthcare, a speaker for Siemens Healthcare and has received research grants from Siemens Healthcare outside of the submitted work. KH reports personal fees from Bayer, personal fees and others from Sofie Biosciences, personal fees from SIRTEX, non-financial support from ABX, personal fees from Adacap, personal fees from Curium, personal fees from Endocyte, grants and personal fees from BTG, personal fees from IPSEN, personal fees from Siemens Healthineers, personal fees from GE Healthcare, personal fees from Amgen, personal fees from Novartis, personal fees from ymAbs, outside the submitted work. WPF is a consultant for Endocyte and BTG, and he received fees from RadioMedix, Bayer, and Parexel outside of the submitted work. MF has received speaker’s honoraria and participated as PI in clinical trials of AstraZeneca, Roche, MSD, and BMS. DCC reports personal fees, non-financial support and others from AstraZeneca, Bayer, Boehringer-Ingelheim, Bristol-Myers Squibb, Chugai, MSD Sharp & Dohme, Novartis, Pfizer, Roche, and Takeda.