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Master Thesis

Evaluation tomodensitométrique de la réponse des carcinomes broncho-pulmonaires métastatiques sous inhibiteurs de checkpoint immunitaire

Abstract : Introduction: radiological evaluation of bronchopulmonary carcinomas (BPC) under nivolumab, anti-PD-L1 antibody, is challenging due to atypical responses such as pseudoprogressions. The aim was to describe this phenomenon and to look for imaging predictive factors of progression-free survival (PFS) and clinical benefit, including lymphoid organs morphology. Methods: this retrospective single center study included all patients who started nivolumab for metastatic BPC, evaluated by CT scans using iRECIST criteria. Prevalence, time and radiological patterns of pseudoprogressions were analyzed. PFS and benefit at 6 months were correlated with clinical, pathological, biological and imaging characteristics, including thymic density, splenic volume and liver size, at baseline and under treatment. Results: a total of 85 patients were included and 8.2% presented pseudoprogression 24 to 67 days after the start of treatment, with no specific radiological pattern. Lymphoid organs morphology and variation were not associated with PFS and benefit at 6 months. Extrapulmonary disease, including bone or adrenal metastasis, and a number of tumour sites greater than 2 was associated with poorer PFS. Response without pseudoprogression was associated with a better PFS than response after pseudoprogression. Conclusion: pseudoprogression is rare and occurs early after start of treatment, and is possibly associated with poorer PFS among responders. The morphology of secondary lymphoid organs is not predictive of benefit or survival. The number of tumour sites, especially extrapulmonary sites, is a prognostic factor.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03197285
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Submitted on : Tuesday, April 13, 2021 - 4:25:00 PM
Last modification on : Friday, September 3, 2021 - 3:32:56 AM

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  • HAL Id : dumas-03197285, version 1

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Aurélien Saltel-Fulero. Evaluation tomodensitométrique de la réponse des carcinomes broncho-pulmonaires métastatiques sous inhibiteurs de checkpoint immunitaire. Médecine humaine et pathologie. 2019. ⟨dumas-03197285⟩

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