Bauckneht Matteo, Genova Carlo, Rossi Giovanni, Rijavec Erika, Dal Bello Maria Giovanna, Ferrarazzo Giulia, Tagliamento Marco, Donegani Maria Isabella, Biello Federica, Chiola Silvia, Zullo Lodovica, Raffa Stefano, Lanfranchi Francesco, Cittadini Giuseppe, Marini Cecilia, Lopci Egesta, Sambuceti Gianmario, Grossi Francesco, Morbelli Silvia
IRCCS Ospedale Policlinico San Martino, Nuclear Medicine, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, UOC Clinica di Oncologia Medica, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
Cancers (Basel). 2021 Jun 22;13(13):3117. doi: 10.3390/cancers13133117.
An emerging clinical need is represented by identifying reliable biomarkers able to discriminate between responders and non-responders among patients showing imaging progression during the administration of immune checkpoints inhibitors for advanced non-small cell lung cancer (NSCLC). In the present study, we analyzed the prognostic power of peripheral-blood systemic inflammation indexes and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this clinical setting. In 45 patients showing radiological progression (defined as RECIST 1.1 progressive disease) during Nivolumab administration, the following lab and imaging parameters were collected: neutrophil-to-lymphocyte ratio (NLR), derived-NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), systemic inflammation index (SII), maximum standardized uptake value, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTV and SII independently predicted OS. Their combination in the immune metabolic prognostic index (IMPI) allowed the identification of patients who might benefit from immunotherapy continuation, despite radiological progression. The combination of FDG PET/CT volumetric data with SII also approximates the immune-metabolic response with respect to baseline, providing additional independent prognostic insights. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden, and their combination might disclose the radiological progression in NSCLC patients receiving Nivolumab.
对于接受免疫检查点抑制剂治疗的晚期非小细胞肺癌（NSCLC）患者，识别能够区分影像学进展患者中的反应者和无反应者的可靠生物标志物代表了一种新出现的临床需求。在本研究中，我们分析了外周血全身炎症指标和18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）在这种临床情况下的预后价值。在45例接受纳武单抗治疗期间出现放射学进展（定义为RECIST 1.1标准的疾病进展）的患者中，收集了以下实验室和影像学参数：中性粒细胞与淋巴细胞比值（NLR）、衍生NLR（dNLR）、淋巴细胞与单核细胞比值（LMR）、血小板与淋巴细胞比值（PLR）、全身炎症指数（SII）、最大标准化摄取值、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）。MTV和SII独立预测总生存期（OS）。它们在免疫代谢预后指数（IMPI）中的组合能够识别出尽管有放射学进展但可能从继续免疫治疗中获益的患者。FDG PET/CT体积数据与SII的组合也能近似相对于基线的免疫代谢反应，提供额外的独立预后见解。总之，全身炎症程度、代谢活跃肿瘤负荷的量化及其组合可能揭示接受纳武单抗治疗的NSCLC患者的放射学进展情况。
