Hashimoto Kosuke, Kaira Kyoichi, Yamaguchi Ou, Mouri Atsuto, Shiono Ayako, Miura Yu, Murayama Yoshitake, Kobayashi Kunihiko, Kagamu Hiroshi, Kuji Ichiei
Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama 350-1298, Japan.
Department of Nuclear Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-City, Saitama 350-1298, Japan.
J Clin Med. 2020 Mar 7;9(3):725. doi: 10.3390/jcm9030725.
It remains unclear whether the accumulation of 2-deoxy-2-[F]fluoro-d-glucose (F-FDG) before the initiation of anti-programmed death-1 (PD-1) antibody can predict the outcome after its treatment. The aim of this study is to retrospectively examine the prognostic significance of F-FDG uptake as a predictive marker of anti-PD-1 antibody. Eighty-five patients with previously treated non-small cell lung cancer (NSCLC) who underwent F-FDG-positron emission tomography (PET) just before administration of nivolumab or pembrolizumab monotherapy were eligible in our study, and metabolic tumor volume (MTV), total lesion glycolysis (TLG) and the maximum of standardized under value (SUV) on F-FDG uptake were assessed. Objective response rate, median progression-free survival and median overall survival were 36.6%, 161 days and 716 days, respectively. The frequency of any immune-related adverse events was significantly higher in patients with low F-FDG uptake on PET than in those with high uptake. By multivariate analysis, the tumor metabolic activity by TLG and MTV was identified as an independent prognostic factor for predicting outcome after anti-PD-1 antibody therapy, but not SUV, predominantly in patients with adenocarcinoma. Metabolic tumor indices as TLG and MTV on F-FDG uptake could predict the prognosis after anti-PD-1 antibodies in patients with previously treated NSCLC.
在开始抗程序性死亡-1（PD-1）抗体治疗之前，2-脱氧-2-[F]氟-D-葡萄糖（F-FDG）的蓄积是否能够预测其治疗后的结果仍不清楚。本研究的目的是回顾性地研究F-FDG摄取作为抗PD-1抗体预测标志物的预后意义。在我们的研究中，85例先前接受过治疗的非小细胞肺癌（NSCLC）患者符合条件，这些患者在接受纳武单抗或派姆单抗单药治疗前刚进行了F-FDG正电子发射断层扫描（PET），并评估了代谢肿瘤体积（MTV）、总病变糖酵解（TLG）以及F-FDG摄取的标准化摄取值最大值（SUV）。客观缓解率、中位无进展生存期和中位总生存期分别为36.6%、161天和716天。PET上F-FDG摄取低的患者发生任何免疫相关不良事件的频率显著高于摄取高的患者。通过多因素分析，主要在腺癌患者中，由TLG和MTV所反映的肿瘤代谢活性被确定为预测抗PD-1抗体治疗后结果的独立预后因素，而SUV不是。F-FDG摄取上的TLG和MTV等代谢肿瘤指标可预测先前接受过治疗的NSCLC患者接受抗PD-1抗体治疗后的预后。
