Gupta Manoj, Choudhury Partha S, Jain Parveen, Sharma Manish, Koyyala Venkata P B, Goyal Sumit, Agarwal Chaturbhuj, Jajodia Ankush, Pasricha Sunil, Sharma Anurag, Batra Ullas
Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India.
Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India.
World J Nucl Med. 2022 Mar 9;21(1):34-43. doi: 10.1055/s-0042-1744201. eCollection 2022 Mar.
We compared the immune response evaluation criteria in solid tumors (iRECIST) with immune adaptive positron emission tomography response criteria in solid tumors (imPERCIST) in lung cancer patients treated with nivolumab. Twenty lung cancer patients underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) scan at baseline (PET-0), after four cycles (PET-1) and six to eight cycles (PET-2) of nivolumab were included. Kappa coefficient ( ) was derived to see the level of agreement in two response criteria. Progression-free survival (PFS) curves were computed by the Kaplan-Meier method and compared with the Log Rank test. Univariate and multivariate regression for the percentage change in the sum of diameters (SoD), standard uptake value maximum (SUVmax), sum of metabolic tumor volume (SoMTV), and sum of total lesion glycolysis (SoTLG) was computed. A -value less than 0.05 was considered significant. Kappa coefficient showed a substantial level of agreement (k 0.769) in two response criteria. Mean PFS in partial response, stable disease, and progressive disease (PD) patients in iRECIST and imPERCIST was 27.3, 17.7, 4.2, and 23.3, 18.8, 3.8 months, respectively. The Kaplan-Meier method with the log rank test showed a significant difference in PFS on intracomparison within both criteria; however, it was not significant on intercomparison. On univariate analysis, the percentage change in SoD, SoMTV, SoTLG was significant. However, on multivariate analysis, only percentage change in SoD was a significant predictor. We concluded that imPERCIST was equally effective as currently recommended criteria iRECIST for response evaluation of nivolumab in lung cancer patients.
我们比较了接受纳武单抗治疗的肺癌患者中实体瘤免疫反应评估标准（iRECIST）与实体瘤免疫适应性正电子发射断层扫描反应标准（imPERCIST）。纳入了20例肺癌患者，在基线期（PET-0）、纳武单抗治疗四个周期后（PET-1）以及六至八个周期后（PET-2）进行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）检查。计算kappa系数（ ）以观察两种反应标准的一致程度。采用Kaplan-Meier方法计算无进展生存期（PFS）曲线，并通过对数秩检验进行比较。计算直径总和（SoD）、最大标准摄取值（SUVmax）、代谢肿瘤体积总和（SoMTV）以及总病变糖酵解总和（SoTLG）的百分比变化的单因素和多因素回归分析。P值小于0.05被认为具有统计学意义。
kappa系数显示两种反应标准具有较高的一致程度（k = 0.769）。iRECIST和imPERCIST标准中部分缓解、疾病稳定和疾病进展（PD）患者的平均PFS分别为27.3、17.7、4.2个月和23.3、18.8、3.8个月。采用对数秩检验的Kaplan-Meier方法显示，两种标准各自内部比较的PFS有显著差异；然而，两种标准之间的比较无显著差异。单因素分析中，SoD、SoMTV、SoTLG的百分比变化具有统计学意义。然而，多因素分析中，只有SoD的百分比变化是显著的预测因素。
我们得出结论，对于肺癌患者纳武单抗反应评估，imPERCIST与当前推荐的标准iRECIST同样有效。
