False positive FDG uptake in melanoma patients treated with talimogene laherparepvec (T‐VEC)
Open Access
- 8 July 2021
- journal article
- research article
- Published by Wiley in Journal of Surgical Oncology
- Vol. 124 (7), 1161-1165
- https://doi.org/10.1002/jso.26607
Abstract
Talimogene laherparepvec (T-VEC) is a genetically modified herpes simplex virus-1-based oncolytic immunotherapy and has been approved for the local treatment of unresectable (stage IIIB/C and IVM1a) cutaneous melanoma. During T-VEC treatment, tumor response is often evaluated using [18F]2-fluoro-2-deoxy- d-glucose(FDG) positron emission tomography/computed tomography (PET/CT). In a Dutch cohort (n = 173), almost one-third of patients developed new-onset FDG uptake in uninjected locoregional lymph nodes during T-VEC. In 36 out of 53 (68%) patients with new nodal FDG uptake, nuclear medicine physicians classified this FDG uptake as “suspected metastases” without clinical or pathological confirmation in the majority of patients. These false positive results indicate that new-onset FDG uptake in locoregional lymph nodes during T-VEC treatment does not necessarily reflect progressive disease, but may be associated with immune infiltration. In current clinical practice, physicians should be aware of the high false positive rate of FDG uptake during treatment with T-VEC in patients with melanoma. Therefore, pathological examination of lymph node lesions with new FDG uptake is recommended to differentiate between progressive disease and immune infiltration after treatment with T-VEC.This publication has 18 references indexed in Scilit:
- Five-Year Outcomes with Dabrafenib plus Trametinib in Metastatic MelanomaThe New England Journal of Medicine, 2019
- Final analyses of OPTiM: a randomized phase III trial of talimogene laherparepvec versus granulocyte-macrophage colony-stimulating factor in unresectable stage III–IV melanomaJournal for ImmunoTherapy of Cancer, 2019
- Five-year survival outcomes for patients with advanced melanoma treated with pembrolizumab in KEYNOTE-001Annals of Oncology, 2019
- High response rates for T‐VEC in early metastatic melanoma (stage IIIB/C‐IVM1a)International Journal of Cancer, 2019
- Nivolumab plus ipilimumab or nivolumab alone versus ipilimumab alone in advanced melanoma (CheckMate 067): 4-year outcomes of a multicentre, randomised, phase 3 trialThe Lancet Oncology, 2018
- Oncolytic immunotherapy: unlocking the potential of viruses to help target cancerCancer Immunology, Immunotherapy, 2017
- Patterns of Clinical Response with Talimogene Laherparepvec (T-VEC) in Patients with Melanoma Treated in the OPTiM Phase III Clinical TrialAnnals of Surgical Oncology, 2016
- Talimogene Laherparepvec Improves Durable Response Rate in Patients With Advanced MelanomaJournal of Clinical Oncology, 2015
- Phase 2 Study of Intralesional PV-10 in Refractory Metastatic MelanomaAnnals of Surgical Oncology, 2014
- Phase II Clinical Trial of a Granulocyte-Macrophage Colony-Stimulating Factor–Encoding, Second-Generation Oncolytic Herpesvirus in Patients With Unresectable Metastatic MelanomaJournal of Clinical Oncology, 2009