Potential of FDG-PET as Prognostic Significance after anti-PD-1 Antibody against Patients with Previously Treated Non-Small Cell Lung Cancer
Potential of FDG-PET as Prognostic Significance after anti-PD-1 Antibody against Patients with Previously Treated Non-Small Cell Lung Cancer
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DOI：
10.3390/jcm9030725
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发表时间：
2020-03-01
影响因子：
3.9
通讯作者：
Kuji, Ichiei
中科院分区：
文献类型：
--
作者：
Hashimoto, Kosuke;Kaira, Kyoichi;Kuji, Ichiei
目前尚不清楚2-脱氧-2-[F-18]氟-d-葡萄糖(F-18-FDG)在抗程序性死亡-1(PD-1)抗体产生前的积聚是否能预测其治疗后的预后。这项研究的目的是回顾研究F-18-FDG摄取作为抗PD-1抗体的预测标志的预后意义。85例既往治疗的非小细胞肺癌(NSCLC)患者在接受nivolumab或Pembrolizumab单药治疗前进行了F-18-FDG正电子发射断层扫描(PET)，并评估了代谢肿瘤体积(MTV)、总病变糖酵解(TLG)和最大摄取值(SUVmax)。客观有效率、中位无进展生存期和中位总生存期分别为36.6%、161天和716天。PET摄取F-18-FDG低的患者任何与免疫相关的不良事件的发生率显著高于摄取高F-18-FDG的患者。通过多因素分析，TLG和MTV的肿瘤代谢活性被确认为预测抗PD-1抗体治疗后预后的独立预后因素，但不是SUVmax，主要是在腺癌患者中。代谢肿瘤指标TLG和MTV对F-18-FDG摄取的影响可以预测抗PD-1抗体治疗后的预后。
It remains unclear whether the accumulation of 2-deoxy-2-[F-18]fluoro-d-glucose (F-18-FDG) before the initiation of anti-programmed death-1 (PD-1) antibody can predict the outcome after its treatment. The aim of this study is to retrospectively examine the prognostic significance of F-18-FDG uptake as a predictive marker of anti-PD-1 antibody. Eighty-five patients with previously treated non-small cell lung cancer (NSCLC) who underwent F-18-FDG-positron emission tomography (PET) just before administration of nivolumab or pembrolizumab monotherapy were eligible in our study, and metabolic tumor volume (MTV), total lesion glycolysis (TLG) and the maximum of standardized under value (SUVmax) on F-18-FDG uptake were assessed. Objective response rate, median progression-free survival and median overall survival were 36.6%, 161 days and 716 days, respectively. The frequency of any immune-related adverse events was significantly higher in patients with low F-18-FDG uptake on PET than in those with high uptake. By multivariate analysis, the tumor metabolic activity by TLG and MTV was identified as an independent prognostic factor for predicting outcome after anti-PD-1 antibody therapy, but not SUVmax, predominantly in patients with adenocarcinoma. Metabolic tumor indices as TLG and MTV on F-18-FDG uptake could predict the prognosis after anti-PD-1 antibodies in patients with previously treated NSCLC.