Correlation of metabolic information on FDG-PET with tissue expression of immune markers in patients with non-small cell lung cancer (NSCLC) who are candidates for upfront surgery

Abstract

The present study shows a direct association between metabolic parameters on FDG-PET and the expression of tumor-related immunity markers, suggesting a potential role for FDG-PET to characterize the tumor microenvironment and select NSCLC patients candidate to checkpoint inhibitors.

Evaluating response to immunotherapy with 18F-FDG PET/CT: where do we stand?

“…Of note, although tumor SUV max was not found as a significant predictor of survival by Seban et al [1], it resulted correlated to the PD-L1 expression status. This finding is in line with what previously suggested by other groups [6,7], the hypothesis being that increased glycolytic activity can be linked to an enhanced immune infiltrate in the stromal compartment. Paradoxically, NSCLC patients presenting with a higher baseline SUV max could have a higher chance of response in case of treatment with ICI.…”

“…Paradoxically, NSCLC patients presenting with a higher baseline SUV max could have a higher chance of response in case of treatment with ICI. This initially theory [6] has indeed anticipated the results published only recently by Takada et al [8] in 89 patients with advanced or recurrent NSCLC reporting a significantly higher response rate in patients with a baseline SUV max ≥ 11.16 (41.3%) compared to patients with lower SUVmax values (11.6%).…”

Metabolic characteristics of programmed cell death‐ligand 1‐expressing lung cancer on 18F‐fluorodeoxyglucose positron emission tomography/computed tomography

“…Moreover, the correlation between glucose metabolism and EGFR mutations/ ALK rearrangements was also reported . Recently, a correlation between metabolic information of FDG‐PET and tissue expression of immune markers in patients with NSCLC who are candidates for upfront surgery was reported . In that paper, they found a statistically significant correlation between SUVmax and SUVmean with the expression of CD8‐tumor infiltrating lymphocytes (TILs) and PD‐1‐TILs, but no correlation between SUVmax and SUVmean with PD‐L1 tumor expression.…”

FDG PET/CT for assessing tumour response to immunotherapy

“…Indeed, in patients with NSCLC, there is a statistically significant association between tumour metabolic parameters on PET and PD1/PD-L1 expression, along with the presence of CD8+ tumour infiltrating lymphocytes (TILs), in resected tumour specimens [31, 32]. The presence of immune infiltrate is already known as a good predictor of response to immunotherapy.…”