Department of Molecular Imaging & Therapy, Austin Health, 145 Studley Road, Heidelberg, Victoria, 3084, Australia.
Olivia Newton-John Cancer Research Institute; and School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia.
Eur J Nucl Med Mol Imaging. 2021 Feb;48(2):428-448. doi: 10.1007/s00259-020-04967-9. Epub 2020 Jul 29.
To investigate the ability of F-FDG PET/CT to assess the response of patients with metastatic melanoma to immunotherapy.
A comprehensive search of the literature for studies examining the prognostic value of F-FDG PET/CT in monitoring the response of patients with metastatic melanoma to immunotherapy was performed. We also screened the references of the selected articles to identify any other relevant studies. Detailed data were extracted and categorized. Comprehensive meta-analysis software was used for analysis.
Twenty four eligible articles were included in the systematic review. Based on the baseline F-FDG PET/CT imaging, the pooled hazard ratios of MTV, SLR, SUV/SULmax, SUV/SULpeak, and TLG for overall survival (OS) were 1.777 (95%CI: 1.389-2.275, p < 0.001), 3.425 (95%CI: 1.707-6.869, p = 0.001), 0.941 (95%CI: 0.599-1.477, p = 0.791), 1.704 (95%CI: 1.253-2.316, p = 0.016), and 1.755 (95%CI: 1.315-2.342, p < 0.001), respectively. The conventional and modified response assessment criteria exhibited a pooled sensitivity of 64% (95%CI: 46-79%) and 94% (95%CI: 81-99%) and a pooled specificity of 80% (95%CI: 59-93%) and 84% (95%CI: 64-95%), respectively, for the early F-FDG PET/CT scan. On the other hand, based on the late F-FDG PET/CT scan, the pooled sensitivity of 67% (95%CI: 35-90%) and 92% (95%CI: 73-99%) and pooled specificity of 77% (95%CI: 56-91%) and 76% (95%CI: 50-93%) were observed for the conventional and modified criteria, respectively. PET-detectable immune-related adverse events (irAEs) were associated with the response to therapy.
The baseline SUVpeak, MTV, and TLG parameters represent promising predictors of the final response of metastatic melanoma patients to immunotherapy. Modified response assessment criteria are potentially an appropriate method for monitoring immunotherapy. irAEs are also valuable for predicting eventual clinical benefit of treatment.
探讨 F-FDG PET/CT 评估转移性黑色素瘤患者对免疫治疗反应的能力。
对评估 F-FDG PET/CT 在监测转移性黑色素瘤患者对免疫治疗反应中的预后价值的文献进行全面检索。我们还筛选了选定文章的参考文献，以确定任何其他相关研究。提取并分类详细数据。使用综合荟萃分析软件进行分析。
共纳入 24 项系统性综述研究。基于基线 F-FDG PET/CT 成像，MTV、SLR、SUV/SULmax、SUV/SULpeak 和 TLG 对总生存期（OS）的合并危险比分别为 1.777（95%CI：1.389-2.275，p<0.001）、3.425（95%CI：1.707-6.869，p=0.001）、0.941（95%CI：0.599-1.477，p=0.791）、1.704（95%CI：1.253-2.316，p=0.016）和 1.755（95%CI：1.315-2.342，p<0.001）。传统和改良的反应评估标准显示，早期 F-FDG PET/CT 扫描的合并敏感性分别为 64%（95%CI：46-79%）和 94%（95%CI：81-99%），特异性分别为 80%（95%CI：59-93%）和 84%（95%CI：64-95%）。另一方面，基于晚期 F-FDG PET/CT 扫描，传统和改良标准的合并敏感性分别为 67%（95%CI：35-90%）和 92%（95%CI：73-99%），特异性分别为 77%（95%CI：56-91%）和 76%（95%CI：50-93%）。PET 检测到的免疫相关不良事件（irAEs）与治疗反应相关。
基线 SUVpeak、MTV 和 TLG 参数是预测转移性黑色素瘤患者对免疫治疗最终反应的有前途的指标。改良的反应评估标准可能是监测免疫治疗的一种合适方法。irAEs 对于预测治疗的最终临床获益也很有价值。
