比较FDG-PET/CT和CT评估不可切除恶性胸膜间皮瘤患者对尼伐单抗加伊匹单抗联合疗法的肿瘤反应和预后。

Q2 Medicine Oncotarget Pub Date : 2024-06-20 DOI:10.18632/oncotarget.28594
Kazuhiro Kitajima, Kozo Kuribayashi, Toshiyuki Minami, Hiroyuki Yokoyama, Akifumi Nakamura, Masaki Hashimoto, Takashi Kijima, Seiki Hasegawa, Hayato Kaida, Koichiro Yamakado
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引用次数: 0

摘要

目标:通过[18F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET/CT)显示的免疫疗法改良PERCIST(imPERCIST)和计算机断层扫描显示的改良RECIST(mRECIST),比较恶性胸膜间皮瘤(MPM)患者接受nivolumab加伊匹单抗一线治疗后的反应评估和预后预测结果。结果:imPERCIST 显示 9 例进展性代谢病 (PMD)、8 例稳定代谢病 (SMD)、4 例部分代谢反应 (PMR) 和 5 例完全代谢反应 (CMR);mRECIST 显示 9 例进展性疾病 (PD)、9 例稳定疾病 (SD)、7 例部分反应 (PR) 和 1 例完全反应 (CR)。虽然一致性很高(κ = 0.827),但 imPERCIST 正确判断 CMR 的比例更高(15.4%)。在中位 10.0 个月后,15 名患者病情恶化,8 名患者死于 MPM。与PMD/PD患者相比,无进展患者(分别为CMR/PMR/SMD、CR/PR/SD)的无进展生存期(PFS)和总生存期(OS)均显著延长(imPERCIST p < 0.0001,p = 0.015;mRECIST p < 0.0001,p = 0.015):26名经组织学证实为MPM且未接受根治性手术的患者(23名男性,3名女性;中位年龄73.5岁)接受了nivolumab加伊匹单抗的联合治疗。在基线和2-4个周期后(3名患者2个周期,17名患者3个周期,6名患者4个周期)进行了FDG-PET/CT和诊断性CT扫描。使用 imPERCIST 和 mRECIST 对治疗反应结果进行评估比较。采用对数秩和考克斯方法进行了PFS和OS分析:结论:对于无法切除的 MPM 患者,FDG-PET 和 CT 可为评估肿瘤反应提供准确的结果,还能预测一线 nivolumab 加 ipilimumab 免疫疗法(约三个周期)后的预后。
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Comparison of FDG-PET/CT and CT for evaluation of tumor response to nivolumab plus ipilimumab combination therapy and prognosis prediction in patients with unresectable malignant pleural mesothelioma.

Objectives: Results for malignant pleural mesothelioma (MPM) patients following first-line treatment with nivolumab plus ipilimumab obtained with immunotherapy-modified PERCIST (imPERCIST), shown by [18F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), and modified RECIST (mRECIST), shown by CT, were compared for response evaluation and prognosis prediction.

Results: imPERCIST indicated nine progressive metabolic disease (PMD), eight stable metabolic disease (SMD), four partial metabolic response (PMR), and five complete metabolic response (CMR) cases. mRECIST showed nine with progressive disease (PD), nine stable disease (SD), seven partial response (PR), and one complete response (CR). Although high concordance was noted (κ = 0.827), imPERCIST correctly judged a greater percentage with CMR (15.4%). Following a median 10.0 months, 15 patients showed progression and eight died from MPM. With both, progression-free survival (PFS) and overall survival (OS) were significantly longer in patients without progression (CMR/PMR/SMD, CR/PR/SD, respectively) as compared to PMD/PD patients (imPERCIST p < 0.0001 and p = 0.015, respectively; mRECIST p < 0.0001 and p = 0.015, respectively).

Methods: Twenty-six patients (23 males, 3 females; median 73.5 years) with histologically proven MPM and no curative surgery received nivolumab plus ipilimumab combination therapy. FDG-PET/CT and diagnostic CT scanning at the baseline, and after 2-4 cycles (2 in three, 3 in 17, 4 in six patients) were performed. Therapeutic response findings evaluated using imPERCIST and mRECIST were compared. PFS and OS analyses were done using log-rank and Cox methods.

Conclusion: For unresectable MPM patient examinations, FDG-PET and CT provide accurate findings for evaluating tumor response and also prognosis prediction following first-line nivolumab plus ipilimumab immunotherapy (approximately three cycles).

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来源期刊
Oncotarget
Oncotarget Oncogenes-CELL BIOLOGY
CiteScore
6.60
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0.00%
发文量
129
审稿时长
1.5 months
期刊介绍: Information not localized
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