scholarly journals Prognostic impact of maximum standardized uptake value (SUVmax) of the primary lesion on survival in advanced non-small-cell lung cancer: A retrospective study

2020 ◽  
Author(s):  
Xiaoling Qiu ◽  
Hongge Liang ◽  
Wei Zhong ◽  
Jing Zhao ◽  
Minjiang Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Standardized Uptake Value ◽  
Lesion Size ◽  
Lung Lesion ◽  
Small Cell ◽  
Small Cell Lung ◽  
Pet Ct

Abstract Background: Positron emission tomography/computed tomography (PET/CT) has been widely recognized for diagnosing and staging lung cancer, but the prognostic value of standardized uptake value (SUV) in patients with advanced non-small-cell lung cancer (NSCLC) remains controversial. We aim to explore whether fluorodeoxyglucose uptake has prognostic significance in patients with advanced NSCLC. Methods: We performed a retrospective analysis of the data of patients with advanced NSCLC who had undergone PET/CT before systemic treatment between June 2012 and June 2016. The relationship between the SUV of the pulmonary lesion and lesion size was evaluated via Spearman’s correlation analysis. We collected patients’ clinical and pathological data. Univariate and multivariate analyses were performed to analyze the factors influencing survival.Results: Altogether, 157 patients with advanced NSCLC were included. Among these, 135 died, 13 survived, and 9 had incomplete data (median follow-up period of 69 months). SUV was correlated with lesion size and was significantly greater for tumors ≥3 cm than for tumors <3 cm (10.2±5.4 vs. 5.6±3.3, t=-6.709, p=0.000). Univariate analysis showed that survival was associated with gender, tumor size, epidermal growth factor receptor (EGFR) gene mutation, SUV of the primary lung lesion, and treatment line. Multivariate analysis showed a significant correlation between SUV of the primary lung lesion and survival. The mortality risk of patients with SUV ≤6 was 35% lower than that of patients with SUV >6 (95% CI 0.436-0.972, Wald value 4.400, p=0.036). Conclusions: The SUV of the primary lung lesion on PET/CT is significantly correlated with survival in previously untreated patients newly diagnosed with advanced NSCLC.

Prospective correlative study of FDG-PET SUV and proteomic profile (VeriStrat) of non-small cell lung cancer patients treated with erlotinib.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18096-e18096
Author(s):  
Chiara Lazzari ◽  
Marcello Tiseo ◽  
Vanesa Gregorc ◽  
Fiorenza Latteri ◽  
Massimo Ippolito ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Advanced Nsclc ◽  
Standardized Uptake Value ◽  
Small Cell ◽  
Wilcoxon Test ◽  
Small Cell Lung ◽  
Egfr Tkis

e18096 Background: Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry (MALDI TOF MS) was used to create and validate a plasma proteomic algorithm VeriStrat (VS), based on 8 m/z peaks, and able to select advanced NSCLC pts who may benefit from EGFR TKIs. The algorithm was associated with PFS and OS of patients treated with EGFR TKIs and not with chemotherapy. Standardized Uptake Value (SUV) is of prognostic value for survival in non-small cell lung cancer. Aim of the current study was to analyze the OS and TTP in advanced NSCLC pts treated with erlotinib (E) according to baseline VeriStrat classification and baseline SUVs of FDG-PET. Methods: Plasma samples were collected before the beginning of E from metastatic NSCLC patients. Acquired spectra were classified according to the VeriStrat algorithm. The FDG-PET was performed the day before the beginning of E. Results: Thirty eight NSCLC pts on E therapy with the following characteristics were analyzed: median age 62 years old, 63% were males, 53% had adenocarcinoma histology, response rate was 26%, median OS 10 mos and (TTP) 3.4 mos. Twenty-six (68%) were classified as VS Good, 12 (32%) as Poor. TTP and OS for VS Good and Poor were 4.1 vs 2.1 mos (HR 0.86, log-rank p=0.6) and 11.1 vs 4.1 mos (HR 0.45,log-rank p=0.02), respectively. Baseline SUV levels were associated with TTP (Wilcoxon test p=0.001) but not with OS (all pts progressed, 5 still alive). All Poor classified pts had SUV ≥ 7 and had the worst TTP and OS; VS Good classified patients had worse TTP and OS if their baseline SUV level was > 7 than those who were VS Good and had SUV<7(see Table: 3-curves comparison log-rank test p value for a trend). Conclusions: We confirmed that pts with VS Poor classification have significantly shorter OS than those classified as VS Good. Pts with VS Good profile and with low baseline SUV levels may benefit more from EGFR TKI than VS Good pts with high SUV.

