Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy
Background: Predictive markers for treatment response and survival outcome have not been identified in patients with advanced non-small-cell lung cancer (NSCLC) receiving chemoimmunotherapy. We aimed to evaluate whether imaging biomarkers of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomo...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-01-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359211068732 |
| _version_ | 1828145934552268800 |
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| author | Chang Gon Kim Sang Hyun Hwang Kyung Hwan Kim Hong In Yoon Hyo Sup Shim Ji Hyun Lee Yejeong Han Beung-Chul Ahn Min Hee Hong Hye Ryun Kim Byoung Chul Cho Arthur Cho Sun Min Lim |
| author_facet | Chang Gon Kim Sang Hyun Hwang Kyung Hwan Kim Hong In Yoon Hyo Sup Shim Ji Hyun Lee Yejeong Han Beung-Chul Ahn Min Hee Hong Hye Ryun Kim Byoung Chul Cho Arthur Cho Sun Min Lim |
| author_sort | Chang Gon Kim |
| collection | DOAJ |
| description | Background: Predictive markers for treatment response and survival outcome have not been identified in patients with advanced non-small-cell lung cancer (NSCLC) receiving chemoimmunotherapy. We aimed to evaluate whether imaging biomarkers of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) and routinely assessed clinico-laboratory values were associated with clinical outcomes in patients with advanced NSCLC receiving pembrolizumab plus platinum-doublet chemotherapy as a first-line treatment. Methods: We retrospectively enrolled 52 patients with advanced NSCLC who underwent baseline 18 F-FDG PET/CT before treatment initiation. PET/CT parameters and clinico-laboratory variables, constituting the prognostic immunotherapy scoring system, were collected. Optimal cut-off values for PET/CT parameters were determined using the maximized log-rank test for progression-free survival (PFS). A multivariate prediction model was developed based on Cox models for PFS, and a scoring system was established based on hazard ratios of the predictive factors. Results: During the median follow-up period of 16.7 months (95% confidence interval: 15.7–17.7 months), 43 (82.7%) and 31 (59.6%) patients experienced disease progression and death, respectively. Objective response was observed in 23 (44.2%) patients. In the multivariate analysis, maximum standardized uptake value, metabolic tumour volume 2.5 , total lesion glycolysis 2.5 , and bone marrow-to-liver uptake ratio from the PET/CT variables and neutrophil-to-lymphocyte ratio (NLR) from the clinico-laboratory variables were independently associated with PFS. The scoring system based on these independent predictive variables significantly predicted the treatment response, PFS, and overall survival. Conclusion: PET/CT variables and NLR were useful biomarkers for predicting outcomes of patients with NSCLC receiving pembrolizumab and chemotherapy as a first-line treatment, suggesting their potential as effective markers for combined PD-1 blockade and chemotherapy. |
| first_indexed | 2024-04-11T20:38:44Z |
| format | Article |
| id | doaj.art-4365ea9b5a2149d7b1bee384511de90e |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-11T20:38:44Z |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-4365ea9b5a2149d7b1bee384511de90e2022-12-22T04:04:16ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592022-01-011410.1177/17588359211068732Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapyChang Gon KimSang Hyun HwangKyung Hwan KimHong In YoonHyo Sup ShimJi Hyun LeeYejeong HanBeung-Chul AhnMin Hee HongHye Ryun KimByoung Chul ChoArthur ChoSun Min LimBackground: Predictive markers for treatment response and survival outcome have not been identified in patients with advanced non-small-cell lung cancer (NSCLC) receiving chemoimmunotherapy. We aimed to evaluate whether imaging biomarkers of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) and routinely assessed clinico-laboratory values were associated with clinical outcomes in patients with advanced NSCLC receiving pembrolizumab plus platinum-doublet chemotherapy as a first-line treatment. Methods: We retrospectively enrolled 52 patients with advanced NSCLC who underwent baseline 18 F-FDG PET/CT before treatment initiation. PET/CT parameters and clinico-laboratory variables, constituting the prognostic immunotherapy scoring system, were collected. Optimal cut-off values for PET/CT parameters were determined using the maximized log-rank test for progression-free survival (PFS). A multivariate prediction model was developed based on Cox models for PFS, and a scoring system was established based on hazard ratios of the predictive factors. Results: During the median follow-up period of 16.7 months (95% confidence interval: 15.7–17.7 months), 43 (82.7%) and 31 (59.6%) patients experienced disease progression and death, respectively. Objective response was observed in 23 (44.2%) patients. In the multivariate analysis, maximum standardized uptake value, metabolic tumour volume 2.5 , total lesion glycolysis 2.5 , and bone marrow-to-liver uptake ratio from the PET/CT variables and neutrophil-to-lymphocyte ratio (NLR) from the clinico-laboratory variables were independently associated with PFS. The scoring system based on these independent predictive variables significantly predicted the treatment response, PFS, and overall survival. Conclusion: PET/CT variables and NLR were useful biomarkers for predicting outcomes of patients with NSCLC receiving pembrolizumab and chemotherapy as a first-line treatment, suggesting their potential as effective markers for combined PD-1 blockade and chemotherapy.https://doi.org/10.1177/17588359211068732 |
| spellingShingle | Chang Gon Kim Sang Hyun Hwang Kyung Hwan Kim Hong In Yoon Hyo Sup Shim Ji Hyun Lee Yejeong Han Beung-Chul Ahn Min Hee Hong Hye Ryun Kim Byoung Chul Cho Arthur Cho Sun Min Lim Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy Therapeutic Advances in Medical Oncology |
| title | Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy |
| title_full | Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy |
| title_fullStr | Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy |
| title_full_unstemmed | Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy |
| title_short | Predicting treatment outcomes using F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy |
| title_sort | predicting treatment outcomes using f fdg pet biomarkers in patients with non small cell lung cancer receiving chemoimmunotherapy |
| url | https://doi.org/10.1177/17588359211068732 |
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