Romain-David Seban1, Jean-Baptiste Assie2,3, Etienne Giroux-Leprieur4, Marie-Ange Massiani5, Michael Soussan6, Gérald Bonardel7, Christos Chouaid2, Margot Playe6, Lucas Goldfarb6, Boris Duchemann8, Nicolas Girard9, Laurence Champion10. 1. Department of Nuclear Medicine, Institut Curie, Saint-Cloud, 92210, Saint-Cloud, France. romain.seban@gmail.com. 2. Department of Pneumology, Paris-Est University, Centre Hospitalier Inter-Communal de Créteil, Inserm U955, UPEC, IMRB, Équipe CEpiA, Créteil, France. 3. Centre de Recherche Des Cordeliers, Inserm, Functional Genomics of Solid Tumors Laboratory, Sorbonne Université, Université de Paris, 75006, Paris, France. 4. Department of Respiratory Diseases and Thoracic Oncology, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France. 5. Department of Medical Oncology, Institut Curie, Saint-Cloud, France. 6. Department of Nuclear Medicine, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France. 7. Department of Nuclear Medicine, Centre Cardiologique du Nord, Saint-Denis, France. 8. Department of Medical Oncology, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France. 9. Institut du Thorax Curie Montsouris, Institut Curie, Paris, France. 10. Department of Nuclear Medicine, Institut Curie, Saint-Cloud, 92210, Saint-Cloud, France.
Abstract
OBJECTIVE: To determine FDG-PET biomarkers associated with long-term benefit (LTB) and survival in advanced non-small cell lung cancer (NSCLC) patients receiving first-line immunotherapy. METHODS: In this multicenter study, we retrospectively analyzed advanced NSCLC patients with a PD-L1 tumor proportion score (TPS) ≥ 50%, who underwent FDG-PET/CT before first-line pembrolizumab, received from August 2017 to September 2019. Parameters extracted were SUVmax, SUVmean, TMTV (total metabolic tumor volume) and TLG (total lesion glycolysis). LTB was defined as objective (complete or partial) response or stable disease as best overall response, maintained for ≥ 12 months. A multivariate prediction model was developed using logistic regression for LTB and Cox models for progression-free survival (PFS) and overall survival (OS). RESULTS: On the 63 eligible patients, with a median follow-up of 13.4 (range, 1.5-29.1) months, 17 (27%) had LTB. Median PFS and OS were 7.7 months (95%CI 5.0-10.5) and 12.1 months (95%CI 8.6-15.6). In multivariate analyses, high TMTV (> 84cm3) and high tumor SUVmean (> 10.1) remained independent factors for predicting LTB (OR 0.2; p = 0.03 and OR 3.7; p = 0.04) and PFS (HR 2.2; p = 0.02 and HR 0.5; p = 0.045). High TMTV was significantly associated with poor OS (HR 3.1; p = 0.03). No association was observed between tumor SUVmax or TLG and clinical outcomes. CONCLUSIONS: In patients with advanced NSCLC and PD-L1 TPS ≥ 50%, baseline low TMTV and high tumor SUVmean correlate with survival and LTB from upfront pembrolizumab. Beyond the initial staging, FDG-PET/CT scan could provide relevant biomarkers associated with clinical outcomes that should be taken into account when considering first-line treatment options.
OBJECTIVE: To determine FDG-PET biomarkers associated with long-term benefit (LTB) and survival in advanced non-small cell lung cancer (NSCLC) patients receiving first-line immunotherapy. METHODS: In this multicenter study, we retrospectively analyzed advanced NSCLCpatients with a PD-L1 tumor proportion score (TPS) ≥ 50%, who underwent FDG-PET/CT before first-line pembrolizumab, received from August 2017 to September 2019. Parameters extracted were SUVmax, SUVmean, TMTV (total metabolic tumor volume) and TLG (total lesion glycolysis). LTB was defined as objective (complete or partial) response or stable disease as best overall response, maintained for ≥ 12 months. A multivariate prediction model was developed using logistic regression for LTB and Cox models for progression-free survival (PFS) and overall survival (OS). RESULTS: On the 63 eligible patients, with a median follow-up of 13.4 (range, 1.5-29.1) months, 17 (27%) had LTB. Median PFS and OS were 7.7 months (95%CI 5.0-10.5) and 12.1 months (95%CI 8.6-15.6). In multivariate analyses, high TMTV (> 84cm3) and high tumor SUVmean (> 10.1) remained independent factors for predicting LTB (OR 0.2; p = 0.03 and OR 3.7; p = 0.04) and PFS (HR 2.2; p = 0.02 and HR 0.5; p = 0.045). High TMTV was significantly associated with poor OS (HR 3.1; p = 0.03). No association was observed between tumor SUVmax or TLG and clinical outcomes. CONCLUSIONS: In patients with advanced NSCLC and PD-L1 TPS ≥ 50%, baseline low TMTV and high tumor SUVmean correlate with survival and LTB from upfront pembrolizumab. Beyond the initial staging, FDG-PET/CT scan could provide relevant biomarkers associated with clinical outcomes that should be taken into account when considering first-line treatment options.
Authors: David Lang; Linda Ritzberger; Vanessa Rambousek; Andreas Horner; Romana Wass; Kaveh Akbari; Bernhard Kaiser; Jürgen Kronbichler; Bernd Lamprecht; Michael Gabriel Journal: Cancers (Basel) Date: 2021-12-03 Impact factor: 6.639
Authors: A Flaus; V Habouzit; N De Leiris; J P Vuillez; M T Leccia; J L Perrot; N Prevot; F Cachin Journal: Sci Rep Date: 2021-09-22 Impact factor: 4.379