글로벌 연구동향
핵의학
- 2022년 03월호
[Ther Adv Med Oncol.] Predicting treatment outcomes using 18 F-FDG PET biomarkers in patients with non-small-cell lung cancer receiving chemoimmunotherapy연세의대 / 김창곤, 황상현, 조응혁*, 임선민*
- 출처
- Ther Adv Med Oncol.
- 등재일
- 2022 Jan 9
- 저널이슈번호
- 14:17588359211068732. doi: 10.1177/17588359211068732.
- 내용
Abstract
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 18F-fluorodeoxyglucose (18F-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 18F-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 volume2.5, total lesion glycolysis2.5, 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.
Affiliations
Chang Gon Kim 1 , Sang Hyun Hwang 2 , Kyung Hwan Kim 3 , Hong In Yoon 3 , Hyo Sup Shim 4 , Ji Hyun Lee 1 , Yejeong Han 1 , Beung-Chul Ahn 1 , Min Hee Hong 1 , Hye Ryun Kim 1 , Byoung Chul Cho 1 , Arthur Cho 5 , Sun Min Lim 6
1 Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Republic of Korea.
2 Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
3 Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Republic of Korea.
4 Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
5 Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
6 Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Centre, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
- 키워드
- 18F-FDG PET/CT; chemoimmunotherapy; non-small-cell lung cancer; predictive model; treatment outcome.
- 덧글달기
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편집위원
18F-FDG PET CT로 화학면역치료를 시행 받는 advanced non-small-cell lung cancer 환자에서 예후를 예측할 수 있음을 보여준 임상연구임. 해당 치료시행에 PET 검사의 유용성을 보여주어 핵의학검사의 활성화에 도움이될 것으로 보이며 폐암관련 임상가 및 핵의학 연구자에게 관심을 끌 연구로 생각됨.
덧글달기닫기2022-03-07 17:37:06
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