(18)F-BMS-986229 PET to assess programmed-death ligand 1 status in gastroesophageal cancer Journal Article
| Authors: | Cytryn, S. L.; Pandit-Taskar, N.; Lumish, M. A.; Maron, S. B.; Gu, P.; Ku, G. Y.; Chou, J. F.; Capanu, M.; Antoine, A.; Loegel, D.; Feder, L.; Philemond, S.; Lyashchenko, S. K.; Lewis, J. S.; Paroder, V.; Srivastava, A.; Tang, L. H.; Schoder, H.; Janjigian, Y. Y. |
| Article Title: | (18)F-BMS-986229 PET to assess programmed-death ligand 1 status in gastroesophageal cancer |
| Abstract: | Anti-programmed death 1 (PD-1) inhibitors are the standard of care for advanced gastroesophageal cancer. Although recommendations and approval by regulatory agencies are often based on programmed death ligand 1 (PD-L1) expression, pathologic assessments of PD-L1 status have several limitations. Single-site biopsies do not adequately capture disease heterogeneity within individual tumor lesions or among several lesions within the same patient, the PD-L1 combined positive score is a dynamic biomarker subject to evolution throughout a patient's disease course, and repeated biopsies are invasive and not always feasible. Methods: This was a prospective pilot study of the PD-L1-targeting radiotracer, 18F-BMS-986229, with PET imaging (PD-L1 PET) in patients with gastroesophageal cancer. Patients were administered the 18F-BMS-986229 radiotracer intravenously at a dose of 370MBq over 1-2min and underwent whole-body PET/CT imaging 60 min later. The primary objective of this study was to evaluate the safety and feasibility of 18F-BMS-986229. The trial is registered with ClinicalTrials.gov (NCT04161781). Results: Between February 3, 2020, and February 2, 2022, 10 patients with gastroesophageal adenocarcinoma underwent PD-L1 PET. There were no adverse events associated with the 18F-BMS-986229 tracer, and imaging did not result in treatment delays; the primary endpoint was achieved. Radiographic evaluation of PD-L1 expression was concordant with pathologic assessment in 88% of biopsied lesions, and 18F-BMS-986229 uptake on PET imaging correlated with pathologic evaluation by the combined positive score (Spearman rank correlation coefficient, 0.64). Seventy-one percent of patients with 18F-BMS-986229 accumulation on PET imaging also had lesions without 18F-BMS-986229 uptake, highlighting the intrapatient heterogeneity of PD-L1 expression. Patients treated with frontline programmed death 1 inhibitors who had 18F-BMS-986229 accumulation in any lesions on PET imaging had longer progression-free survival than patients without tracer accumulation in any lesions (median progression-free survival, 28.4 vs. 9.9mo), though the small sample size prevents any definitive conclusions. Conclusion: PD-L1 PET imaging was safe, feasible, and concordant with pathologic evaluation and offers a potential noninvasive tool to assess PD-L1 expression. © 2024 by the Society of Nuclear Medicine andMolecular Imaging. |
| Keywords: | adult; clinical article; protein expression; aged; middle aged; survival rate; unclassified drug; clinical feature; clinical trial; radiation dose; positron emission tomography; follow up; prospective study; prospective studies; metabolism; progression free survival; diagnostic imaging; risk factor; feasibility study; immunotherapy; whole body imaging; pilot study; pilot projects; patient safety; radiopharmaceutical agent; esophagus cancer; esophageal adenocarcinoma; stomach neoplasms; esophagus tumor; esophageal neoplasms; stomach tumor; gastric adenocarcinoma; programmed death 1 ligand 1; fluorine radioisotopes; gastroesophageal cancer; fluorine; fluorine-18; humans; human; male; female; article; cd274 protein, human; positron emission tomography-computed tomography; positron emission tomography computed tomography; b7-h1 antigen; pd-l1 heterogeneity; pd-l1 pet; fluorine bms 986229 18 f |
| Journal Title: | Journal of Nuclear Medicine |
| Volume: | 65 |
| Issue: | 5 |
| ISSN: | 0161-5505 |
| Publisher: | Society of Nuclear Medicine |
| Date Published: | 2024-05-01 |
| Start Page: | 722 |
| End Page: | 727 |
| Language: | English |
| DOI: | 10.2967/jnumed.123.267186 |
| PUBMED: | 38514081 |
| PROVIDER: | scopus |
| PMCID: | PMC11064823 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Yelena Y. Janjigian -- Source: Scopus |
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