Prognostic value of baseline metabolic tumor volume measured on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in melanoma patients treated with ipilimumab therapy Journal Article


Authors: Ito, K.; Schöder, H.; Teng, R.; Humm, J. L.; Ni, A.; Wolchok, J. D.; Weber, W. A.
Article Title: Prognostic value of baseline metabolic tumor volume measured on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in melanoma patients treated with ipilimumab therapy
Abstract: Purpose: Ipilimumab induces durable remission in about 15–20% of patients with metastatic melanoma. However, reliable predictors of response to ipilimumab are currently lacking. Whole-body metabolic tumor volume (wMTV) has been shown to be a strong prognostic factor in a variety of malignancies treated with chemotherapy, but few results have been reported for patients treated with immunotherapy. The purpose of this study was to investigate the prognostic value of wMTV and other metabolic parameters from baseline 18 F-FDG PET/CT scans in patients with melanoma being treated with ipilimumab. Methods: The prognostic impact of wMTV, as well as mean standardized uptake values and total lesion glycolysis, was evaluated in 142 consecutive patients with melanoma treated with single-agent ipilimumab therapy. Metabolic parameters were dichotomized by their respective medians and correlated with overall survival (OS). In addition, the prognostic value of metabolic parameters combined with known clinical prognostic factors was evaluated in multivariate analyses. Results: The median OS time in all patients was 14.7 months (95% CI 10.45–18.93 months). wMTV was a strong independent prognostic factor for OS (p = 0.001). The median survival in patients with a metabolic volume above the median was 10.8 months (95% CI 5.88–15.81 months) as compared with 26.0 months (95% CI 3.02–49.15 months) in patients with an MTV below the median. A multivariate model including wMTV and known clinical prognostic factors, such as age and the presence of brain metastases, further improved the identification of patient subgroups with different OS times. Conclusion: wMTV appears to be a strong independent prognostic factor in melanoma patients treated with ipilimumab, and can be determined semiautomatically from routine 18 F- FDG PET/CT scans. wMTV, combined with clinical prognostic factors, could be used to personalize immunotherapy and in future clinical studies. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: adult; treatment outcome; aged; major clinical study; overall survival; ipilimumab; melanoma; retrospective study; fluorodeoxyglucose f 18; brain metastasis; high risk population; ctla-4; pet; glycolysis; metabolic parameters; metabolic tumor volume; cancer prognosis; human; male; female; article; patient history of chemotherapy; positron emission tomography-computed tomography; mean standardized uptake value
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 46
Issue: 4
ISSN: 1619-7070
Publisher: Springer  
Date Published: 2019-04-01
Start Page: 930
End Page: 939
Language: English
DOI: 10.1007/s00259-018-4211-0
PUBMED: 30488098
PROVIDER: scopus
PMCID: PMC6451667
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Jedd D Wolchok
    905 Wolchok
  2. Heiko Schoder
    546 Schoder
  3. John Laurence Humm
    434 Humm
  4. Wolfgang Andreas Weber
    173 Weber
  5. Ai   Ni
    99 Ni
  6. Rebecca Teng
    8 Teng
  7. Kimiteru Ito
    26 Ito