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Published on: February 12, 2017
Imaging response to neoadjuvant checkpoint inhibitor therapy in Merkel cell carcinoma: Association with pathologic
Jordan Beam1, Deepak Kalbi2, Jack Slatton1
1University of Alabama at Birmingham Heersink School of Medicine, 1670 University Boulevard, Birmingham, AL, 35223, USA.
Background:
Radiographic biomarkers of response are needed to identify patients with Merkel cell carcinoma (MCC) who respond to neoadjuvant immunotherapy. We evaluated FDG-PET/CT characteristics associated with pathologic response.
Methods:
Patients with stage III MCC treated with neoadjuvant immunotherapy and surgery (2021-2025) were retrospectively evaluated. Imaging response markers including standardized uptake value (SUVmax), total lesion glycolysis (TLG, g), and PET/CT tumor volume (cm3) were compared to pathologic response.
Results:
Of 13 patients, 3 (23%) achieved pathologic complete response (no viable tumor), 4 (31%) achieved major response (<10% viable tumor), and 6 (46%) achieved partial/no response (>10% viable tumor). Among patients with pre- and post-neoadjuvant immunotherapy imaging (n = 7), greater reductions in SUVmax and PET/CT tumor volume were observed in complete responders; none achieved statistical significance.
Conclusions:
These preliminary findings highlight the need for larger prospective studies evaluating radiographic biomarkers of treatment response in MCC.
