Clinical Investigation
Prognostic value of pretreatment 18F-FDG PET/CT in patients with metastatic melanoma treated with anti-PD1 immunotherapy
Lai Ruihe, Teng Yue, Zhao Lianjun, Sun Yiwen, Li Aimei, Xu Shoulin, Jiang Chong
Published 2023-02-25
Cite as Chin J Nucl Med Mol Imaging, 2023, 43(2): 79-84. DOI: 10.3760/cma.j.cn321828-20210727-00251
Abstract
ObjectiveTo assess the prognostic value of pretreatment 18F-FDG PET/CT metabolic parameters in patients with metastatic malignant melanoma treated with anti-programmed cell death-1 (PD1) immunotherapy.
MethodsA retrospective analysis of 29 patients (15 males, 14 females, age (59.1±13.0) years) with pathologically diagnosed metastatic malignant melanoma in Nanjing Drum Tower Hospital between June 2017 and October 2020 was conducted. Anti-PD1 immunotherapy were performed in all patients after 18F-FDG PET/CT imaging. 18F-FDG PET/CT parameters including SUVmax, bone marrow-to-liver SUVmax ratio (BLR), spleen-to-liver SUVmax ratio (SLR) were obtained. Total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) of primary lesions were measured automatically using the thresholds of 40%SUVmax. The median value of each PET parameter was regarded as the threshold value and was used to divide patients into 2 groups (≥ and < the median value, respectively). Kaplan-Meier survival curve and Cox proportional risk model were used to analyze the overall survival (OS) differences between groups.
ResultsThe median follow-up time was 15.0 months and 13 patients died. The median OS was 26.0(95% CI: 20.4-31.6) months. The median SUVmax, TMTV, TLG, BLR and SLR were 6.2, 8.2 cm3, 38.6 g, 0.82 and 0.84 respectively. Kaplan-Meier method and log-rank test showed that differences of OS between SUVmax≥6.2 and <6.2 groups, TLG≥38.6 g and <38.6 g groups, BLR≥0.82 and <0.82 groups, SLR≥0.84 and <0.84 groups were not significant (χ2 values: 0.01-0.35, P values: 0.061-0.929), while patients with TMTV≥8.2 cm3 suffered from poorer OS compared with those with TMTV<8.2 cm3 (χ2=5.90, P=0.015). Cox multivariate analysis showed that TMTV (hazard risk (HR)=6.347, 95% CI: 1.039-38.789) was a significant predictor of OS (P=0.045).
Conclusion18F-FDG PET/CT parameter TMTV is the independent predictive factor of OS in metastatic melanoma treated with anti-PD1 immunotherapy.
Key words:
Melanoma; Neoplasm metastasis; Immunotherapy; Programmed cell death 1 receptor; Positron-emission tomography; Tomography, X-ray computed; Fluorodeoxyglucose F18
Contributor Information
Lai Ruihe
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 21008, China
Teng Yue
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 21008, China
Zhao Lianjun
The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China
Sun Yiwen
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 21008, China
Li Aimei
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 21008, China
Xu Shoulin
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 21008, China
Jiang Chong
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 21008, China
