Functional imaging with 18F-FDG PET/CT and diffusion weighted imaging (DWI) in early response evaluation of combination therapy of elotuzumab, lenalidomide, and dexamethasone in a relapsed multiple myeloma patient

Elotuzumab is the first monoclonal antibody approved for the treatment of relapsed-refractory multiple myeloma (MM) in combination with lenalidomide, an immunodulatory drug, and dexamethasone. We report on a multiply pre-treated MM patient with disease progression due to appearance of new focal lesi...

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Hauptverfasser: Sachpekidis, Christos (VerfasserIn) , Dimitrakopoulou-Strauss, Antonia (VerfasserIn) , Delorme, Stefan (VerfasserIn) , Goldschmidt, Hartmut (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 15 December 2017
In: Diagnostics
Year: 2017, Jahrgang: 7, Heft: 4
ISSN:2075-4418
DOI:10.3390/diagnostics7040061
Online-Zugang:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.3390/diagnostics7040061
Verlag, kostenfrei, Volltext: http://www.mdpi.com/2075-4418/7/4/61
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Verfasserangaben:Christos Sachpekidis, Antonia Dimitrakopoulou-Strauss, Stefan Delorme and Hartmut Goldschmidt

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520 |a Elotuzumab is the first monoclonal antibody approved for the treatment of relapsed-refractory multiple myeloma (MM) in combination with lenalidomide, an immunodulatory drug, and dexamethasone. We report on a multiply pre-treated MM patient with disease progression due to appearance of new focal lesions on imaging modalities, who was started on a combination treatment of elotuzumab, lenalidomide, and dexamethasone. After completion of three cycles of the new therapy the patient responded very well with a major decline of serological myeloma activity parameters serum monoclonal protein, kappa light chains, free light chains (FLC) ratio. The patient was also monitored with the functional imaging modalities 18F-FDG PET/CT and diffusion weighted imaging (DWI), which exhibited a mismatch of almost complete metabolic remission on positron emission tomography/computed tomography (PET/CT) with 18F-fluoro-2-deoxy-d-glucose (18F-FDG) (consistent with the serological response), and signal elevation persistence on DWI. This case demonstrates the potentially superior performance of 18F-FDG PET/CT over DWI in early response evaluation of combined treatment with a monoclonal antibody, an immunomodulatory drug, and dexamethasone in MM. 
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