What is the optimal timing for PET/CT to assess disease and treatment response with nivo + AVD?

The S1826 study did not require interim imaging. Despite this, I routinely order an imaging test prior to cycle 3, day 1 for patients on the N-AVD regimen. In most cases, I order PET/CT scans. I continue therapy in patients with a Deauville score of 4 or less (partial or complete response) rather th...

I do not routinely order interim scans in patients receiving N-AVD as long as they have assessable disease (palpable LAD) on exam and are clinically doing all right. If no assessable disease, then I get CT scans after 3 cycles (prior to cycle 4). This is to rule out primary refractory disease, which...

For stage I/II unfavorable classical Hodgkin Lymphoma (B symptoms or bulky mediastinal disease or >10 cm adenopathy) patients, 4 cycles of Nivolumab-AVD regimen is followed by involved site 30 Gy radiation therapy, then a restaging FDG-PET/CT scan is performed. If the Deauville score is 1 to 3, regu...

There are no good data for this. I still tend to do a PET/CT scan after 2 cycles since old habits die hard and to ensure that there isn’t clear refractory disease (pseudoprogression is not really an issue with PD-1 blockade in HL as compared to solid tumors), but in reality this was already of dubio...

I think that the interim PET after 2 cycles may still be of value, especially if the patient has a need to abandon nivolumab because of toxicity- the early response assessment may be useful in terms of determining additional therapy. There is a risk of pseudo progression on interim PET after Nivolum...

As per S1826, PET2 is not routinely performed when administering N+AVD. PET scans with CPI-based therapy are notoriously fiddly, and I would not advocate escalation or de-escalation based upon interim PET (PET2, e.g.) while administering N+AVD … so why do the scan? Of course, in the context of conce...