Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/7/1634 |
| _version_ | 1797539284008304640 |
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| author | Lavinia Monaco Maria Gemelli Irene Gotuzzo Matteo Bauckneht Cinzia Crivellaro Carlo Genova Diego Cortinovis Lodovica Zullo Luca Carlofrancesco Ammoni Davide Paolo Bernasconi Giovanni Rossi Silvia Morbelli Luca Guerra |
| author_facet | Lavinia Monaco Maria Gemelli Irene Gotuzzo Matteo Bauckneht Cinzia Crivellaro Carlo Genova Diego Cortinovis Lodovica Zullo Luca Carlofrancesco Ammoni Davide Paolo Bernasconi Giovanni Rossi Silvia Morbelli Luca Guerra |
| author_sort | Lavinia Monaco |
| collection | DOAJ |
| description | 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, <i>p</i> = 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 (<i>p</i> = 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. |
| first_indexed | 2024-03-10T12:42:49Z |
| format | Article |
| id | doaj.art-afd41b65078e4b02ab11b3a7d817f5f4 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T12:42:49Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-afd41b65078e4b02ab11b3a7d817f5f42023-11-21T13:43:16ZengMDPI AGCancers2072-66942021-04-01137163410.3390/cancers13071634Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World ExperienceLavinia Monaco0Maria Gemelli1Irene Gotuzzo2Matteo Bauckneht3Cinzia Crivellaro4Carlo Genova5Diego Cortinovis6Lodovica Zullo7Luca Carlofrancesco Ammoni8Davide Paolo Bernasconi9Giovanni Rossi10Silvia Morbelli11Luca Guerra12School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, ItalyMedical Oncology, ASST Monza, San Gerardo Hospital, 20900 Monza, ItalySchool of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, ItalyIRCCS Ospedale Policlinico San Martino, 16132 Genoa, ItalyNuclear Medicine, ASST Monza San Gerardo Hospital, 20900 Monza, ItalyUOC Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, 16132 Genova, ItalyMedical Oncology, ASST Monza, San Gerardo Hospital, 20900 Monza, ItalyUOC Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, 16132 Genova, ItalyMedical Oncology, ASST Monza, San Gerardo Hospital, University of Brescia, 25123 Brescia, ItalyBicocca Biostatistics Bioinformatics and Bioimaging Center—B4, School of Medicine and Surgery, University Milano Bicocca, 20128 Milano, ItalyDepartment of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, ItalyIRCCS Ospedale Policlinico San Martino, 16132 Genoa, ItalySchool of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, ItalyImmune-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, <i>p</i> = 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 (<i>p</i> = 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.https://www.mdpi.com/2072-6694/13/7/1634immunotherapyNSCLCPET/CTresponse to therapymetabolic tumor volumequantification |
| spellingShingle | Lavinia Monaco Maria Gemelli Irene Gotuzzo Matteo Bauckneht Cinzia Crivellaro Carlo Genova Diego Cortinovis Lodovica Zullo Luca Carlofrancesco Ammoni Davide Paolo Bernasconi Giovanni Rossi Silvia Morbelli Luca Guerra Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience Cancers immunotherapy NSCLC PET/CT response to therapy metabolic tumor volume quantification |
| title | Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience |
| title_full | Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience |
| title_fullStr | Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience |
| title_full_unstemmed | Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience |
| title_short | Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience |
| title_sort | metabolic parameters as biomarkers of response to immunotherapy and prognosis in non small cell lung cancer nsclc a real world experience |
| topic | immunotherapy NSCLC PET/CT response to therapy metabolic tumor volume quantification |
| url | https://www.mdpi.com/2072-6694/13/7/1634 |
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