Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Division of Endocrinology and Diabetes, Department of Medicine I, University Hospital, University of Würzburg, Wurzburg, Germany.
Eur J Nucl Med Mol Imaging. 2024 Oct;51(12):3643-3650. doi: 10.1007/s00259-024-06800-z. Epub 2024 Jun 19.
In patients affected with adrenocortical carcinoma (ACC), C-X-C motif chemokine receptor 4 (CXCR4) is highly expressed in sites of disease in an ex-vivo setting. We aimed to determine the predictive value of CXCR4-targeting [Ga]Ga-PentixaFor PET/CT for outcome when compared to clinical parameters.
We identified 41 metastasized ACC patients imaged with [Ga]Ga-PentixaFor PET/CT. Scans were assessed visually and on a quantitative level by manually segmenting the tumor burden (providing tumor volume [TV], peak/mean/maximum standardized uptake values [SUV] and tumor chemokine receptor binding on the cell surface [TRB], defined as SUV multiplied by tumor volume). Clinical parameters included sex, previous therapies, age, Weiss-Score, and Ki67 index. Following imaging, overall survival (OS) was recorded.
After [Ga]Ga-PentixaFor PET/CT, median OS was 9 months (range, 1-96 months). On univariable analysis, only higher TRB (per 10 ml, HR 1.004, 95%CI: 1.0001-1.007, P = 0.005) and presence of CXCR4-positive peritoneal metastases (PM) were associated with shorter OS (HR 2.03, 95%CI: 1.03-4.02, P = 0.04). Presence of CXCR4-positive liver metastases (LM) trended towards significance (HR 1.85, 0.9-4.1, P = 0.11), while all other parameters failed to predict survival. On multivariable analysis, only TRB was an independent predictor for OS (HR 1.0, 95%CI: 1.00-1.001, P = 0.02). On Kaplan-Meier analysis, TRB above median (13.3 months vs. below median, 6.4 months) and presence of CXCR4-positive PM (6.4 months, vs. no PM, 11.4 months) were associated with shorter survival (P < 0.05, respectively). Presence of LM, however, was also linked to less favorable outcome (8.5 months vs. no LM, 18.1 months), without reaching significance (P = 0.07).
In advanced ACC, elevated tumor chemokine receptor binding on the tumor cell surface detected through [Ga]Ga-PentixaFor PET/CT is an independent predictor for OS, while other imaging and clinical parameters failed to provide relevant prognostic information.
在患有肾上腺皮质癌（ACC）的患者中，C-X-C 基序趋化因子受体 4（CXCR4）在疾病部位高表达。我们旨在确定与临床参数相比，靶向 CXCR4 的 [Ga]Ga-PentixaFor PET/CT 对预后的预测价值。
我们鉴定了 41 例转移的 ACC 患者，这些患者接受了 [Ga]Ga-PentixaFor PET/CT 成像。扫描通过手动分割肿瘤负荷进行视觉评估和定量评估（提供肿瘤体积[TV]、峰值/平均/最大标准化摄取值[SUV]和肿瘤趋化因子受体在细胞表面的结合[TRB]，定义为 SUV 乘以肿瘤体积）。临床参数包括性别、既往治疗、年龄、Weiss 评分和 Ki67 指数。成像后记录总生存期（OS）。
在 [Ga]Ga-PentixaFor PET/CT 后，中位 OS 为 9 个月（范围 1-96 个月）。在单变量分析中，只有更高的 TRB（每 10ml，HR 1.004，95%CI：1.0001-1.007，P=0.005）和存在 CXCR4 阳性腹膜转移（PM）与较短的 OS 相关（HR 2.03，95%CI：1.03-4.02，P=0.04）。存在 CXCR4 阳性肝转移（LM）也有意义（HR 1.85，95%CI：0.9-4.1，P=0.11），而所有其他参数均无法预测生存。在多变量分析中，只有 TRB 是 OS 的独立预测因素（HR 1.0，95%CI：1.00-1.001，P=0.02）。在 Kaplan-Meier 分析中，TRB 高于中位数（13.3 个月与低于中位数，6.4 个月）和存在 CXCR4 阳性 PM（6.4 个月，与无 PM，11.4 个月）与较短的生存相关（P<0.05，分别）。然而，存在 LM 也与预后不良相关（8.5 个月，与无 LM，18.1 个月），但无统计学意义（P=0.07）。
在晚期 ACC 中，通过 [Ga]Ga-PentixaFor PET/CT 检测到肿瘤细胞表面升高的肿瘤趋化因子受体结合是 OS 的独立预测因素，而其他成像和临床参数未能提供相关的预后信息。
Zotero 插件