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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

Rivista di Medicina Nucleare e Imaging Molecolare


A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the Society of Radiopharmaceutical Sciences and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 Nov 22

DOI: 10.23736/S1824-4785.17.03035-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Immunotherapy treatment: an issue for metabolic response

Luca TAGLIABUE 1 , Antonella CAPOZZA 2, Claudio MAIOLI 3, Andrea LUCIANI 4, Anna M. IERARDI 5, Gianpaolo CARRAFIELLO 5

1 Nuclear Medicine Unit, Department of Diagnostic Services, University Hospital “San Paolo” ASST dei Santi Paolo e Carlo, Milan, Italy; 2 Post-graduate School of Nuclear Medicine, University of Milan, Milan, Italy; 3 Department of Health Science, San Paolo Hospita, University of Milan, Milan, Italy; 4 Oncology Unit, Department of Medicine, University Hospital “San Paolo” ASST dei Santi Paolo e Carlo, Milan, Italy; 5 Radiology Unit, Department of Imaging, University Hospital “San Paolo” ASST dei Santi Paolo e Carlo, Milan, Italy


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Since the beginning of second decade of this century, when it was introduced in many oncologic scenarios, immunotherapy has become an important tool in the management of a growing number of cancers. Engaging the host immune system in cancer therapy seems to be useful, improving not only progression free survival but also overall survival, until the achieving the goal that many advanced cancers, previously considered without effective treatment options, have now become successfully treatable. Moreover, considering the relatively recent introduction of these drugs in clinical scenarios and the continuous releasing of new drugs, large validated clinical experiences are lacking and many issues are today debated; by the way, the evaluation of the response to immune-therapy poses major concerns. Engaging the host immune system in fighting against cancer is an energy-consuming process, requiring T-cell recruiting; this process, named “pseudo-progression”, sometimes produces an increase of both dimensional and metabolic ratio of the lesions, as well as the appearance of “new lesions”. This behavior, always considered as undisputed progressive disease when traditional chemotherapy is employed, should be carefully considered in the field of immunotherapy, where the phenomenon of “flare” followed by regression of the disease can occur. In this paper, Authors analyzed the best available evidences in this field, reviewed the most important issues emerged along the developing of immunotherapy, and addressed evidences and concerns about the evaluation of response when using immunotherapy drugs, in terms of both radiological and nuclear medicine criteria.


KEY WORDS: Immunotherapy - Response to therapy - [18F]FDG PET/CT - Response criteria

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Publication History

Article first published online: November 22, 2017
Manuscript accepted: November 7, 2017
Manuscript received: September 27, 2017

Per citare questo articolo

Tagliabue L, Capozza A, Maioli C, Luciani A, Ierardi AM, Carrafiello G. Immunotherapy treatment: an issue for metabolic response. Q J Nucl Med Mol Imaging 2017 Nov 22. DOI: 10.23736/S1824-4785.17.03035-7

Corresponding author e-mail

luca.tagliabue@asst-santipaolocarlo.it