scholarly journals Prognostic and Predictive Values of Metabolic Parameters of 18F-FDG PET/CT in Patients With Non-Small Cell Lung Cancer Treated With Chemotherapy

2019 ◽  
Vol 18 ◽  
pp. 153601211984602 ◽  
Author(s):  
Xueyan Li ◽  
Dawei Wang ◽  
Lijuan Yu
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Cox Regression ◽  
Standardized Uptake Value ◽  
Small Cell ◽  
Metabolic Parameters ◽  
Small Cell Lung ◽  
Predictive Values ◽  
Pet Ct

Objectives: Increasing interests have been focused on using artificial intelligence (AI) to extend prognostic value of medical imaging. Feature extraction is a critical step for successful application of AI. The aim of this study was to explore several metabolic parameters measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) as potential AI features in predicting the effectiveness of chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods: A set of metabolic parameters of PET/CT and clinical characteristics were detected from 137 patients with NSCLC treated with at least 1 cycle of chemotherapy. Survival receiver–operating characteristic (ROC) analysis was used to define the more significant parameters chosen for the following survival analysis. Patient survival was analyzed by Kaplan-Meier method, log-rank test, and Cox regression. Results: Survival ROC showed that maximum standardized uptake value (SUVmax), metabolic tumor volume 50% (MTV50), and total lesion glycolysis 50% (TLG50) had larger area under the curve, and the optimal cutoff values were 11.72, 4.04, and 34.55, respectively. Univariate and multivariate analyses synergistically showed that late PET/CT stage and MTV50 >4.04 were independent factors of poor survival in patients with NSCLC who received chemotherapy. Conclusions: Several potential prognostic biomarkers of PET/CT imaging have been extracted for predicting survival and selecting patients with NSCLC who are more likely to benefit from chemotherapy. The identification may accelerate the development of AI methods to improve treatment outcome for NSCLC.

scholarly journals First-Line Pembrolizumab Mono- or Combination Therapy of Non-Small Cell Lung Cancer: Baseline Metabolic Biomarkers Predict Outcomes

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6096
Author(s):  
David Lang ◽  
Linda Ritzberger ◽  
Vanessa Rambousek ◽  
Andreas Horner ◽  
Romana Wass ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Cox Regression ◽  
Standardized Uptake Value ◽  
Metabolic Tumor Volume ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Pet Ct

Quantitative biomarkers derived from positron-emission tomography/computed tomography (PET/CT) have been suggested as prognostic variables in immune-checkpoint inhibitor (ICI) treated non-small cell lung cancer (NSCLC). As such, data for first-line ICI therapy and especially for chemotherapy–ICI combinations are still scarce, we retrospectively evaluated baseline 18F-FDG-PET/CT of 85 consecutive patients receiving first-line pembrolizumab with chemotherapy (n = 70) or as monotherapy (n = 15). Maximum and mean standardized uptake value, total metabolic tumor volume (MTV), total lesion glycolysis, bone marrow-/and spleen to liver ratio (BLR/SLR) were calculated. Kaplan–Meier analyses and Cox regression models were used to assess progression-free/overall survival (PFS/OS) and their determinant variables. Median follow-up was 12 months (M; 95% confidence interval 10–14). Multivariate selection for PFS/OS revealed MTV as most relevant PET/CT biomarker (p < 0.001). Median PFS/OS were significantly longer in patients with MTV ≤ 70 mL vs. >70 mL (PFS: 10 M (4–16) vs. 4 M (3–5), p = 0.001; OS: not reached vs. 10 M (5–15), p = 0.004). Disease control rate was 81% vs. 53% for MTV ≤/> 70 mL (p = 0.007). BLR ≤ 1.06 vs. >1.06 was associated with better outcomes (PFS: 8 M (4–13) vs. 4 M (3–6), p = 0.034; OS: 19 M (12-/) vs. 6 M (4–12), p = 0.005). In patients with MTV > 70 mL, concomitant BLR ≤ 1.06 indicated a better prognosis. Higher MTV is associated with inferior PFS/OS in first-line ICI-treated NSCLC, with BLR allowing additional risk stratification.

