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在非小细胞肺癌中新辅助化疗-免疫疗法:正子发射断层扫描能预测完整的病理反应吗?

Joseph Seitlinger¹, Olivier Salko², Luciano Bulgarelli Maqueda³

¹Division of Thoracic and Upper Gastrointestinal Surgery, McGill University, Montreal, Quebec, Canada; Department of Thoracic Surgery, Nancy University Hospital, Nancy, France.

The Annals of thoracic surgery

|October 30, 2025

概括

新辅助化疗和免疫疗法 (化疗-IO) 对非小细胞肺癌具有前景,PET扫描标准化吸收值减少70%,预测病理完整反应. 这项现实研究支持化疗IO的安全性和有效性.

科学领域:

胸部瘤学胸部瘤学
医疗成像医学成像
免疫治疗是一种免疫疗法.

背景情况:

新辅助化疗和免疫疗法 (化疗-IO) 对可手术的非小细胞肺癌 (NSCLC) 提供了生存益处.
关于化学-IO在NSCLC中的有效性的现实数据有限,这阻碍了临床试验可重复性评估.

研究的目的:

评估新辅助化疗-IO在II-III期NSCLC患者的实际安全性和有效性.
为了确定潜在的成像生物标志物来预测治疗反应.

主要方法:

来自加拿大两个中心的NSCLC注册和胸部手术数据库的回顾性分析.
包括78名II-III期NSCLC患者,接受至少一轮新辅助化疗-IO.
卡普兰-梅尔生存分析和ROC曲线分析用于预测基于标准化吸收值 (SUV) 减少的病理完整反应 (pCR).

主要成果:

54%的患者经历了化疗-IO (47%级1-2,14%级3) 的不良事件.
病理完整响应 (pCR) 的比率为24%.
在PET扫描上最大SUV的70%降低与pCR显著相关 (AUC=0.89,P=.01),特别是在PD-L1TPS≥50%的患者中.

结论:

新辅助化疗-IO是安全的,并在现实世界NSCLC队列中证明了短期疗效.
在PET扫描中,SUV的减少显示了在接受化疗IO的NSCLC患者中作为pCR的替代生物标志物的潜力,这需要进一步验证.

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