[F]FDG-PET/CT atypical response patterns to immunotherapy in non-small cell lung cancer patients: long term prognosis assessment and clinical management proposal.

Aim: To determine the long-term prognosis of immune-related response profiles (pseudoprogression and dissociated response), not covered by conventional PERCIST criteria, in patients with non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICPIs).

Methods: 109 patients were prospectively included and underwent [F]FDG-PET/CT at baseline, after 7 weeks (PET1), and 3 months (PET2) of treatment. On PET1, tumor response was assessed using standard PERCIST criteria.

Total metabolic tumor volume on F-FDG PET/CT is a game-changer for patients with metastatic lung cancer treated with immunotherapy.

Purpose: Because of atypical response imaging patterns in patients with metastatic non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICPIs), new biomarkers are needed for a better monitoring of treatment efficacy. The aim of this prospective study was to evaluate the prognostic value of volume-derived positron-emission tomography (PET) parameters on baseline and follow-up F-fluoro-deoxy-glucose PET (F-FDG-PET) scans and compare it with the conventional PET Response Criteria in Solid Tumors (PERCIST).

Methods: Patients with metastatic NSCLC were included in two different single-center prospective trials.