The comparison of 18F-alfatide PET/CT and 18F-FDG PET/CT in predicting chemoradiotherapy sensitivity in patients with advanced non-small cell lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20558-e20558
Author(s):  
Xiaohui Luan ◽  
Yong Huang ◽  
Ning Liu ◽  
Song Gao ◽  
Jinsong Zheng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Advanced Nsclc ◽  
Small Cell ◽  
Small Cell Lung ◽  
Pet Ct ◽  
Fdg Pet Ct

e20558 Background: Both 18F-alfatide positron emission tomography/computed tomography(PET/CT) and 18F-fluorodeoxyglucose (18F-FDG) PET/CT were potential in predicting thearapy sensitivity, in this study,we recruited patients with advanced NSCLC to detect and compare the potential predictive vaue of them on the CRT sensitivity of patients with advanced non-small cell lung cancer (NSCLC). Methods: According to the design of Natural Science Foundation ofChina (NSFC) 81372413, twenty-four patients with advanced NSCLC accepted 18F-alfatide PET/CT before radiotherapy (T1), another thirty-nine patients underwent 18F-FDG PET/CT at both T1 and during CRT (40Gy of radiotherapy, T2). Logistic regression analyse was used to evaluate the correlations between PET parameters and CRT sensitivity providing an odds ratio (OR), 95% confidence interval (CI) and p value. Propensity score matching (PSM) approach was used to control confounding. Results: Logistic regression analyse showed that Karnofsky Performance Status (KPS) score was correlative with CRT sensitivity. After PSM, controlling KPS scores, twenty-four pairs of patients were matched. The results showed that SUVmax obtained from baseline 18F-alfatide PET/CT was associated with CRT sensitivity in both univariate and multivariable logistic regression analysis (OR: 0.532, 95% CI: 0.305–0.927, p = 0.026; OR:0.376, 95% CI: 0.165-0.860, p = 0.021), but the baseline 18F-FDG PET/CT was not. Univariate analyses showed that the percent change in MTV of 18F-FDG PET/CT between T1 and T2 was correlative with CRTsensitivity (OR: 1.039, 95% CI: 1.003-1.077, p = 0.036). When patients’ KPS score was considered simultaneously, it was still related to CRT sensitivity (OR:1.038, 95% CI: 1.001-1.077, p = 0.045). Conclusions: 18F-alfatidePET/CT may be better than 18F-FDG PET/CT in predicting CRT sensitivity, and 18F-FDG PET/CT is potential in monitoring the tumor response to CRT in patients with advanced NSCLC.

scholarly journals First-Line Pembrolizumab Therapy of Non-Small Cell Lung Cancer: Baseline Metabolic Biomarkers Predict Outcomes

2021 ◽  
Author(s):  
David Lang ◽  
Linda Ritzberger ◽  
Vanessa Rambousek ◽  
Andreas Horner ◽  
Romana Wass ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Cox Regression ◽  
Standardized Uptake Value ◽  
Metabolic Tumor Volume ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Pet Ct

Quantitative biomarkers derived from positron-emission tomography/computed tomography (PET/CT) have been suggested as prognostic variables in immune-checkpoint inhibitor (ICI) treated non-small cell lung cancer (NSCLC). As such data for first-line ICI therapy and especially for chemotherapy-ICI combinations are still scarce, we retrospectively evaluated baseline 18F-FDG-PET/CT of 85 consecutive patients receiving first-line pembrolizumab with chemotherapy (n=70) or as monotherapy (n=15). Maximum and mean standardized uptake value, metabolic tumor volume (MTV), total lesion glycolysis and bone marrow-/ spleen to liver ratio (BLR/SLR) were calculated. Kaplan-Meier analyses and Cox-regression models were used to assess progression-free/overall survival (PFS/OS) and their determinant variables. Multivariate selection for PFS/OS revealed MTV as most relevant PET/CT biomarker (p&lt;0.001). Median PFS/OS were significantly longer in patients with MTV&le;70mL versus &gt;70mL (PFS: 10 months (M; 95% confidence interval 4-16) vs. 4M (3-5), p=0.001; OS: not reached vs. 10M (5-15), p=0.004). Disease control rate was 81% vs. 53% for MTV&le;/&gt;70mL (p=0.007). BLR &le;1.06 versus &gt;1.06 was associated with better outcomes (PFS: 8M (4-13) vs. 4M (3-6), p=0.034; OS: 19M (12-/) vs. 6M (4-12), p=0.005). In patients with MTV&gt;70mL, concomitant BLR&le;1.06 indicated a better prognosis. Higher MTV is associated with inferior PFS/OS in first-line ICI treated NSCLC, with BLR allowing additional risk stratification.

