Nuklearmedizin 2025; 64(01): 44
DOI: 10.1055/s-0045-1804280
Abstracts │ NuklearMedizin 2025
Leuchtturm-Vorträge
Beste Abstracts

PET/CT-guided immune checkpoint blocker treatment discontinuation vs. treatment continuation in lung cancer long-term responders – a National Network Genomic Medicine Lung Cancer Germany (nNGM) analysis

C Furth
1   Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland
,
M Wiesweg
2   Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Deutschland
,
A Rasokat
3   Department I of Internal Medicine, University Hospital of Cologne, Köln, Deutschland
,
K Jonas
4   Translational Oncology/Early Clinical Trial Unit, Bavarian Cancer Research Center, National Center for Tumor Diseases, Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Deutschland
,
J Kollmeier
5   Helios Klinikum Emil von Behring, Lungenklinik Heckeshorn, Berlin Lung Institute, Berlin, Deutschland
,
N Reinmuth
6   Asklepios Lung Clinic, Member of the German Center for Lung Research, Gauting, Deutschland
,
H Lüders
7   Klinik für Pneumologie, Evangelische Lungenklinik, Berlin-Buch, Berlin, Deutschland
,
J Roeper
8   Department of Hematology and Oncology, Pius-Hospital, Oldenburg, Deutschland
,
A Rittmeyer
9   Department of Thoracic Oncology, LKI Lungenfachklinik Immenhausen, Immenhausen, Deutschland
,
S Heinzen
10   Hematology/Oncology, Department of Medicine II, University Hospital Frankfurt, Frankfurt, Deutschland
,
F C Saalfeld
11   Clinic for Internal Medicine I, Carl-Gustav-Carus Dresden University Hospital, TU Dresden, Dresden, Deutschland
,
C Wesseler
12   Department of Thoracic Oncology, Asklepios Klinikum Hamburg-Harburg, Hamburg, Deutschland
,
D Kauffmann-Guerrero
13   University Hospital, LMU Munich, Member of the German Center for Lung Research, München, Deutschland
,
P Christopoulos
14   Department of Thoracic Oncology, National Center for Tumor Diseases , Heidelberg University Hospital , Heidelberg, Deutschland
15   Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, Heidelberg, Deutschland
,
M Kemper
16   Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Muenster, Münster, Deutschland
,
M Collienne
17   DKFZ-Hector Cancer Institute and Department of Personalized Oncology at the University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Deutschland
18   Division of Personalized Medical Oncology (A420), German Cancer Research Center, German Center for Lung Research, Heidelberg, Deutschland
,
E Berezucki
19   Department of Internal Medicine 2, University Hospital Regensburg, Regensburg, Deutschland
,
T Overbeck
20   Department of Haematology and Medical Oncology, University of Göttingen Medical Center, Göttingen, Deutschland
,
C Kropf-Sanchen
21   Department of Pulmonology, Internal Medicine II, University of Ulm, Ulm, Deutschland
,
M Reck
22   Lung Clinic Grosshansdorf, Airway Research Center North, German Center of Lung Research, Grosshansdorf, Deutschland
,
N Frost
23   Department of Infectious Diseases and Pulmonary Medicine, Charité – Universitätsmedizin Berlin, (Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Berlin, Deutschland
› Author Affiliations
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Ziel/Aim: Optimal duration of immune checkpoint blocker (ICB)-treatment in lung cancer has not been determined yet. One in five patients treated with first-line ICB achieves durable responses for≥2 years. Treatment continuation beyond 2 years impacts on economic burden and might cause avoidable toxicities. Thus, safe discontinuation strategies represent an urgent medical need.

Methodik/Methods: For this retrospective cohort analysis, 430 nNGM-patients from 20 centers and stable on first-line ICB-based treatment for≥2 years were enrolled into 2 cohorts, either with a PET/CT after≥2 years and offer to discontinue treatment (A, n=101) or with continued ICB administration without PET/CT (B, n=329). Treatment outcome was assessed with PET/CT as a time-depending covariate.

Ergebnisse/Results: Frequencies of (non-) squamous NSCLC and SCLC were 72%, 21% and 7%, respectively. In cohort A, median time to PET/CT was 26 months [25-27] with a complete metabolic response (CMR) observed in 59 (58%) cases. In non-CMR patients (n=42, 42%), 28 rebiopsies were performed (67%), confirming residual vital cancer in 13 patients (46%). Of these, 10 patients (77%) underwent subsequent local ablative treatments. Median duration of ICB-treatment was 28 (A) vs. 44 months (B) (p<0.001), with the main reasons for treatment discontinuation being the PET/CT (A: 89%) and subsequent irAE (B: 31%). After a median FU of 46 months [44-49], HR for PFS and OS (A vs. B) were 0.55 [0.31-0.96; p=0.03] and 0.45 [0.20-1.05; p=0.06], respectively.

Schlussfolgerungen/Conclusions: Shorter treatment duration in group A was not associated with inferior PFS or OS, and patients benefitted from a lower incidence of treatment-limiting irAE. PET/CT-guided treatment seems reasonable, might identify high-risk patients and should be evaluated prospectively.



Publication History

Article published online:
12 March 2025

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