Total Metabolic Tumor Volume on 18F-FDG PET/CT Is a Useful Prognostic Biomarker for Patients with Extensive Small-Cell Lung Cancer Undergoing First-Line Chemo-Immunotherapy

Author:

Grambow-Velilla Julia12,Seban Romain-David34ORCID,Chouahnia Kader5,Assié Jean-Baptiste6ORCID,Champion Laurence34,Girard Nicolas78,Bonardel Gerald9,Matton Lise5,Soussan Michael1,Chouaïd Christos10ORCID,Duchemann Boris511ORCID

Affiliation:

1. Department of Nuclear Medicine, AP-HP, Avicenne University Hospital, 93000 Bobigny, France

2. Department of Nuclear Medicine, AP-HP, European Hospital Georges-Pompidou, University of Paris, 75015 Paris, France

3. Department of Nuclear Medicine, Institut Curie, 92210 Saint-Cloud, France

4. Laboratoire d’Imagerie Translationnelle en Oncologie, Inserm, Institut Curie, 91401 Orsay, France

5. Department of Medical Thoracic and Medical Oncology, AP-HP, Avicenne University Hospital, 93000 Bobigny, France

6. Unité de Pneumologie, CHU Henri Mondor, UPEC, 94000 Créteil, France

7. Institut du Thorax Curie Montsouris, Institut Curie, 75005 Paris, France

8. Paris Saclay, UVSQ, UFR Simone Veil, 78180 Versailles, France

9. Nuclear Medicine, Centre Cardiologique du Nord, 93200 Saint-Denis, France

10. Department of Pneumology, Centre Hospitalier Inter-Communal de Créteil, Paris-Est University, 94010 Créteil, France

11. Inserm UMR 1272 “Hypoxie et Poumon”, UFR SMBH Léonard de Vinci, Université Sorbonne Paris Nord, 93000 Bobigny, France

Abstract

Background: We aimed to evaluate the prognostic value of imaging biomarkers on 18F-FDG PET/CT in extensive-stage small-cell lung cancer (ES-SCLC) patients undergoing first-line chemo-immunotherapy. Methods: In this multicenter and retrospective study, we considered two cohorts, depending on the type of first-line therapy: chemo-immunotherapy (CIT) versus chemotherapy alone (CT). All patients underwent baseline 18-FDG PET/CT before therapy between June 2016 and September 2021. We evaluated clinical, biological, and PET parameters, and used cutoffs from previously published studies or predictiveness curves to assess the association with progression-free survival (PFS) or overall survival (OS) with Cox prediction models. Results: Sixty-eight patients were included (CIT: CT) (36: 32 patients). The median PFS was 5.9:6.5 months, while the median OS was 12.1:9.8 months. dNLR (the derived neutrophils/(leucocytes-neutrophils) ratio) was an independent predictor of short PFS and OS in the two cohorts (p < 0.05). High total metabolic tumor volume (TMTVhigh if > 241 cm3) correlated with outcomes, but only in the CIT cohort (PFS for TMTVhigh in multivariable analysis: HR 2.5; 95%CI 1.1–5.9). Conclusion: Baseline 18F-FDG PET/CT using TMTV could help to predict worse outcomes for ES-SCLC patients undergoing first-line CIT. This suggests that baseline TMTV may be used to identify patients that are unlikely to benefit from CIT.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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