440 Activity and safety of camrelizumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced non-small-cell lung cancer

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A466-A466
Author(s):  
Guo Gui Sun ◽  
Jing Hao Jia ◽  
Peng Gao ◽  
Xue Min Yao ◽  
Ming Da Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Small Cell ◽  
Large Sample Size ◽  
Small Cell Lung ◽  
Previously Treated ◽  
Line Chemotherapy

BackgroundEffective options are limited for patients with non–small-cell lung cancer (NSCLC) whose disease progresses after first-line chemotherapy. Camrelizumab is a potent anti-PD-1 monoclonal antibody and has shown promising activity in NSCLC. We assessed the activity and safety of camrelizumab for patients with previously treated, advanced NSCLC patients with negative oncogenic drivers.MethodsPatients who progressed during or following platinum-based doublet chemotherapy were enrolled. All patients received camrelizumab(200 mg)every 3 weeks or in combination with chemotherapy until loss of clinical benefit. The primary endpoint was objective response rate (ORR), other endpoints included disease control rate (DCR), progression-free survival (PFS) and safety.ResultsBetween Aug 5, 2019, and Jun 19, 2020, we enrolled 29 patients, 25 patients were available evaluated, ORR and DCR was 36% (9/25) and 92% (23/25), respectively. 25 of 29 patients were still receiving the treatment, the median PFS was not yet achieved. Compared with those without reactive cutaneous capillary endothelial proliferation (RCCEP), patients with RCCEP had higher ORR (60% vs. 28.6%). Treatment-related adverse events (AEs) occurred in 69.0% of patients (all Grade), and the most common were RCCEP (37.9%), pneumonitis (6.9%), and chest congestion (6.9%). Treatment-related grade 3 to 4 adverse events occurred in 10.3% of patients.ConclusionsIn patients with previously treated advanced NSCLC, camrelizumab demonstrated improved ORR and DCR, compared with historical data of the 2nd line chemotherapy, with a manageable safety profile. While patients with RCCEP derived greater benefit from camrelizumab. Further studies are needed in large sample size trials.

scholarly journals How patients being treated for non-small cell lung cancer value treatment benefit despite side effects

2021 ◽  
Author(s):  
Mona L. Martin ◽  
Julia Correll ◽  
Andrew Walding ◽  
Anna Rydén
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Advanced Nsclc ◽  
Small Cell ◽  
Small Cell Lung ◽  
Treatment Benefit ◽  
Treatment Expectations ◽  
Treatment Benefits

Abstract Purpose To describe symptoms and side effects experienced by patients with advanced non-small cell lung cancer (NSCLC), assess how patients allocate sensations (i.e. symptoms or side effects) to either the disease or its treatment, and evaluate how patients balance side effects with treatment benefits. Methods Qualitative sub-studies were conducted as part of two clinical trials in patients treated for advanced NSCLC (AURA [NCT01802632]; ARCTIC [NCT02352948]). Results Interviews were conducted with 23 patients and 19 patients in the AURA and ARCTIC sub-studies, respectively. The most commonly experienced symptoms/side effects were respiratory (81% of patients), digestive (76%), pain and discomfort (76%), energy-related (71%), and sensory (62%). Patients identified a sensation as a treatment side effect if they had not experienced it before, if there was a temporal link between the sensation and receipt of treatment, and/or if their doctors consistently told or asked them about it in relation to side effects. Themes that emerged when patients talked about their cancer treatment and its side effects related to the serious nature of their advanced disease and their treatment expectations. Patients focused on treatment benefits, wanting a better quality of life, being hopeful, not really having a choice, and not thinking about side effects. Conclusions In these two qualitative sub-studies, patients with advanced NSCLC valued the benefits of their treatment regardless of side effects that they experienced. Patients weighed their options against the seriousness of their disease and expressed their willingness to tolerate their side effects in return for receiving continued treatment benefits.

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