Dynamic Adaptation of Tumor Immune Response with Nivolumab Demonstrated by 18F-FDG PET/CT

Naghmehossadat Eshghi, Tamara F. Lundeen, Phillip H Kuo

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


A 61-year-old woman with lung adenocarcinoma failed first-line treatment and was placed on immunotherapy with nivolumab. FDG-PET/CT before immunotherapy showed metastases to thoracic nodes, liver, adrenal gland, and skeleton. Seven weeks after starting nivolumab, FDG-PET/CT showed mild residual activity in thoracic nodes and otherwise complete response. After 15 weeks, enlarged and FDG-avid axillary lymphadenopathy and worsening supraclavicular lymphadenopathy developed. After 20 weeks, FDG-PET/CT demonstrated marked improvement of axillary and supraclavicular lymphadenopathy. This case demonstrates that later progression of disease can still respond to continuing immunotherapy, hypothetically because of dynamic adaptations in the tug-of-war between the immunotherapy-augmented immune system and tumor.

Original languageEnglish (US)
Pages (from-to)114-116
Number of pages3
JournalClinical nuclear medicine
Issue number2
StatePublished - Feb 1 2018


  • PET/CT
  • flourodeoxyglucose
  • immunotherapy
  • lung cancer
  • nivolumab

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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