Burgermeister Simon, Gabryś Hubert S, Basler Lucas, Hogan Sabrina A, Pavic Matea, Bogowicz Marta, Martínez Gómez Julia M, Vuong Diem, Tanadini-Lang Stephanie, Foerster Robert, Huellner Martin W, Dummer Reinhard, Levesque Mitchell P, Guckenberger Matthias
Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Department of Dermatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Front Oncol. 2022 Apr 14;12:830627. doi: 10.3389/fonc.2022.830627. eCollection 2022.
We explored imaging and blood bio-markers for survival prediction in a cohort of patients with metastatic melanoma treated with immune checkpoint inhibition.
94 consecutive metastatic melanoma patients treated with immune checkpoint inhibition were included into this study. PET/CT imaging was available at baseline (Tp0), 3 months (Tp1) and 6 months (Tp2) after start of immunotherapy. Radiological response at Tp2 was evaluated using iRECIST. Total tumor burden (TB) at each time-point was measured and relative change of TB compared to baseline was calculated. LDH, CRP and S-100B were also analyzed. Cox proportional hazards model and logistic regression were used for survival analysis.
iRECIST at Tp2 was significantly associated with overall survival (OS) with C-index=0.68. TB at baseline was not associated with OS, whereas TB at Tp1 and Tp2 provided similar predictive power with C-index of 0.67 and 0.71, respectively. Appearance of new metastatic lesions during follow-up was an independent prognostic factor (C-index=0.73). Elevated LDH and S-100B ratios at Tp2 were significantly associated with worse OS: C-index=0.73 for LDH and 0.73 for S-100B. Correlation of LDH with TB was weak (r=0.34). A multivariate model including TB change, S-100B, and appearance of new lesions showed the best predictive performance with C-index=0.83.
Our analysis shows only a weak correlation between LDH and TB. Additionally, baseline TB was not a prognostic factor in our cohort. A multivariate model combining early blood and imaging biomarkers achieved the best predictive power with regard to survival, outperforming iRECIST.
我们在一组接受免疫检查点抑制治疗的转移性黑色素瘤患者中探索了用于生存预测的影像学和血液生物标志物。
本研究纳入了94例连续接受免疫检查点抑制治疗的转移性黑色素瘤患者。在免疫治疗开始后的基线期（Tp0）、3个月（Tp1）和6个月（Tp2）可获得PET/CT影像。使用iRECIST评估Tp2时的放射学反应。测量每个时间点的总肿瘤负荷（TB），并计算与基线相比TB的相对变化。还分析了乳酸脱氢酶（LDH）、C反应蛋白（CRP）和S-100B。采用Cox比例风险模型和逻辑回归进行生存分析。
Tp2时的iRECIST与总生存期（OS）显著相关，C指数=0.68。基线时的TB与OS无关，而Tp1和Tp2时的TB具有相似的预测能力，C指数分别为0.67和0.71。随访期间出现新的转移病灶是一个独立的预后因素（C指数=0.73）。Tp2时LDH和S-100B比值升高与较差的OS显著相关：LDH的C指数=0.73，S-100B的C指数=0.73。LDH与TB的相关性较弱（r=0.34）。一个包含TB变化、S-100B和新病灶出现情况的多变量模型显示出最佳的预测性能，C指数=0.83。
我们的分析表明LDH与TB之间只有微弱的相关性。此外，基线TB在我们的队列中不是一个预后因素。一个结合早期血液和影像学生物标志物的多变量模型在生存预测方面具有最佳的预测能力，优于iRECIST。
