Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA.
Department of Data Science, Dana-Farber Cancer Institute, Boston MA.
JCO Precis Oncol. 2023 Mar;7:e2200603. doi: 10.1200/PO.22.00603.
Patients with oncogene-driven advanced non-small-cell lung cancer (NSCLC) treated with effective targeted therapy demonstrate characteristic tumor volume dynamics with initial response, nadir, and subsequent regrowth. This study investigated tumor volume nadir and time to nadir in patients with -rearranged advanced NSCLC treated with alectinib.
In patients with advanced -rearranged NSCLC treated with alectinib monotherapy, tumor volume dynamics were evaluated on serial computed tomography (CT) scans using a previously validated CT tumor measurement technique. A linear regression model was built to predict tumor volume nadir. Time-to-event analyses were performed to evaluate time to nadir.
Among 45 patients who experienced initial volume decrease, 37 patients (25 with tumor regrowth and 12 without regrowth but >6 months follow-up) were studied for nadir volume (V). The linear model to predict tumor volume nadir was built using the baseline tumor volume (V): V-V = .696 × V + 5,326 ( < 2 × 10; adjusted R = 0.86). The percent volume changes at nadir (median, -90.9%, mean, -85.3%) showed larger decrease in patients who were treated with alectinib as first-line therapy than in the ≥2nd-line group and were independent of V and clinical variables. Time to nadir had a median of 11.5 months and was longer in the first-line group ( = .04).
The tumor nadir volume in patients with -rearranged advanced NSCLC treated with alectinib can be predicted by the liner regression model and consists of approximately 30% of the baseline volume minus 5 cm, providing additional insights into precision therapy monitoring and potential guides for local ablative therapy to prolong disease control.
接受有效靶向治疗的驱动基因阳性晚期非小细胞肺癌（NSCLC）患者表现出初始反应、最低点和随后生长的特征性肿瘤体积动态。本研究调查了接受艾乐替尼治疗的 -重排晚期 NSCLC 患者的肿瘤体积最低点和达到最低点的时间。
在接受艾乐替尼单药治疗的 -重排晚期 NSCLC 患者中，使用先前验证的 CT 肿瘤测量技术在连续 CT 扫描上评估肿瘤体积动态。建立线性回归模型来预测肿瘤体积最低点。进行生存分析以评估达到最低点的时间。
在经历初始体积下降的 45 名患者中，有 37 名患者（25 名肿瘤有生长，12 名无生长但随访时间 > 6 个月）进行了最低点体积（V）的研究。用于预测肿瘤体积最低点的线性模型是使用基线肿瘤体积（V）构建的：V-V =.696 × V + 5,326（< 2 × 10；调整后的 R = 0.86）。最低点的体积变化百分比（中位数，-90.9%，平均值，-85.3%）在接受艾乐替尼一线治疗的患者中显示出更大的下降，与 V 和临床变量无关。达到最低点的时间中位数为 11.5 个月，一线组更长（=.04）。
接受艾乐替尼治疗的 -重排晚期 NSCLC 患者的肿瘤最低点体积可通过线性回归模型预测，最低点体积由基线体积减去约 30%减去 5 cm 组成，为精准治疗监测提供了更多见解，并为延长疾病控制的局部消融治疗提供了潜在指导。
