Malet Julie, Ancel Julien, Moubtakir Abdenasser, Papathanassiou Dimitri, Deslée Gaëtan, Dewolf Maxime
Department of Respiratory Diseases, Reims University Hospital, 45, Rue Cognacq-Jay, 51100 Reims, France.
INSERM UMRS 1250, University of Reims Champagne-Ardenne, 51100 Reims, France.
Life (Basel). 2023 Apr 20;13(4):1051. doi: 10.3390/life13041051.
Anti-PD-1/PD-L1 therapy indications are broadened in non-small cell lung cancer (NSCLC) although immune checkpoint inhibitors (ICI) do not provide benefits for the entire population. Texture features based on positron emission tomography/computed tomography (PET/CT), especially entropy (based on a gray-level co-occurrence matrix (GLCM)), could be interesting as predictors in NSCLC. The aim of our retrospective study was to evaluate the association between GLCM-entropy and response to anti-PD-1/PD-L1 monotherapy at the first evaluation in stage III or IV NSCLC, comparing patients with progressive disease (PD) and non-progressive disease (non-PD). In total, 47 patients were included. Response Evaluation Criteria in Solid Tumors (RECIST 1.1) were used to evaluate the response to ICI treatment (nivolumab, pembrolizumab, or atezolizumab). At the first evaluation, 25 patients were PD and 22 were non-PD. GLCM-entropy was not predictive of response at the first evaluation. Furthermore, GLCM-entropy was not associated with progression-free survival (PFS) ( = 0.393) or overall survival (OS) ( = 0.220). Finally, GLCM-entropy measured in PET/CT performed before ICI initiation in stage III or IV NSCLC was not predictive of response at the first evaluation. However, this study demonstrates the feasibility of using texture parameters in routine clinical practice. The interest of measuring PET/CT texture parameters in NSCLC remains to be evaluated in larger prospective studies.
尽管免疫检查点抑制剂（ICI）并非对所有非小细胞肺癌（NSCLC）患者都有益，但抗PD - 1/PD - L1疗法在NSCLC中的适应症正在扩大。基于正电子发射断层扫描/计算机断层扫描（PET/CT）的纹理特征，尤其是熵（基于灰度共生矩阵（GLCM）），作为NSCLC的预测指标可能具有研究价值。我们这项回顾性研究的目的是评估在III期或IV期NSCLC患者首次评估时，GLCM - 熵与抗PD - 1/PD - L1单药治疗反应之间的关联，比较疾病进展（PD）和疾病未进展（非PD）的患者。总共纳入了47例患者。实体瘤疗效评价标准（RECIST 1.1）用于评估ICI治疗（纳武单抗、派姆单抗或阿特珠单抗）的反应。在首次评估时，25例患者疾病进展，22例患者疾病未进展。GLCM - 熵在首次评估时不能预测反应。此外，GLCM - 熵与无进展生存期（PFS）（ = 0.393）或总生存期（OS）（ = 0.220）均无关联。最后，在III期或IV期NSCLC患者开始ICI治疗前进行的PET/CT检查中测量的GLCM - 熵，在首次评估时不能预测反应。然而，本研究证明了在常规临床实践中使用纹理参数的可行性。在更大规模的前瞻性研究中仍有待评估测量NSCLC患者PET/CT纹理参数的意义。
