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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

21.11.2019 | Original Article

Baseline metabolic tumor burden on FDG PET/CT scans predicts outcome in advanced NSCLC patients treated with immune checkpoint inhibitors

verfasst von: Romain-David Seban, Laura Mezquita, Arnaud Berenbaum, Laurent Dercle, Angela Botticella, Cécile Le Pechoux, Caroline Caramella, Eric Deutsch, Serena Grimaldi, Julien Adam, Samy Ammari, David Planchard, Sophie Leboulleux, Benjamin Besse

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2020

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Abstract

Purpose

We aimed to evaluate if imaging biomarkers on FDG PET are associated with clinical outcomes in patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs).

Methods

In this retrospective monocentric study, we included 109 patients with advanced NSCLC who underwent baseline FDG PET/CT before ICI initiation between July 2013 and September 2018. Clinical, biological (including dNLR = neutrophils/[leukocytes minus neutrophils]), pathological and PET parameters (tumor SUVmax, total metabolic tumor volume [TMTV]) were evaluated. A multivariate prediction model was developed using Cox models for progression-free survival (PFS) and overall survival (OS). The association between biomarkers on FDG PET/CT and disease clinical benefit (DCB) was tested using logistic regression.

Results

Eighty patients were eligible. Median follow-up was 11.6 months (95%CI 7.7–15.5). Sixty-four and 52 patients experienced progression and death, respectively. DCB was 40%. In multivariate analyses, TMTV > 75 cm³ and dNLR > 3 were associated with shorter OS (HR 2.5, 95%CI 1.3–4.7 and HR 3.3, 95%CI 1.6–6.4) and absence of DCB (OR 0.3, 95%CI 0.1–0.9 and OR 0.4, 95%CI 0.2–0.9). Unlike TMTV, dNLR was a significant prognostic factor for PFS (HR 1.9, 95%CI 1.1–3.3) along with anemia (HR 1.9, 95%CI 1.2–3.8). No association was observed between tumor SUVmax and PFS or OS.

Conclusion

Baseline tumor burden (TMTV) on FDG PET/CT scans and inflammatory status (dNLR) were associated with poor OS and absence of DCB for ICI treatment in advanced NSCLC patients, unlike tumor SUVmax, and may be used together to improve the selection of appropriate candidates.

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Titel: Baseline metabolic tumor burden on FDG PET/CT scans predicts outcome in advanced NSCLC patients treated with immune checkpoint inhibitors
verfasst von: Romain-David Seban
Laura Mezquita
Arnaud Berenbaum
Laurent Dercle
Angela Botticella
Cécile Le Pechoux
Caroline Caramella
Eric Deutsch
Serena Grimaldi
Julien Adam
Samy Ammari
David Planchard
Sophie Leboulleux
Benjamin Besse
Publikationsdatum: 21.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 5/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04615-x

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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