Reducing number of target lesions for RECIST1.1 to predict survivals in patients with advanced non-small-cell lung cancer undergoing anti-PD1/PD-L1 monotherapy
Reducing number of target lesions for RECIST1.1 to predict survivals in patients with advanced non-small-cell lung cancer undergoing anti-PD1/PD-L1 monotherapy
复制标题
减少 RECIST1.1 的靶病灶数量以预测接受抗 PD1/PD-L1 单药治疗的晚期非小细胞肺癌患者的生存率
DOI：
10.1016/j.lungcan.2021.12.015
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发表时间：
2022-01-17
期刊：
影响因子：
5.3
通讯作者：
Hong, Shaodong
中科院分区：
文献类型：
--
作者：
He, Li-Na;Chen, Tao;Hong, Shaodong
目的：实体肿瘤反应评价标准（RECIST） 1.1版为多发性实体肿瘤提供了常规和标准化的反应评估。我们研究了在不影响接受抗pd -1/PD-L1单药治疗的晚期非小细胞肺癌（aNSCLC）患者的反应分类和生存预测的情况下，可以测量的最小目标病变数量。材料和方法：回顾性研究125例至少有两个可测量病变的接受PD-1/PD-L1抑制剂治疗的aNSCLC患者。肿瘤测量允许多达两个病变每个器官和五个病变共审查。个人之间的协议和。对反应状态的方法间一致性值进行评估，基于多达五个目标病变，而不是最大的一个到四个病变。计算Cindex以评估基于所选目标病变数量的反应分类预测总生存期（OS）的预后准确性。生存分析采用Cox回归分析。结果：当测量最大的两个病变与最多五个病变时，可以获得高度一致的反应分配（99.2%）。利用最大的2 ~ 4个病变产生。kappa值分别为0.986、1.000和1.000，显著高于测量最大单个病变时的kappa值（0.850）。总生存期（OS）的c指数在评估最大的一个到五个病变时相似，范围从0.646到0.654。Cox回归分析显示，无论选择的目标病变数量如何，放射学反应都能显著预测OS。结论：减少靶病变数量不会影响接受抗pd -1/PD-L1治疗的aNSCLC患者的OS预测。考虑到个体内部和方法之间的高度一致性，建议使用最大的两个病变来评估反应。
Objectives: The Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 provides conventional and standardized response assessment for multiple solid tumors. We investigated the smallest number of target lesions that can be measured without compromising response categorization and survival prediction in patients with advanced non-small-cell lung cancer (aNSCLC) undergoing anti-PD-1/PD-L1 monotherapy.Material and methods: 125 aNSCLC patients with at least two measurable lesions undergoing PD-1/PD-L1 inhibitor treatment were retrospectively studied. Tumor measurements allowing up to two lesions per organ and five lesions in total were reviewed. Inter-individual agreement and. values for inter-method concordance on response status were evaluated based on up to five target lesions versus the largest one through four lesions. Cindex was calculated to evaluate the prognostic accuracy of response categorization based on the selected number of target lesions for predicting overall survival (OS). Cox regression analysis was conducted for survival analysis.Results: The highly consistent response assignment (99.2%) could be obtained when measuring the largest two lesions versus up to five lesions. Using the largest two through four lesions produced. values of 0.986, 1.000 and 1.000 for response assessment, values significantly higher than those obtained when measuring the largest single lesion (kappa = 0.850). C-index for overall survival (OS) was similar when assessing the largest one through five lesions, ranging from 0.646 to 0.654. Cox regression analyses showed that radiological response significantly predicted OS, irrespective of the number of target lesions selected.Conclusions: Reducing the number of target lesions does not affect OS prediction in aNSCLC patients treated with anti-PD-1/PD-L1 therapy. Considering the high intra-individual and inter-method concordance, using the largest two lesions in total is proposed to assess response.