TY - JOUR T1 - <strong>Value of combined 18F-FDG/18F-NaF PET/CT in tumor detection and therapy response in patients with advanced bladder cancer treated with Cabozantinib plus Nivolumab alone or in combination with Ipilimumab</strong> JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 754 LP - 754 VL - 58 IS - supplement 1 AU - Esther Mena AU - Jeffrey Lin AU - Maria Liza Lindenberg AU - Ismail Turkbey AU - Stephen Adler AU - Yolanda McKinney AU - Philip Eclarinal AU - Alicia Forest AU - Juanita Weaver AU - Anita Ton AU - Peter Choyke AU - Andrea Apolo Y1 - 2017/05/01 UR - http://jnm.snmjournals.org/content/58/supplement_1/754.abstract N2 - 754Objectives: To evaluate the use of combined 18F-FDG and 18F-NaF PET/CT (FDG-NaF PET/CT) in tumor detection and treatment response assessment in patients with advanced bladder cancer, undergoing treatment with cabozantinib plus nivolumab +/- ipilimumab.Methods: We prospectively enrolled 16 patients with advanced bladder cancer including urothelial carcinoma (n= 13) and urachal adenocarcinoma of the bladder (n=3) into a phase I trial of cabozantinib plus nivolumab +/- ipilimumab. All patients underwent two subsequent PET/CTs in a single day: an FDG PET/CT immediately followed by a NaF PET/CT scan, at baseline, and at 8 weeks restaging. Comparison was made between FDG alone and combined FDG-NaF PET/CT for tumor detection. PET response assessment was assessed using the combined FDG-NaF PET/CT imaging. Patients were categorized as having complete response, partial response, stable disease, or progression disease. Combined FDG-NaF PET/CT findings were compared with 1- year follow-up clinical response assessment using RECIST 1.1.Results: A total of 32 combined FDG-NaF PET/CTs were assessed in 16 patients. Baseline FDG PET/CT detected 124 soft tissue lesions and 50 bone lesions, whereas baseline combined FDG-NaF PET/CTs detected 128 bone lesions. Restaging 8 weeks FDG-NaF PET/CTs accurately classified 13/16 (81.2%) of patients (predicting treatment response in 11 and disease progression in 2 patients), whereas 3/16 (18.8%) of patients were misclassified (1 as a responder and 2 as disease progression).Conclusion: In patients with advanced bladder cancer, combination of FDG-NaF PET/CT imaging was feasible and detected two times more bone lesions than FDG PET/CT alone. Restaging FDG-NaF PET/CTs at 8 weeks post-treatment with cabozantinib plus nivolumab +/- ipilimumab accurately predicted treatment response in 81.2% of the patients when compared to clinical response using RECIST 1.1 at one-year follow-up. Research Support: ER -