RT Journal Article
SR Electronic
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
FD Society of Nuclear Medicine
SP 754
OP 754
VO 58
IS supplement 1
A1 Esther Mena
A1 Jeffrey Lin
A1 Maria Liza Lindenberg
A1 Ismail Turkbey
A1 Stephen Adler
A1 Yolanda McKinney
A1 Philip Eclarinal
A1 Alicia Forest
A1 Juanita Weaver
A1 Anita Ton
A1 Peter Choyke
A1 Andrea Apolo
YR 2017
UL http://jnm.snmjournals.org/content/58/supplement_1/754.abstract
AB 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: