Wang Kaiyue, Wang Xiaohan, Meng Xue, Zhang Guodong, Cai Guoxin
School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Jinan, 250117, Shandong, China.
Ann Nucl Med. 2025 May 10. doi: 10.1007/s12149-025-02057-0.
This study aims to predict the pathological response of patients with non-small cell lung cancer (NSCLC) in prospective trials of neoadjuvant camrelizumab combined with chemotherapy by integrating the clinical characteristics, PET-associated parameters, and hematological indicators.
A prospective analysis was conducted among 24 patients undergoing surgery after neoadjuvant camrelizumab plus chemotherapy. F-Fluorodeoxyglucose (FDG) scans were performed before and after neoadjuvant therapy (pre-NAT, post-NAT). Tumor and secondary lymphoid organ metabolic parameters, along with circulating inflammatory and immune indicators, were measured and correlated with pathological response. Receiver operating characteristic (ROC) curve was used to assess biomarkers' predictive accuracy.
Major pathological response (MPR) and pathological complete response (pCR) were achieved in 45.8% (11/24) and 33.3% (8/24) of patients. Before treatment, patients who achieved a pCR had significantly greater SUVmax values (p = 0.011) than non-pCR patients. After treatment, the MPR group exhibited significantly lower SUVmax values than the non-MPR group (p = 0.048). The rate of change in the SUVmax (ΔSUVmax%) differed significantly between the pCR and non-pCR groups (p = 0.019) and between the MPR and non-MPR groups (p = 0.013). After NAT, the lymph nodes' SUVmax in the ypN0 group was significantly lower than that in the ypN + group (p = 0.032). ROC analysis indicated that pre-NAT SUVmax and ΔSUVmax% best distinguished pCR and MPR patients, respectively, with AUCs of 0.82 (p = 0.012) and 0.80 (p = 0.014).
Pre-NAT SUVmax, and ΔSUVmax% are promising biomarkers for predicting pathological response to neoadjuvant camrelizumab and chemotherapy.
NCT06241807.
本研究旨在通过整合临床特征、PET相关参数和血液学指标，在前瞻性新辅助卡瑞利珠单抗联合化疗试验中预测非小细胞肺癌（NSCLC）患者的病理反应。
对24例接受新辅助卡瑞利珠单抗联合化疗后手术的患者进行前瞻性分析。在新辅助治疗前后（NAT前、NAT后）进行F-氟脱氧葡萄糖（FDG）扫描。测量肿瘤和二级淋巴器官代谢参数以及循环炎症和免疫指标，并将其与病理反应相关联。采用受试者操作特征（ROC）曲线评估生物标志物的预测准确性。
45.8%（11/24）的患者达到主要病理反应（MPR），33.3%（8/24）的患者达到病理完全缓解（pCR）。治疗前，达到pCR的患者的SUVmax值显著高于未达到pCR的患者（p = 0.011）。治疗后，MPR组的SUVmax值显著低于非MPR组（p = 0.048）。SUVmax的变化率（ΔSUVmax%）在pCR组和非pCR组之间（p = 0.019）以及MPR组和非MPR组之间（p = 0.013）存在显著差异。NAT后，ypN0组淋巴结的SUVmax显著低于ypN+组（p = 0.032）。ROC分析表明，NAT前的SUVmax和ΔSUVmax%分别最能区分pCR和MPR患者，AUC分别为0.82（p = 0.012）和0.80（p = 0.014）。
NAT前的SUVmax和ΔSUVmax%是预测新辅助卡瑞利珠单抗和化疗病理反应的有前景的生物标志物。
NCT06241807。
