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Because of deficiencies in l-arginine biosynthesis, some cancers are susceptible to therapeutic intervention with arginine deiminase (ADI), an enzyme responsible for consuming the dietary supply of l-arginine to deprive the disease of an essential nutrient. ADI is currently being evaluated in several clinical trials, and fully realizing the drug's potential will depend on invoking the appropriate metrics to judge clinical response. Without a clear biologic mandate, PET/CT with (18)F-FDG is currently used to monitor patients treated with ADI. However, it is unclear if it can be expected that (18)F-FDG responses will indicate (or predict) clinical benefit.

Novel Mechanistic Insights into Arginine Deiminase Pharmacology Suggest 18F-FDG Is Not Suitable to Evaluate Clinical Response in Melanoma

Novel Mechanistic Insights into Arginine Deiminase Pharmacology Suggest ¹⁸F-FDG Is Not Suitable to Evaluate Clinical Response in Melanoma