Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience

Cancers

DavidePaolo Bernasconi¹  Giovanni Rossi²  Silvia Morbelli³  Matteo Bauckneht³  Diego Cortinovis⁴  Maria Gemelli⁴  LucaCarlofrancesco Ammoni⁵  Cinzia Crivellaro⁶  Luca Guerra⁷  Lavinia Monaco⁷  Irene Gotuzzo⁷  Carlo Genova⁸  Lodovica Zullo⁹ 

[1] Bicocca Biostatistics Bioinformatics and Bioimaging Center—B4, School of Medicine and Surgery, University Milano Bicocca, 20128 Milano, Italy;Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy;IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy;Medical Oncology, ASST Monza, San Gerardo Hospital, 20900 Monza, Italy;Medical Oncology, ASST Monza, San Gerardo Hospital, University of Brescia, 25123 Brescia, Italy;Nuclear Medicine, ASST Monza San Gerardo Hospital, 20900 Monza, Italy;School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy;UOC Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;UOC Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;

关键词: immunotherapy;    NSCLC;    PET/CT;    response to therapy;    metabolic tumor volume;    quantification;   

DOI  :  10.3390/cancers13071634

来源: DOAJ

【 摘 要 】

Immune-checkpoint inhibitors (ICIs) have been proven to have great efficacy in non-small cell lung cancer (NSCLC) as single agents or in combination therapy, being capable to induce deep and durable remission. However, severe adverse events may occur and about 40% of patients do not benefit from the treatment. Predictive factors of response to ICIs are needed in order to customize treatment. The aim of this study is to evaluate the correlation between quantitative positron emission tomography (PET) parameters defined before starting ICI therapy and responses to treatment and patient outcome. We retrospectively analyzed 92 NSCLC patients treated with nivolumab, pembrolizumab or atezolizumab. Basal PET/computed tomography (CT) scan parameters (whole-body metabolic tumor volume—wMTV, total lesion glycolysis—wTLG, higher standardized uptake volume maximum and mean—SUVmax and SUVmean) were calculated for each patient and correlated with outcomes. Patients who achieved disease control (complete response + partial response + stable disease) had significantly lower MTV median values than patients who had not (progressive disease) (77 vs. 160.2, p = 0.039). Furthermore, patients with MTV and TLG values lower than the median values had improved OS compared to patients with higher MTV and TLG (p = 0.03 and 0.05, respectively). No relation was found between the other parameters and outcome. In conclusion, baseline metabolic tumor burden, measured with MTV, might be an independent predictor of treatment response to ICI and a prognostic biomarker in NSCLC patients.

【 授权许可】

Unknown