Clinical nuclear medicine · 2025
Prognostic Value of 18F-FDG PET/CT in Neoadjuvant PD-1 Inhibitor-treated NSCLC: A Five-year Follow-up Study.
Клиническое исследование I фазыСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Tao Xiuli, Zhang Qian, Li Ning, Wang Shuhang, Guo Wei, Yuan Pei, Ying Jianming, Li Jing, Guo Lei, Tang Wei, Liu Ying, Zhang Zewei, Zhao Shijun, Gao Shugeng, Wu Ning
Аннотация
BACKGROUND: Neoadjuvant immunotherapy has shown promising short-term outcomes of perioperative treatments for resectable non-small cell lung cancer (NSCLC) and is expected to release long-term survival benefits. Here, we reported the long-term prognostic value of 18F-FDG PET/CT over ∼a 5-year follow-up.
PATIENTS AND METHODS: A total of 35 patients with NSCLC (29 males and 6 females; median age, 62 y) received 2 doses of sintilimab, followed by complete tumor resection and PET/CT scans at baseline and post-neoadjuvant stages. We investigated the prognostic value of PET/CT for overall survival (OS) and progression-free survival (PFS), focusing on metabolic parameters of primary tumors, mediastinal lymph nodes, lymphoid organs, and immune-related adverse events on imaging.
RESULTS: During a median follow-up of 62.6 months, patients with low primary tumor metabolism (SULmax ≤6.6, SULpeak ≤4.0/3.9, or SULmean ≤2.7) at post-neoadjuvant scan were alive and disease-free, demonstrating improved OS (P = 0.07, 0.07, and 0.09) and significantly enhanced PFS (P = 0.01, 0.02, and 0.02); those with low metabolic tumor volume ≤49.3 or total lesion glycolysis ≤41.0 at post-neoadjuvant scan also had significantly improved OS (P = 0.03 and 0.05). Patients with low lymph node metabolism (SULmax ≤4.6) at baseline scan had significantly improved PFS (P = 0.04).
CONCLUSIONS: This is the first study to report the long-term prognostic value of 18F-FDG PET/CT for resectable NSCLC after neoadjuvant immunotherapy. Low primary tumor metabolism at post-neoadjuvant scan and low lymph node metabolism at baseline scan are promising prognostic markers for improved clinical outcomes.
PATIENTS AND METHODS: A total of 35 patients with NSCLC (29 males and 6 females; median age, 62 y) received 2 doses of sintilimab, followed by complete tumor resection and PET/CT scans at baseline and post-neoadjuvant stages. We investigated the prognostic value of PET/CT for overall survival (OS) and progression-free survival (PFS), focusing on metabolic parameters of primary tumors, mediastinal lymph nodes, lymphoid organs, and immune-related adverse events on imaging.
RESULTS: During a median follow-up of 62.6 months, patients with low primary tumor metabolism (SULmax ≤6.6, SULpeak ≤4.0/3.9, or SULmean ≤2.7) at post-neoadjuvant scan were alive and disease-free, demonstrating improved OS (P = 0.07, 0.07, and 0.09) and significantly enhanced PFS (P = 0.01, 0.02, and 0.02); those with low metabolic tumor volume ≤49.3 or total lesion glycolysis ≤41.0 at post-neoadjuvant scan also had significantly improved OS (P = 0.03 and 0.05). Patients with low lymph node metabolism (SULmax ≤4.6) at baseline scan had significantly improved PFS (P = 0.04).
CONCLUSIONS: This is the first study to report the long-term prognostic value of 18F-FDG PET/CT for resectable NSCLC after neoadjuvant immunotherapy. Low primary tumor metabolism at post-neoadjuvant scan and low lymph node metabolism at baseline scan are promising prognostic markers for improved clinical outcomes.