case_images: PMC10773865_01
case_images: 18-FDG PET/CT for assessing the fast tumor response to immunotherapy with cemiplimab. (A) Baseline 18-FDG PET images in advanced CC patient showing multiple lung (B), liver (C) and lymph node metastases. (D) Early assessment after two cycles of cemiplimab showed a metabolic complete response to immunotherapy with disappearing of lung metastases (E) and of two hepatic nodules (F) to 18-FDG PET scan performed in February 2023.
case_images: fimmu-14-1303893-g001.jpg
case_images: PMC10773865_01_fimmu-14-1303893-g001.jpg
case_images: f1
case_images: In September 2022, a new metabolic assessment revealed disease progression with multiple lung metastases to the anterior segment of the right upper lobe (12x11 mm and 18x17 mm) with maximum standardized uptake value (SUVmax) of 9.1 and 7.7 respectively, to the anterior segment of the left lower lobe (17x14 mm) with SUVmax 7.8, new appearance of hyperaccumulation in two hypodense hepatic lesions in the VII and VI segments (SUVmax 5.7), and a lymphadenopathy to the right hilar region (SUVmax 5.3) (see  Figure 1 ).The combined positive score (CPS) for PD-L1 on tumor tissue from the last surgery was negative.
case_images: 18-FDG PET/CT scan demonstrates the persistence of complete response after only two cycles of cemiplimab definitively discontinued for severe toxicities. (A) Baseline 18-FDG PET image. (B) 18-FGD PET showing complete response after two cycles of immunotherapy. (C) 18-FDG showing the persistence of complete response following nine and thirteen months (June and October 2023), despite the discontinuation of immunotherapy. (D-F) As result of an effective immune activation, the 18-FDG PET scan showed an intense increase in uptake to the spleen, a finding not present at the previous pre-immunotherapy examination.
case_images: fimmu-14-1303893-g002.jpg
case_images: PMC10773865_01_fimmu-14-1303893-g002.jpg
case_images: f2
case_images: Probably as result of an effective immune activation, the 18-FDG PET scan showed an intense increase in uptake to the spleen, a finding not present at the previous pre-immunotherapy examination (see  Figure 2 ). Interestingly, nine and thirteen months after the start of cemiplimab treatment, the patient is off therapy and still disease-free (complete response) as documented by the last 18-FDG PET scan (see  Figure 2 ).