Abstract：
OBJECTIVE: The introduction of immunotherapy in pleural mesothelioma (PM) has highlighted the need for effective outcome predictors. This study explores the role of [18F]FDG PET/CT in predicting outcomes in PM treated with immunotherapy.
METHODS: Patients from the NIPU trial, receiving ipilimumab and nivolumab +/- telomerase vaccine in second-line, were included. [18F]FDG PET/CT was obtained at baseline (n = 100) and at week-5 (n = 76). Metabolic tumour volume (MTV) and peak standardised uptake value (SUVpeak) were evaluated in relation to survival outcomes. Wilcoxon rank-sum test was used to assess differences in MTV, total lesion glycolysis (TLG), maximum standardised uptake value (SUVmax) and SUVpeak between patients exhibiting an objective response, defined as either partial response or complete response according to the modified Response Criteria in Solid Tumours (mRECIST) and immune RECIST (iRECIST), and non-responders, defined as either stable disease or progressive disease as their best overall response.
RESULTS: Univariate Cox regression revealed significant associations of MTV with OS (HR 1.36, CI: 1.14, 1.62, p < 0.001) and PFS (HR 1.18, CI: 1.03, 1.34, p = 0.02), while multivariate analysis showed a significant association with OS only (HR 1.35, CI: 1.09, 1.68, p = 0.007). While SUVpeak was not significantly associated with OS or PFS in univariate analyses, it was significantly associated with OS in multivariate analysis (HR 0.43, CI: 0.23, 0.80, p = 0.008). Objective responders had significant reductions in TLG, SUVmax and SUVpeak at week-5.
CONCLUSIONS: MTV provides prognostic value in PM treated with immunotherapy. High SUVpeak was not associated with inferior outcomes, which could be attributed to the distinct mechanisms of immunotherapy. Early reductions in PET metrics correlated with treatment response.
BACKGROUND: The NIPU trial (NCT04300244) is registered at clinicaltrials.gov. https://classic.
RESULTS: gov/ct2/show/NCT04300244?cond=Pleural+Mesothelioma&cntry=NO&draw=2&rank=4.
METHODS: Patients from the NIPU trial, receiving ipilimumab and nivolumab +/- telomerase vaccine in second-line, were included. [18F]FDG PET/CT was obtained at baseline (n = 100) and at week-5 (n = 76). Metabolic tumour volume (MTV) and peak standardised uptake value (SUVpeak) were evaluated in relation to survival outcomes. Wilcoxon rank-sum test was used to assess differences in MTV, total lesion glycolysis (TLG), maximum standardised uptake value (SUVmax) and SUVpeak between patients exhibiting an objective response, defined as either partial response or complete response according to the modified Response Criteria in Solid Tumours (mRECIST) and immune RECIST (iRECIST), and non-responders, defined as either stable disease or progressive disease as their best overall response.
RESULTS: Univariate Cox regression revealed significant associations of MTV with OS (HR 1.36, CI: 1.14, 1.62, p < 0.001) and PFS (HR 1.18, CI: 1.03, 1.34, p = 0.02), while multivariate analysis showed a significant association with OS only (HR 1.35, CI: 1.09, 1.68, p = 0.007). While SUVpeak was not significantly associated with OS or PFS in univariate analyses, it was significantly associated with OS in multivariate analysis (HR 0.43, CI: 0.23, 0.80, p = 0.008). Objective responders had significant reductions in TLG, SUVmax and SUVpeak at week-5.
CONCLUSIONS: MTV provides prognostic value in PM treated with immunotherapy. High SUVpeak was not associated with inferior outcomes, which could be attributed to the distinct mechanisms of immunotherapy. Early reductions in PET metrics correlated with treatment response.
BACKGROUND: The NIPU trial (NCT04300244) is registered at clinicaltrials.gov. https://classic.
RESULTS: gov/ct2/show/NCT04300244?cond=Pleural+Mesothelioma&cntry=NO&draw=2&rank=4.
摘要：
目的：在胸膜间皮瘤（PM）中引入免疫疗法强调了对有效预后预测因子的需求。这项研究探讨了[18F]FDGPET/CT在预测免疫疗法治疗PM结果中的作用。
方法：来自NIPU试验的患者，在二线接受ipilimumab和nivolumab+/-端粒酶疫苗，包括在内。在基线(n=100)和第5周(n=76)获得[18F]FDGPET/CT。评估代谢肿瘤体积（MTV）和峰值标准化摄取值（SUVpeak）与生存结果的关系。Wilcoxon秩和检验用于评估MTV的差异，总病变糖酵解（TLG），显示客观反应的患者之间的最大标准化摄取值（SUVmax）和SUVpeak，根据改良的实体瘤反应标准（mRECIST）和免疫RECIST（iRECIST）定义为部分反应或完全反应，和无应答者，定义为稳定的疾病或进行性疾病作为他们的最佳整体反应。
结果：单变量Cox回归显示MTV与OS（HR1.36，CI：1.14，1.62，p<0.001）和PFS（HR1.18，CI：1.03，1.34，p=0.02）显著相关，而多变量分析显示仅与OS显著相关(HR1.35,CI:1.09,1.68,p=0.007)。虽然在单变量分析中SUVpeak与OS或PFS没有显着相关，在多变量分析中,其与OS显著相关(HR0.43,CI:0.23,0.80,p=0.008).客观反应者的TLG显着减少，SUVmax和SUVpeak在第5周。
结论：MTV在接受免疫治疗治疗的PM中具有预后价值。高SUV峰值与不良结局无关，这可以归因于免疫治疗的独特机制。PET指标的早期降低与治疗反应相关。
背景：NIPU试验（NCT04300244）已在clinicaltrials.gov上注册。https://经典。
结果：gov/ct2/show/NCT04300244?cond=胸膜+间皮瘤&cntry=NO&draw=2&rank=4。
方法：来自NIPU试验的患者，在二线接受ipilimumab和nivolumab+/-端粒酶疫苗，包括在内。在基线(n=100)和第5周(n=76)获得[18F]FDGPET/CT。评估代谢肿瘤体积（MTV）和峰值标准化摄取值（SUVpeak）与生存结果的关系。Wilcoxon秩和检验用于评估MTV的差异，总病变糖酵解（TLG），显示客观反应的患者之间的最大标准化摄取值（SUVmax）和SUVpeak，根据改良的实体瘤反应标准（mRECIST）和免疫RECIST（iRECIST）定义为部分反应或完全反应，和无应答者，定义为稳定的疾病或进行性疾病作为他们的最佳整体反应。
结果：单变量Cox回归显示MTV与OS（HR1.36，CI：1.14，1.62，p<0.001）和PFS（HR1.18，CI：1.03，1.34，p=0.02）显著相关，而多变量分析显示仅与OS显著相关(HR1.35,CI:1.09,1.68,p=0.007)。虽然在单变量分析中SUVpeak与OS或PFS没有显着相关，在多变量分析中,其与OS显著相关(HR0.43,CI:0.23,0.80,p=0.008).客观反应者的TLG显着减少，SUVmax和SUVpeak在第5周。
结论：MTV在接受免疫治疗治疗的PM中具有预后价值。高SUV峰值与不良结局无关，这可以归因于免疫治疗的独特机制。PET指标的早期降低与治疗反应相关。
背景：NIPU试验（NCT04300244）已在clinicaltrials.gov上注册。https://经典。
结果：gov/ct2/show/NCT04300244?cond=胸膜+间皮瘤&cntry=NO&draw=2&rank=4。
