Can FDG-PET after neoadjuvant chemotherapy plus nivolumab predict residual disease in non-small cell lung cancer?

Neoadjuvant therapy with nivolumab improves event-free survival (EFS) in patients with resectable non-small cell lung cancer, and a pathological complete response is a predictor of longer EFS. We assessed metabolic responses using 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) before and after neoadjuvant treatment to explore its surrogacy for pathological complete response (pCR). We describe three patients with squamous cell lung carcinoma who underwent neoadjuvant therapy with nivolumab plus chemotherapy, followed by surgery. In Cases 1 and 2, preoperative tumour response were PR per RECIST and demonstrated marked metabolic response on FDG-PET after neoadjuvant therapy, with both resected tumours showing a pCR. On the other hand, Case 3 showed a tumour response before surgery (PR per RECIST), however, the tumour, maintained FDG uptake (19.5 → 15.1), and the resected tumour remained residual cells (RVT, 15%). Thus, reduction of FDG uptake on FDG-PET can predict the pathological response to neoadjuvant therapy with nivolumab.

Informations de copyright

© 2024 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.

Déclaration de conflit d'intérêts

Hiroaki Akamatsu, Honoraria; Amgen Inc, AstraZeneca K.K., Boehringer Ingelheim Japan Inc., Bristol‐Myers Squibb, Chugai Pharmaceutical Co. Ltd., Eli Lilly Japan K.K., MSD K.K., Nippon Kayaku. Co. Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co. Ltd., Pfizer Inc, Takeda Pharmaceutical Co. Ltd. and Taiho Pharmaceutical Co. Ltd. Advisory role; Amgen Inc, and Janssen Pharmaceutical K.K., Sandoz. Research funding; Amgen Inc, Chugai Pharmaceutical Co. Ltd. and MSD K.K. Nobuyuki Yamamoto, Honoraria; AbbVie Inc., Accuray Japan K.K., Amgen K.K., AstraZeneca K.K., Boehringer Ingelheim Japan Inc., Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo Co., Ltd., Eli Lilly Japan K.K., Guardant Health Japan Corp., Janssen Pharmaceutical K.K., Merck Biopharma Co., Ltd., Miyarisan Pharmaceutical Co., Ltd., MSD K.K., Kyorin Pharmaceutical Co., Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co. Ltd., Pfizer Inc, Takeda Pharmaceutical Co. Ltd. and Taiho Pharmaceutical Co. Ltd., Terumo Corp., Tsumura & Co.. Advisory role; Amgen K.K., AstraZeneca K.K., Chugai Pharmaceutical Co. Ltd., Eli Lilly Japan K.K., MSD K.K., Novartis Pharma K.K., Ono Pharmaceutical Co. Ltd. Research funding; AbbVie Inc., Amgen K.K., Asahi Kasei Corporation, AstraZeneca K.K., A2 Healthcare Corporation, Boehringer Ingelheim Japan Inc., Bristol‐Myers Squibb K.K., Chugai Pharmaceutical Co. Ltd., EPS Holdings, Inc., IQVIA Services Japan K.K., Janssen Pharmaceutical K.K., Mebix, Inc., MSD K.K., Novartis Pharma K.K., Ono Pharmaceutical Co. Ltd., Taiho Pharmaceutical Co. Ltd.. Data safety Monitoring Board: AstraZeneca K.K. All other authors declare no conflict of interest.