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Pretreatment Metabolic Parameters Measured by 18F-FDG PET to Predict the Pathological Treatment Response of HCC Patients Treated With PD-1 Inhibitors and Lenvatinib as a Conversion Therapy in BCLC Stage C.


ABSTRACT:

Objectives

This study aimed to assess the pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) as a predictor of the pathological treatment response (PTR) of hepatocellular carcinoma (HCC) patients treated with PD-1 inhibitors and lenvatinib as a conversion therapy in BCLC stage C.

Methods

All patients (n=20) underwent pretreatment 18F-FDG PET/CT and were treated with conversion therapy and surgery. Patients were categorized into responders (n=9) and non-responders (n=11) according to PTR. The parameters of PET/CT, including lesion size, SUVmean (mean standard uptake value), MTV (metabolic tumor volume), TLG (total lesion glycolysis), SUVpeak (peak standard uptake value), and TLR (tumor-to-normal liver standardized uptake value ratio), were calculated. The diagnostic efficacy was evaluated by receiver operating characteristic analysis (ROC). PTR was compared with pretreatment PET/CT parameters by using Spearman correlation analysis. The patients were followed up.

Results

There was significant difference in TLR (5.59 ± 1.90 vs. 2.84 ± 1.70, respectively; P=0.003) between responders and non-responders, with the largest area under the curve (sensitivity=100%, specificity=72.7%, AUC=0.899, 95%CI: 0.759-1.000, optimal diagnostic threshold of 3.09). The relationship between 18F-FDG PET/CT parameters and PTR indicated TLR was moderately and positively correlated with pathological treatment response, with correlation coefficients (rs) of 0.69 (P<0.01). During the follow-up, no patients died, and tumor recurrence was found in one of the responders (11.1%). In all 11 non-responders, tumor recurrence was found in six patients (54.5%) and four patients (36.4%) died.

Conclusions

TLR may be a powerful marker to predict PTR of HCC patients with BCLC stage C who were treated with conversion therapy.

SUBMITTER: Wang G 

PROVIDER: S-EPMC9204225 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Pretreatment Metabolic Parameters Measured by <sup>18</sup>F-FDG PET to Predict the Pathological Treatment Response of HCC Patients Treated With PD-1 Inhibitors and Lenvatinib as a Conversion Therapy in BCLC Stage C.

Wang Guanyun G   Zhang Wenwen W   Chen Jiaxin J   Luan Xiaohui X   Wang Zhanbo Z   Wang Yanmei Y   Xu Xiaodan X   Yao Shulin S   Guan Zhiwei Z   Tian Jiahe J   Lu Shichun S   Xu Baixuan B   Ma Guangyu G  

Frontiers in oncology 20220603


<h4>Objectives</h4>This study aimed to assess the pretreatment <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/computed tomography (<sup>18</sup>F-FDG PET/CT) as a predictor of the pathological treatment response (PTR) of hepatocellular carcinoma (HCC) patients treated with PD-1 inhibitors and lenvatinib as a conversion therapy in BCLC stage C.<h4>Methods</h4>All patients (n=20) underwent pretreatment <sup>18</sup>F-FDG PET/CT and were treated with conversion therapy and surgery.  ...[more]

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