Correlation between inflammatory markers and quantitative imaging biomrakers in pretreatment 18F-FDg PET/CT in NSCLC patients treated with first-line immune checkpoint inhibitors

Background: Reliable predictive and prognostic markers are still lacking for patients treated with PD-1/PD-L1 for NSCLC. We investigated the potential of 18F-FDG PET/CT scans in NSCLC patients treated with first-line anti PD1/PDL1 alone or with platinum-based chemotherapy.

Methods: We retrospectively analysed 116 patients treated at our Institute between October 2018 to December 2023, who underwent ¹⁸F-FDG PET/CT for staging. Baseline standardized uptake value of primary tumour (SUV) and metabolic tumor volume (MTV), as well as clinical and biological parameters were analysed. Associations between these parameters and OS and PFS were evaluated.

Results: We found a moderate significant correlation between baseline serum CRP levels and SUV with a rho of 0.42 (p=0.0002). Patients with a SUV ratio above the median of 3.33 had a higher proportion of partial response compared to patients with a ratio below the median (83.8% vs. 58.3%, p=0.02). Additionally, the proportion of patients with progressive disease as best response was significantly lower in patients with a ratio above compared to below the median (5.4% vs. 33.3%, p=0.01). Multivariate analysis revealed that sex (p=0,01), adrenal metastases (p=0,03), bone metastases (p=0,04), lung metastases (p=0,03) and TTF1 status (p=0,02) were significant predictors of OS. Lung metastases(p=0,02), and TTF1 status (p=0,02) were significant predictors for PFS. SUV and MTV were not significant predictors of PFS and OS

Conclusion: The present study showed that SUV of FDG PET/CT scans of the tumor impacted the responses to anti PD1/PDL1 and baseline CRP levels correlate significantly with SUV.

Publication History

Article published online:
18 March 2025