Baseline metabolic tumor volume as a strong predictive and prognostic biomarker in patients with non-small cell lung cancer treated with PD1 inhibitors: a prospective study
Open Access
- 23 July 2020
- journal article
- research article
- Published by BMJ in Journal for ImmunoTherapy of Cancer
- Vol. 8 (2), e000645
- https://doi.org/10.1136/jitc-2020-000645
Abstract
Background Reliable predictive and prognostic markers are still lacking for patients treated with programmed death receptor 1 (PD1) inhibitors for non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the prognostic and predictive values of different baseline metabolic parameters, including metabolic tumor volume (MTV), from 18F-fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET/CT) scans in patients with NSCLC treated with PD1 inhibitors. Methods Maximum and peak standardized uptake values, MTV and total lesion glycolysis (TLG), as well as clinical and biological parameters, were recorded in 75 prospectively included patients with NSCLC treated with PD1 inhibitors. Associations between these parameters and overall survival (OS) were evaluated as well as their accuracy to predict early treatment discontinuation (ETD). Results A high MTV and a high TLG were significantly associated with a lower OS (p3) was 10.5 months (95% CI: 6.2 to upper limit: unreached), while the median OS in patients with MTV below the median was not reached. Patients with no prior chemotherapy had a poorer OS than patients who had received prior systemic treatment (p=0.04). MTV and TLG could reliably predict ETD (area under the receiver operating characteristic curve=0.76, 95% CI: 0.65 to 0.87 and 0.72, 95% CI: 0.62 to 0.84, respectively). Conclusion MTV is a strong prognostic and predictive factor in patients with NSCLC treated with PD1 inhibitors and can be easily determined from routine 18F-FDG PET/CT scans. MTV, could help to personalize immunotherapy and be used to stratify patients in future clinical studies.Keywords
Funding Information
- GIRCI Méditérannée, France (Bourse Recherche GIRCI Méditérannée)
This publication has 34 references indexed in Scilit:
- Nivolumab versus Docetaxel in Advanced Nonsquamous Non–Small-Cell Lung CancerNew England Journal of Medicine, 2015
- Nivolumab versus Docetaxel in Advanced Squamous-Cell Non–Small-Cell Lung CancerNew England Journal of Medicine, 2015
- Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysisEuropean Journal of Nuclear Medicine and Molecular Imaging, 2014
- The role of metabolic tumor volume and total lesion glycolysis on 18F-FDG PET/CT in the prognosis of epithelial ovarian cancerEuropean Journal of Nuclear Medicine and Molecular Imaging, 2014
- Baseline metabolic tumour volume is an independent prognostic factor in Hodgkin lymphomaEuropean Journal of Nuclear Medicine and Molecular Imaging, 2014
- Fiji: an open-source platform for biological-image analysisNature Methods, 2012
- FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0European Journal of Nuclear Medicine and Molecular Imaging, 2009
- Standards for PET Image Acquisition and Quantitative Data AnalysisJournal of Nuclear Medicine, 2009
- Efficacy and Safety of Two Doses of Pemetrexed Supplemented with Folic Acid and Vitamin B12 in Previously Treated Patients with Non-Small Cell Lung CancerClinical Cancer Research, 2008
- Molecular analysis of the RET and NTRK1 gene rearrangements in papillary thyroid carcinoma in the Polish populationMutation Research, 2006