Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer

ObjectiveTo analyse positron emission tomography/ computed tomography (PET/CT) imaging and clinical data from patients with non-small cell lung cancer (NSCLC), to identify characteristics of survival beneficiaries of immune checkpoint inhibitors (ICIs) treatment and to establish a survival predictio...

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Main Authors: Lu Zheng, Yanzhu Bian, Yujing Hu, Congna Tian, Xinchao Zhang, Shuheng Li, Xin Yang, Yanan Qin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1477275/full
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author Lu Zheng
Lu Zheng
Yanzhu Bian
Yanzhu Bian
Yujing Hu
Congna Tian
Xinchao Zhang
Shuheng Li
Xin Yang
Yanan Qin
author_facet Lu Zheng
Lu Zheng
Yanzhu Bian
Yanzhu Bian
Yujing Hu
Congna Tian
Xinchao Zhang
Shuheng Li
Xin Yang
Yanan Qin
author_sort Lu Zheng
collection DOAJ
description ObjectiveTo analyse positron emission tomography/ computed tomography (PET/CT) imaging and clinical data from patients with non-small cell lung cancer (NSCLC), to identify characteristics of survival beneficiaries of immune checkpoint inhibitors (ICIs) treatment and to establish a survival prediction model.MethodsA retrospective analysis was conducted on PET/CT imaging and clinical parameters of 155 NSCLC patients who underwent baseline PET/CT examination at the Department of Nuclear Medicine, Hebei General Hospital. The Kaplan–Meier curve was employed to compare progression-free survival (PFS) and overall survival (OS) between the ICIs and non-ICIs group and to assess the impact of variables on PFS and OS in the ICIs group. Multivariate Cox proportional hazards regression analysis was conducted with parameters significantly associated with survival in univariate analysis.ResultsSignificant differences were observed in PFS (χ2 = 11.910, p = 0.0006) and OS (χ2 = 8.343, p = 0.0039). Independent predictors of PFS in the ICIs group included smoking history[hazard ratio (HR) = 2.522, 95% confidence interval (CI): 1.044 ~ 6.091, p = 0.0398], SUVmax of the primary lesion(HR = 0.2376, 95%CI: 0.1018 ~ 0.5548, p = 0.0009), MTVp (HR = 0.0755, 95%CI: 0.0284 ~ 0.2003, p < 0.001), and TLGp (HR = 0.1820, 95%CI: 0.0754 ~ 0.4395, p = 0.0002). These were also independent predictors of OS in the ICIs group[HR(95%CI) were 2.729 (1.125 ~ 6.619), 0.2636 (0.1143 ~ 0.6079), 0.0715 (0.0268 ~ 0.1907), 0.2102 (0.0885 ~ 0.4992), both p < 0.05)]. Age was an additional independent predictor of OS (HR = 0.4140, 95%CI: 0.1748 ~ 0.9801, p = 0.0449).ConclusionSmoking history, primary lesion SUVmax, MTVp, and TLGp were independent predictors of PFS, whilst age, smoking history, SUVmax, MTVp, and TLGp were independent predictors of OS in the ICIs group. Patients without a history of smoking and with SUVmax ≤19.2, MTVp ≤20.745cm3, TLGp ≤158.62 g, and age ≤ 60 years benefited more from ICI treatment.
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spelling doaj-art-a41c371c0b7448d3ba78000177e85b3e2025-01-31T06:40:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011210.3389/fmed.2025.14772751477275Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancerLu Zheng0Lu Zheng1Yanzhu Bian2Yanzhu Bian3Yujing Hu4Congna Tian5Xinchao Zhang6Shuheng Li7Xin Yang8Yanan Qin9Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaHebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, ChinaDepartment of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaHebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, Shijiazhuang, ChinaDepartment of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Nuclear Medicine, Affiliated Hospital of Hebei University, Baoding, ChinaDepartment of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaDepartment of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, ChinaObjectiveTo analyse positron emission tomography/ computed tomography (PET/CT) imaging and clinical data from patients with non-small cell lung cancer (NSCLC), to identify characteristics of survival beneficiaries of immune checkpoint inhibitors (ICIs) treatment and to establish a survival prediction model.MethodsA retrospective analysis was conducted on PET/CT imaging and clinical parameters of 155 NSCLC patients who underwent baseline PET/CT examination at the Department of Nuclear Medicine, Hebei General Hospital. The Kaplan–Meier curve was employed to compare progression-free survival (PFS) and overall survival (OS) between the ICIs and non-ICIs group and to assess the impact of variables on PFS and OS in the ICIs group. Multivariate Cox proportional hazards regression analysis was conducted with parameters significantly associated with survival in univariate analysis.ResultsSignificant differences were observed in PFS (χ2 = 11.910, p = 0.0006) and OS (χ2 = 8.343, p = 0.0039). Independent predictors of PFS in the ICIs group included smoking history[hazard ratio (HR) = 2.522, 95% confidence interval (CI): 1.044 ~ 6.091, p = 0.0398], SUVmax of the primary lesion(HR = 0.2376, 95%CI: 0.1018 ~ 0.5548, p = 0.0009), MTVp (HR = 0.0755, 95%CI: 0.0284 ~ 0.2003, p < 0.001), and TLGp (HR = 0.1820, 95%CI: 0.0754 ~ 0.4395, p = 0.0002). These were also independent predictors of OS in the ICIs group[HR(95%CI) were 2.729 (1.125 ~ 6.619), 0.2636 (0.1143 ~ 0.6079), 0.0715 (0.0268 ~ 0.1907), 0.2102 (0.0885 ~ 0.4992), both p < 0.05)]. Age was an additional independent predictor of OS (HR = 0.4140, 95%CI: 0.1748 ~ 0.9801, p = 0.0449).ConclusionSmoking history, primary lesion SUVmax, MTVp, and TLGp were independent predictors of PFS, whilst age, smoking history, SUVmax, MTVp, and TLGp were independent predictors of OS in the ICIs group. Patients without a history of smoking and with SUVmax ≤19.2, MTVp ≤20.745cm3, TLGp ≤158.62 g, and age ≤ 60 years benefited more from ICI treatment.https://www.frontiersin.org/articles/10.3389/fmed.2025.1477275/fullPET/CTSUVnon-small cell lung cancerimmune checkpoint inhibitorsprognosis
spellingShingle Lu Zheng
Lu Zheng
Yanzhu Bian
Yanzhu Bian
Yujing Hu
Congna Tian
Xinchao Zhang
Shuheng Li
Xin Yang
Yanan Qin
Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer
Frontiers in Medicine
PET/CT
SUV
non-small cell lung cancer
immune checkpoint inhibitors
prognosis
title Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer
title_full Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer
title_fullStr Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer
title_full_unstemmed Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer
title_short Baseline 18F-FDG PET/CT parameters in predicting the efficacy of immunotherapy in non-small cell lung cancer
title_sort baseline 18f fdg pet ct parameters in predicting the efficacy of immunotherapy in non small cell lung cancer
topic PET/CT
SUV
non-small cell lung cancer
immune checkpoint inhibitors
prognosis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1477275/full
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