FDG-PET/CT and CT compared for evaluation of tumor response to first-line immunotherapy and prediction of prognosis in non-small-cell lung cancer patients.
{"title":"FDG-PET/CT and CT compared for evaluation of tumor response to first-line immunotherapy and prediction of prognosis in non-small-cell lung cancer patients.","authors":"Kazuhiro Kitajima, Kosuke Matsuda, Toshiyuki Minami, Akifumi Nakamura, Kozo Kuribayashi, Soichiro Funaki, Takashi Kijima, Koichiro Yamakado","doi":"10.1159/000546339","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy-modified positron emission tomography response criteria in solid tumors (imPERCIST) using FDG-PET/CT and immune-related response evaluation criteria in solid tumors (irRECIST) using CT were compared for evaluation of response prognosis prediction, and effect on patient management in non-small-cell lung cancer (NSCLC) patients treated with first-line immunotherapy, or immunotherapy and chemotherapy combined.</p><p><strong>Methods: </strong>Thirty-three patients (26 males, median 68.0 years old) with histologically NSCLC without EGFR/ALK/KRAS alterations underwent pembrolizumab treatment only or immunotherapy combined with chemotherapy. FDG-PET/CT and diagnostic CT scanning was performed at the baseline and after two to four cycles (2 in 8, 3 in 12, 4 in 13 patients). Findings for therapeutic response obtained with imPERCIST and irRECIST were compared. Progression-free survival (PFS) and overall survival (OS) were examined using log-rank and Cox methods.</p><p><strong>Results: </strong>imPERCIST indicated that 10 patients had complete metabolic response (CMR), eight partial metabolic response (PMR), three stable metabolic disease (SMD), and 12 progressive metabolic disease (PMD), while irRECIST showed that two had complete response (CR), 14 PR, nine SD, and eight PD, indicating substantial concordance (κ=0.615). Twenty-eight patients showed progression and 18 died from NSCLC after a median 16.2 months. Patients showing response based on imPERCIST and irRECIST (CMR/PMR, CR/PR, respectively) showed significantly longer PFS and OS than non-responders (SMD/PMD, SD/PD, respectively) (imPERCIST p<0.0001 and p=0.0001, respectively; irRECIST p=0.0018 and p=0.011, respectively). imPERCIST resulted in a change of management in 12 of the 33 patients (36.3%) with an additional effect on patient management in 4 patients (12.1%) evaluated by irRECIST.</p><p><strong>Conclusion: </strong>For evaluation of NSCLC patients for tumor response and patient management following first-line immunotherapy or that combined with chemotherapy, and predicting prognosis, both FDG-PET/CT and CT findings are accurate, with FDG-PET/CT superior.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-22"},"PeriodicalIF":2.5000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000546339","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Immunotherapy-modified positron emission tomography response criteria in solid tumors (imPERCIST) using FDG-PET/CT and immune-related response evaluation criteria in solid tumors (irRECIST) using CT were compared for evaluation of response prognosis prediction, and effect on patient management in non-small-cell lung cancer (NSCLC) patients treated with first-line immunotherapy, or immunotherapy and chemotherapy combined.
Methods: Thirty-three patients (26 males, median 68.0 years old) with histologically NSCLC without EGFR/ALK/KRAS alterations underwent pembrolizumab treatment only or immunotherapy combined with chemotherapy. FDG-PET/CT and diagnostic CT scanning was performed at the baseline and after two to four cycles (2 in 8, 3 in 12, 4 in 13 patients). Findings for therapeutic response obtained with imPERCIST and irRECIST were compared. Progression-free survival (PFS) and overall survival (OS) were examined using log-rank and Cox methods.
Results: imPERCIST indicated that 10 patients had complete metabolic response (CMR), eight partial metabolic response (PMR), three stable metabolic disease (SMD), and 12 progressive metabolic disease (PMD), while irRECIST showed that two had complete response (CR), 14 PR, nine SD, and eight PD, indicating substantial concordance (κ=0.615). Twenty-eight patients showed progression and 18 died from NSCLC after a median 16.2 months. Patients showing response based on imPERCIST and irRECIST (CMR/PMR, CR/PR, respectively) showed significantly longer PFS and OS than non-responders (SMD/PMD, SD/PD, respectively) (imPERCIST p<0.0001 and p=0.0001, respectively; irRECIST p=0.0018 and p=0.011, respectively). imPERCIST resulted in a change of management in 12 of the 33 patients (36.3%) with an additional effect on patient management in 4 patients (12.1%) evaluated by irRECIST.
Conclusion: For evaluation of NSCLC patients for tumor response and patient management following first-line immunotherapy or that combined with chemotherapy, and predicting prognosis, both FDG-PET/CT and CT findings are accurate, with FDG-PET/CT superior.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
