DCE-CT parameters as new functional imaging biomarkers at baseline and during immune checkpoint inhibitor therapy in patients with lung cancer - a feasibility study

With the development of immune checkpoint inhibitors for the treatment of non-small cell lung cancer, the need for new functional imaging techniques and early response assessments has increased to account for new response patterns and the high cost of treatment. The present study was designed to ass...

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Bibliographic Details
Published in:	Cancer imaging Vol. 24; no. 1; pp. 105 - 12
Main Authors:	Andersen, Michael Brun, Drljevic-Nielsen, Aska, Ehlers, Jeanette Haar, Thorup, Kennet Sønderstgaard, Baandrup, Anders Ohlhues, Palne, Majbritt, Rasmussen, Finn
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 13-08-2024 BioMed Central BMC
Subjects:	Aged Aged, 80 and over Biological markers Cancer Carcinoma Carcinoma, Non-Small-Cell Lung - diagnostic imaging Carcinoma, Non-Small-Cell Lung - drug therapy Care and treatment Clinical oncology Contrast Media CT imaging Diagnostic imaging Feasibility Studies Female Humans Immune Checkpoint Inhibitors - therapeutic use Lung cancer, Non-small cell Lung Neoplasms - diagnostic imaging Lung Neoplasms - drug therapy Male Middle Aged Non-small-cell lung Oncology, Experimental Permeability Prognosis Prospective Studies Spiral computed Thorax Tomography Tomography, X-Ray Computed - methods Carcinoma Spiral computed Immunotherapy Clinical oncology Tomography Thorax Non-small-cell lung
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Summary:	With the development of immune checkpoint inhibitors for the treatment of non-small cell lung cancer, the need for new functional imaging techniques and early response assessments has increased to account for new response patterns and the high cost of treatment. The present study was designed to assess the prognostic impact of dynamic contrast-enhanced computed tomography (DCE-CT) on survival outcomes in non-small cell lung cancer patients treated with immune checkpoint inhibitors. Thirty-three patients with inoperable non-small-cell lung cancer treated with immune checkpoint inhibitors were prospectively enrolled for DCE-CT as part of their follow-up. A single target lesion at baseline and subsequent follow-up examinations were enclosed in the DCE-CT. Blood volume deconvolution (BV ), blood flow deconvolution (BF ), blood flow maximum slope (BF ) and permeability were assessed using overall survival (OS) and progression-free survival (PFS) as endpoints in Kaplan Meier and Cox regression analyses. High baseline Blood Volume (BV ) (> 12.97 ml × 100 g ) was associated with a favorable OS (26.7 vs 7.9 months; p = 0.050) and PFS (14.6 vs 2.5 months; p = 0.050). At early follow-up on day seven a higher relative increase in BF (> 24.50% for OS and > 12.04% for PFS) was associated with an unfavorable OS (8.7 months vs 23.1 months; p < 0.025) and PFS (2.5 vs 13.7 months; p < 0.018). The relative change in BF (categorical) on day seven was a predictor of OS (HR 0.26, CI95: 0.06 to 0.93 p = 0.039) and PFS (HR 0.27, CI95: 0.09 to 0.85 p = 0.026). DCE-CT-identified parameters may serve as potential prognostic biomarkers at baseline and during early treatment in patients with NSCLC treated with immune checkpoint inhibitor therapy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1470-7330 1740-5025 1470-7330
DOI:	10.1186/s40644-024-00745-0