Open Access18F-FDG PET/CT Monitoring of Response to Programmed Death Protein 1 Blockade in Metastatic Basal Cell Carcinoma
Author(s) -
Hossein Jadvar,
Gino K. In
Publication year - 2021
Publication title -
clinical nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.637
H-Index - 57
eISSN - 1536-0229
pISSN - 0363-9762
DOI - 10.1097/rlu.0000000000003528
Subject(s) - medicine , corpectomy , pembrolizumab , basal cell carcinoma , positron emission tomography , salvage therapy , nuclear medicine , oncology , pathology , basal cell , immunotherapy , chemotherapy , surgery , cancer , decompression
A 73-year-old woman with history of metastatic basal cell carcinoma presented with a large spinal mass demonstrating a high mutational burden of 111 mutations/Mb. She underwent T12 corpectomy and T10-L3 posterior spinal fusion followed by adjuvant radiation. After 2 years of surveillance, FDG PET/CT and a contrast-enhanced MRI revealed recurrence, prompting salvage therapy with the hedgehog signaling pathway inhibitor, sonidegib, which only transiently stabilized the disease. An off-label treatment with the programmed death protein 1 inhibitor, pembrolizumab, was initiated. Serial FDG PET/CT showed gradual decline in tumor metabolism over the next 12 months, leading to complete metabolic response.