Pd38-04 Exploring the Role of FDG Pet/Ct in Predicting Pembrolizumab Response for Metastatic Urothelial Carcinoma

You have accessJournal of UrologyBladder Cancer: Invasive IV (PD38)1 May 2024PD38-04 EXPLORING THE ROLE OF FDG PET/CT IN PREDICTING PEMBROLIZUMAB RESPONSE FOR METASTATIC UROTHELIAL CARCINOMA Rikuto Yasujima, Hajime Tanaka, Junichi Tsuchiya, Akira Hasegawa, Hiroki Tanaka, Tomoki Kimura, Kotaro Suzuki, Tsubasa Ito, Riko Ikeda, Shunya Matsumoto, Kasumi Yoshitomi, Masaki Kobayashi, Motohiro Fujiwara, Yuki Nakamura, Wei Chen, Bo Fan, Yudai Ishikawa, Shohei Fukuda, Yuma Waseda, Soichiro Yoshida, and Yasuhisa Fujii Rikuto YasujimaRikuto Yasujima , Hajime TanakaHajime Tanaka , Junichi TsuchiyaJunichi Tsuchiya , Akira HasegawaAkira Hasegawa , Hiroki TanakaHiroki Tanaka , Tomoki KimuraTomoki Kimura , Kotaro SuzukiKotaro Suzuki , Tsubasa ItoTsubasa Ito , Riko IkedaRiko Ikeda , Shunya MatsumotoShunya Matsumoto , Kasumi YoshitomiKasumi Yoshitomi , Masaki KobayashiMasaki Kobayashi , Motohiro FujiwaraMotohiro Fujiwara , Yuki NakamuraYuki Nakamura , Wei ChenWei Chen , Bo FanBo Fan , Yudai IshikawaYudai Ishikawa , Shohei FukudaShohei Fukuda , Yuma WasedaYuma Waseda , Soichiro YoshidaSoichiro Yoshida , and Yasuhisa FujiiYasuhisa Fujii View All Author Informationhttps://doi.org/10.1097/01.JU.0001009424.64728.0c.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the associations of FDG PET/CT findings with treatment response to pembrolizumab in metastatic urothelial carcinoma (mUC). METHODS: We analyzed 50 measurable lesions (≥1.0 cm) suspected of metastases that were identified in 17 patients with mUC who received pembrolizumab. The patients were required to undergo FDG PET/CT prior to the induction of pembrolizumab, on which SUV-derived parameters and tumor diameter were analyzed for the lesions. The best response was evaluated referring to RECIST ver1.1 on a per-lesion basis. The associations of the parameters obtained from FDG PET/CT with lesion-based treatment responses and overall survival (OS) of patients were evaluated. RESULTS: The median age was 71 and 13 patients (76%) were male. ECOG performance status was 0-1 in all patients. The primary cancer site was in the bladder in 13 patients (76%). In lesion-based analysis, the median SUVmax, SUVmean, and tumor diameter were 6.40, 2.61, and 15.6 mm, respectively. Metastatic sites included lymph node (n=26), lung (n=7), bone (n=7), liver (n=2), or others (n=8). The best response was CR/PR/SD/PD in 12 (24%)/5 (10%)/8 (16%)/25 (50%) lesions, showing the lesion-based objective response rate of 34%. Lesions with objective response had higher SUVmax and smaller diameter, and were more often lymph nodes (p<0.01, =0.07, 0.01, respectively). On the multivariable analysis, higher SUVmax and smaller diameter were independently associated with objective response on a per-lesion basis. When the SUVmax divided by tumor diameter (SUVmax/TD) was further analyzed, AUC for objective response was 0.800 with SUVmax/TD, showing improvement compared to those based on SUVmax (0.716) or tumor diameter (0.662) alone. The best cut-off value of SUVmax/TD was 0.483/mm. During the median follow up of 10.4 months, 13 patients (76%) died of any cause. When the highest value of SUVmax/TD for metastatic lesions was analyzed in each case, OS from the induction of pembrolizumab was significantly longer in patients with high SUVmax/TD than those with low SUVmax/TD (median OS: not reached vs. 9 months, p<0.01). CONCLUSIONS: Higher SUVmax and smaller tumor diameter were significantly associated with better response to pembrolizumab per lesion. SUVmax/TD may be usefulness to predict treatment outcomes of pembrolizumab for mUC. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e807 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rikuto Yasujima More articles by this author Hajime Tanaka More articles by this author Junichi Tsuchiya More articles by this author Akira Hasegawa More articles by this author Hiroki Tanaka More articles by this author Tomoki Kimura More articles by this author Kotaro Suzuki More articles by this author Tsubasa Ito More articles by this author Riko Ikeda More articles by this author Shunya Matsumoto More articles by this author Kasumi Yoshitomi More articles by this author Masaki Kobayashi More articles by this author Motohiro Fujiwara More articles by this author Yuki Nakamura More articles by this author Wei Chen More articles by this author Bo Fan More articles by this author Yudai Ishikawa More articles by this author Shohei Fukuda More articles by this author Yuma Waseda More articles by this author Soichiro Yoshida More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...