放射性标记抗PD-L1肽PET/CT在预测新辅助免疫治疗联合化疗对可切除非小细胞肺癌疗效中的应用
Radiolabelled anti-PD-L1 peptide PET/CT in predicting the efficacy of neoadjuvant immunotherapy combined with chemotherapy in resectable non-small cell lung cancer.
作者信息
Zhou Xin, Yan Shi, Li Dan, Zhu Hua, Liu Bing, Liu Shiwei, Zhao Wei, Yang Zhi, Wu Nan, Li Nan
机构信息
State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China.
Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd., Beijing, 100142, China.
出版信息
Ann Nucl Med. 2025 Apr;39(4):364-372. doi: 10.1007/s12149-024-02009-0. Epub 2024 Dec 14.
BACKGROUND
This study aimed to evaluate the predictive value of baseline PD-L1 targeted peptide Ga-NOTA-WL12 PET/CT in neoadjuvant immunotherapy combined with chemotherapy of resectable NSCLC.
METHODS
Patients with resectable NSCLC (n = 20) enrolled in this prospective study received baseline paired Ga-NOTA-WL12 PET/CT and F-FDG PET/CT. After 2-4 cycles of toripalimab plus nab-paclitaxel and cisplatin, surgery was performed if R0 resection was available. The major pathologic response (MPR) state of the post-operative specimen was recorded. The imaging parameters of the Ga-NOTA-WL12 PET/CT, F-FDG PET/CT and CT between the MPR and non-MPR groups and their predictive efficacy of MPR were compared.
RESULTS
Among 20 patients, 17 patients underwent surgery, 10 achieved an MPR and 7 did not. The SUV and tumour-to-blood pool (TBR) of baseline Ga-NOTA-WL12 in the MPR group were higher than those in the non-MPR group, and the difference in TBR was statistically significant. The ΔSUL% of F-FDG exhibited differences between the MPR and non-MPR groups with no significance. Baseline F-FDG PET/CT parameters and ΔD% failed to differentiate the two groups. The areas under the ROC curves of SUV, TBR in Ga-NOTA-WL12 PET/CT, ΔD% and ΔSUL% in F-FDG PET/CT were 0.76, 0.79, 0.71 and 0.80, respectively, in predicting MPR.
CONCLUSION
Baseline Ga-NOTA-WL12 PET/CT has a potential to predict the pathological response of neoadjuvant immunotherapy combined with chemotherapy in patients with resectable NSCLC, whose efficacy is comparable to that of therapy evaluations employing baseline and follow-up CT and F-FDG PET/CT examinations.
TRIAL REGISTRATION
NCT04304066, registered 13 November 2020, https://register.
CLINICALTRIALS
gov/prs/app/action/SelectProtocol?sid=S000AEI9&selectaction=Edit&uid=U000503E&ts=2&cx=-awajet .
背景
本研究旨在评估基线程序性死亡受体配体1（PD-L1）靶向肽镓-氮杂环辛四酸- WL12正电子发射断层扫描/计算机断层扫描（Ga-NOTA-WL12 PET/CT）在可切除非小细胞肺癌新辅助免疫治疗联合化疗中的预测价值。
方法
本前瞻性研究纳入20例可切除非小细胞肺癌患者，均接受基线配对的Ga-NOTA-WL12 PET/CT和氟代脱氧葡萄糖（F-FDG）PET/CT检查。在接受2 - 4周期的替雷利珠单抗联合白蛋白结合型紫杉醇和顺铂治疗后，若能实现R0切除则进行手术。记录术后标本的主要病理反应（MPR）状态。比较MPR组和非MPR组之间Ga-NOTA-WL12 PET/CT、F-FDG PET/CT及计算机断层扫描（CT）的影像参数及其对MPR的预测效能。
结果
20例患者中，17例接受了手术，10例达到MPR，7例未达到。MPR组基线Ga-NOTA-WL12的标准摄取值（SUV）和肿瘤与血池比值（TBR）高于非MPR组，且TBR差异具有统计学意义。F-FDG的标准化摄取值变化百分比（ΔSUL%）在MPR组和非MPR组之间存在差异，但无统计学意义。基线F-FDG PET/CT参数及直径变化百分比（ΔD%）未能区分两组。Ga-NOTA-WL12 PET/CT中的SUV、TBR，F-FDG PET/CT中的ΔD%和ΔSUL%在预测MPR时的受试者工作特征曲线下面积分别为0.76、0.79、0.71和0.80。
结论
基线Ga-NOTA-WL12 PET/CT有可能预测可切除非小细胞肺癌患者新辅助免疫治疗联合化疗的病理反应，其效能与采用基线及随访CT和F-FDG PET/CT检查进行疗效评估相当。
试验注册
NCT04304066，于2020年11月13日注册，https://register.
临床试验
gov/prs/app/action/SelectProtocol?sid=S000AEI9&selectaction=Edit&uid=U000503E&ts=2&cx=-awajet 。
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