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正电子发射断层扫描预测恶性肿瘤免疫检查点抑制剂(ICIs)的预后价值。

Predictive value of positron emission tomography for the prognosis of immune checkpoint inhibitors (ICIs) in malignant tumors.

机构信息

Department of Oncology, The First Affiliated Hospital of Fujian Medical University, Chazhong Road No. 20, Fuzhou, 350005, Fujian, China.

出版信息

Cancer Immunol Immunother. 2020 Jun;69(6):927-936. doi: 10.1007/s00262-020-02515-w. Epub 2020 Feb 19.

Abstract

PURPOSE

This study aimed at investigating the value of applying positron emission tomography (PET) to early predict the effect of immune checkpoint inhibitors (ICIs) in malignant tumors.

METHODS

Electronic databases MEDLINE/PubMed, EMBASE, and Cochrane Library were searched to identify relevant trials. The primary endpoints were progression-free survival (PFS) and overall survival (OS). The results were analyzed utilizing Stata 12.0 statistical software. Subgroup analyses were implemented based on primary tumors, study designs, continents, type of ICIs, evaluation index of PET, and evaluated PET timing.

RESULTS

Fifteen studies incorporating 664 individuals were eligible. Compared with PET nonresponse group, PET response group displayed a significantly prolonged PFS (HR 0.27, 95% CI [0.16, 0.44]; P < 0.001) and OS (HR 0.56, 95% CI [0.48, 0.65]; P < 0.001). Analogical outcomes were obtained in subgroup analyses of PFS in non-small cell lung cancer, prospective, America, ipilimumab, nivolumab/pembrolizumab combined ipilimumab, PET Response Criteria in Solid Tumors (PERCIST), baseline PET and early PET timing arms without heterogeneity; so did OS in melanoma, retrospective, Europe, America, ipilimumab, nivolumab/pembrolizumab, PERCIST, baseline metabolic tissue volume, baseline standard uptake value, and baseline total lesion glycolysis, baseline PET timing, early PET timing and late PET timing arms.

CONCLUSION

Our study demonstrated that PET was a promising approach to early predict the prognosis of ICIs for malignancies.

摘要

目的

本研究旨在探讨正电子发射断层扫描(PET)在早期预测恶性肿瘤免疫检查点抑制剂(ICI)疗效中的价值。

方法

通过电子数据库 MEDLINE/PubMed、EMBASE 和 Cochrane Library 搜索相关试验。主要终点是无进展生存期(PFS)和总生存期(OS)。采用 Stata 12.0 统计软件进行结果分析。根据原发肿瘤、研究设计、大陆、ICI 类型、PET 评价指标和评价 PET 时间进行亚组分析。

结果

符合条件的 15 项研究共纳入 664 例患者。与 PET 无反应组相比,PET 反应组 PFS(HR 0.27,95%CI [0.16, 0.44];P<0.001)和 OS(HR 0.56,95%CI [0.48, 0.65];P<0.001)显著延长。在非小细胞肺癌、前瞻性、美国、伊匹单抗、纳武单抗/帕博利珠单抗联合伊匹单抗、实体瘤疗效评价标准(PERCIST)、基线 PET 和早期 PET 时间亚组的 PFS 中,也得到了类似的结果,无异质性;在黑色素瘤、回顾性、欧洲、美国、伊匹单抗、纳武单抗/帕博利珠单抗、PERCIST、基线代谢组织体积、基线标准摄取值、基线总肿瘤糖酵解、基线 PET 时间、早期 PET 时间和晚期 PET 时间亚组的 OS 中,也得到了类似的结果。

结论

本研究表明,PET 是一种有前途的早期预测恶性肿瘤 ICI 预后的方法。

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