FDG-PET biomarkers associated with long-term benefit from first-line immunotherapy in patients with advanced non-small c
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SHORT COMMUNICATION
FDG‑PET biomarkers associated with long‑term benefit from first‑line immunotherapy in patients with advanced non‑small cell lung cancer Romain‑David Seban1 · Jean‑Baptiste Assie2,3 · Etienne Giroux‑Leprieur4 · Marie‑Ange Massiani5 · Michael Soussan6 · Gérald Bonardel7 · Christos Chouaid2 · Margot Playe6 · Lucas Goldfarb6 · Boris Duchemann8 · Nicolas Girard9 · Laurence Champion1 Received: 17 July 2020 / Accepted: 7 October 2020 © The Japanese Society of Nuclear Medicine 2020
Abstract Objective To determine FDG-PET biomarkers associated with long-term benefit (LTB) and survival in advanced non-small cell lung cancer (NSCLC) patients receiving first-line immunotherapy. Methods In this multicenter study, we retrospectively analyzed advanced NSCLC patients with a PD-L1 tumor proportion score (TPS) ≥ 50%, who underwent FDG-PET/CT before first-line pembrolizumab, received from August 2017 to September 2019. Parameters extracted were SUVmax, SUVmean, TMTV (total metabolic tumor volume) and TLG (total lesion glycolysis). LTB was defined as objective (complete or partial) response or stable disease as best overall response, maintained for ≥ 12 months. A multivariate prediction model was developed using logistic regression for LTB and Cox models for progression-free survival (PFS) and overall survival (OS). Results On the 63 eligible patients, with a median follow-up of 13.4 (range, 1.5–29.1) months, 17 (27%) had LTB. Median PFS and OS were 7.7 months (95%CI 5.0–10.5) and 12.1 months (95%CI 8.6–15.6). In multivariate analyses, high TMTV (> 84cm3) and high tumor SUVmean (> 10.1) remained independent factors for predicting LTB (OR 0.2; p = 0.03 and OR 3.7; p = 0.04) and PFS (HR 2.2; p = 0.02 and HR 0.5; p = 0.045). High TMTV was significantly associated with poor OS (HR 3.1; p = 0.03). No association was observed between tumor SUVmax or TLG and clinical outcomes. Conclusions In patients with advanced NSCLC and PD-L1 TPS ≥ 50%, baseline low TMTV and high tumor SUVmean correlate with survival and LTB from upfront pembrolizumab. Beyond the initial staging, FDG-PET/CT scan could provide relevant biomarkers associated with clinical outcomes that should be taken into account when considering first-line treatment options. Keywords Lung cancer · Positron emission tomography · Long-term benefit · Biomarkers · Immunotherapy
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12149-020-01539-7) contains supplementary material, which is available to authorized users. * Romain‑David Seban [email protected] 1
Department of Nuclear Medicine, Institut Curie, Saint‑Cloud, 92210 Saint‑Cloud, France
Department of Pneumology, Paris-Est University, Centre Hospitalier Inter-Communal de Créteil, Inserm U955, UPEC, IMRB, Équipe CEpiA, Créteil, France
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Centre de Recherche Des Cordeliers, Inserm, Functional Genomics of Solid Tumors Laboratory, Sorbonne Université, Université de Paris, 75006 Paris, France
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Department of Medical Oncology, Institu
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